Physicians who screen positive for depressive symptoms as interns are more likely to screen positive up to 10 years later than their peers who did not, a study in JAMA Network Open has found.
“This research suggests that there may be lasting consequences of depressive symptoms well beyond the years spent in medical training, emphasizing the need to support training doctors to safeguard the long-term health of those entrusted to ensure the health of others,” wrote Erin Kim, B.S., of the University of Michigan Medical School and colleagues.
The researchers examined data from physicians who participated in the Intern Health Study, an annual study begun in 2007 that assesses the mental health of incoming U.S.-based resident physicians. Enrolled participants had baseline assessments of depressive symptoms before starting residency and were followed up quarterly during their first year of training (their intern year). Participants were then invited to continue in the study and undergo annual assessments. The researchers used the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and defined an elevated score as a score of 10 or higher, which suggests moderate to severe depression.
The final analysis included 2,867 follow-up assessments among 858 participants with complete PHQ-9 data and no elevated symptoms at baseline. Participants were followed for up to 10 years, and the mean follow-up was five years.
Overall, 35.2% of participants had elevated PHQ-9 scores on at least one quarterly survey during their intern year. A greater proportion of participants in this group had elevated scores at their annual follow-ups than those who did not have elevated scores as interns, as follows:
- 21.9% vs 6.6% at year 1
- 8.8% vs 2.4% at year 5
- 8.9% vs 3.7% at year 8
In addition, at the 10-year follow-up, participants who screened positive for depressive symptoms as interns had a higher prevalence of screening positive than the general adult population, 12.6% vs 7.7%. Across the 10-year study period, the participants who had elevated PHQ-9 scores as interns also had higher mean scores than those who did not have elevated scores as interns.
“Our research also highlights the need to better support mental health among physicians as they progress through training and to destigmatize mental health care within our professional culture,” The researchers wrote. “Universal well-being needs assessments for counseling services, opt-out counseling programs, and autoenrollment of interns in mental health resources to decrease barriers to access and overcome stigma should be further considered as potential solutions.”
For related information, see the Psychiatric News article “Positive Psychology: Not a ‘Just Be Happy’ Approach to Physician Wellness in 2020.”
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