Depressive symptoms during internship drop, but depression still high
Depression during physician training remains high, but the average increase in depressive symptoms associated with internship has declined from 2007 to 2019, results of a study have shown.
First-year resident physicians (interns) who started training between 2007 and 2019 were assessed in this repeated annual cohort study conducted at US healthcare organizations. The authors evaluated depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9) at baseline and quarterly throughout internship.
Baseline depressive symptoms rose from 2007 to 2019 (PHQ-9 score, 2.3 to 2.9; difference, 0.6, 95 percent confidence interval [CI], 0.3–0.8) among 16,965 interns. The prevalence of baseline predictors of greater increase in depressive symptoms with internship also increased across cohorts.
However, the average change in depressive symptoms with internship dropped by 24.4 percent from 2007 to 2019 (change in PHQ-9 score, 4.1 to 3.0; difference, –1.0, 95 percent CI, –1.5 to –0.6) despite the higher prevalence of baseline risk factors.
Such change was higher among women (4.7 to 3.3; difference, –1.4, 95 percent CI, –1.9 to –0.9) than men (3.5 to 2.9; difference, –0.6, 95 percent CI, –1.2 to –0.05) and among nonsurgical interns (4.1 to 3.0; difference, –1.1, 95 percent CI, –1.6 to –0.6) than surgical interns (4.0 to 3.2; difference, –0.8, 95 percent CI, –1.2 to –0.4).
“In parallel to the decrease in depressive symptom change, there were increases in sleep hours, quality of faculty feedback, and use of mental health services and a decrease in work hours across cohorts,” the authors said.
“The decrease in work hours was greater for nonsurgical than surgical interns. Further, the increase in mental health treatment across cohorts was greater for women than men,” they added.The study was limited by observational data, which are subject to biases due to nonrandom sampling, missing data, and unmeasured confounders that limit causal conclusions.