Specific life events, genetics and internship situations are associated with an increase in depression for new doctors during the medical internship phase, according to a new study published in the Archives of General Psychiatry.
A total of 740 interns in residency programs at 13 hospitals nationwide during the 2007-08 and 2008-09 academic years took part in the study, which assessed depression based, in part, on scores from a nine-item Patient Health Questionnaire (PHQ-9). The study found that the percentage clinicians who met the criteria for depression rose from 3.9 percent at the start of the internship to nearly 26 percent during the internship.
"When myself and co-investigator Constance Guille were interns four years ago, we noticed that people who were well adjusted and happy a few months before were having trouble sleeping and problems with their relationships and just struggling to adjust," Srijan Sen, MD, the study's lead author from the University of Michigan, Ann Arbor, told Medscape Psychiatry. "So it struck us that these problems were very common during internship."
The study's authors found that close to 42 percent of clinicians participating met the criteria for depression during at least one of the three-month assessment intervals. The number of participants who were considered "severely depressed" shifted from 0 percent at the internship's start to 2.3 percent after three months, 1.6 percent after six months, 1.8 percent after nine months and 0.8 percent after one year.
"Most subjects who met criteria for depression were classified as moderately depressed, with few subjects meeting PHQ-9 criteria for moderately severe or severe depression," the study's authors wrote. "Because the development of major depression has been linked to a higher risk of future depressive episodes and greater long-term morbidity risk, future studies should examine how the rate of depression changes as training physicians progress through their careers."
Medical specialty and age were not found to be factors in the development of depression, the study's authors noted.