Depression and suicidality among psychiatric residents - results from a multi-country study

Nikolina Jovanović; Julian Beezhold; Masaru Tateno; Elizabeth Barrett; Ilias Vlachos; Andrea Fiorillo; Cecile Hanon; Olga Kazakova; Alexander Nawka; Philippe Wuyts; Vanessa Wong; Szilvia Papp; Jasna Rujević; Goran Racetovic; Adriana Mihai; João Gama Marques; Amit Malik; Ulrike Weiss; Teelia Rolko; Marija Rusaka; Nanna Platz Clausen; Elena Shmunk; Anja Podlesek

doi:10.1016/j.jad.2019.02.023

Depression and suicidality among psychiatric residents - results from a multi-country study

J Affect Disord. 2019 Apr 15:249:192-198. doi: 10.1016/j.jad.2019.02.023. Epub 2019 Feb 7.

Authors

Nikolina Jovanović¹, Julian Beezhold², Masaru Tateno³, Elizabeth Barrett⁴, Ilias Vlachos⁵, Andrea Fiorillo⁶, Cecile Hanon⁷, Olga Kazakova⁸, Alexander Nawka⁹, Philippe Wuyts¹⁰, Vanessa Wong¹¹, Szilvia Papp¹², Jasna Rujević¹³, Goran Racetovic¹⁴, Adriana Mihai¹⁵, João Gama Marques¹⁶, Amit Malik¹⁷, Ulrike Weiss¹⁸, Teelia Rolko¹⁹, Marija Rusaka²⁰, Nanna Platz Clausen²¹, Elena Shmunk²², Anja Podlesek²³

Affiliations

¹ Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Blizard Institute, Queen Mary University of London, NCfMH, Glen Road, London E13 8SP, UK. Electronic address: n.jovanovic@qmul.ac.uk.
² Hellesdon Hospital and Norwich Medical School, University of East Anglia, Norwich, UK.
³ Tokiwa Child Development Center, Tokiwa Hospital and Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, Japan.
⁴ Children's University Hospital, Temple St., Dublin and School of Medicine and Medical Sciences, University College Dublin, Ireland.
⁵ 1st Psychiatric Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
⁶ Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy.
⁷ Regional Ressource Center of Old Age Psychiatry, Corentin-Celton Hospital, Issy-les-Moulineaux and Academic Hospital of West Paris, APHP Descartes University Paris 5, France.
⁸ Psychiatric Clinic of Minsk City, Minsk, Belarus.
⁹ Institute of Neuropsychiatric Care (INEP), Prague and Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, Czech Republic.
¹⁰ Private Practice, 140 Avenue Victor Hugo, 75116 Paris, France.
¹¹ Private practice, 122A New Henry House, 10 Ice House Street, Central, Hong Kong.
¹² Department of Psychiatry and Psychoterapy, Semmelweis University, Budapest, Hungary.
¹³ Department of child psychiatry, University Children's Hospital, Bohoričeva 20, 1525 Ljubljana, Slovenia.
¹⁴ PHI Health Center Prijedor, Community Mental Health Center, Kralja Aleksandra 23, 79000 Prijedor, Bosnia and Herzegovina.
¹⁵ Department of Psychiatry, University of Medicine and Pharmacy of Tîrgu Mureş, Tîrgu Mureş, Romania.
¹⁶ Hospital Júlio de Matos do Centro Hospitalar Psiquiátrico de Lisboa e Clínica Universitária de Psiquiatria e Psicologia Médica da Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
¹⁷ InnerHour, Mumbai, India.
¹⁸ Heiligenfeld Klinik Waldmünchen, Krankenhausstrasse 3, 93449 Waldmünchen, Germany.
¹⁹ Psychiatric Clinic, Tartu University Hospital, Tartu, Estonia.
²⁰ Riga Stradins University, Riga, Latvia.
²¹ Department for Affective Disorders, Aarhus University Hospital, Denmark.
²² Siberian State Medical University, Moskovsky tract 2, Tomsk 634050, Russia.
²³ Department of Psychology, University of Ljubljana, Aškerčeva 2, SI-1000 Ljubljana, Slovenia.

PMID: 30772747
DOI: 10.1016/j.jad.2019.02.023

Abstract

Background: Previous studies have highlighted risks for depression and suicide in medical cohorts, but evidence regarding psychiatric residents is missing. This study aimed to determine rates of depression, suicide ideation and suicide attempt among psychiatric residents and to identify associated individual, educational and work-related risk factors.

Methods: A total of 1980 residents from 22 countries completed the online survey which collected data on depression (PHQ-9), suicidality (SIBQ), socio-demographic profiles, training, and education. Generalized linear modeling and logistic regression analysis were used to predict depression and suicide ideation, respectively.

Results: The vast majority of residents did not report depression, suicide ideation or attempting suicide during psychiatric training. Approximately 15% (n = 280) of residents met criteria for depression, 12.3% (n = 225) reported active suicide ideation, and 0.7% (n = 12) attempted suicide during the training. Long working hours and no clinical supervision were associated with depression, while more completed years of training and lack of other postgraduate education (e.g. PhD or psychotherapy training) were associated with increased risk for suicide ideation during psychiatric training. Being single and female was associated with worse mental health during training.

Limitations: Due to the cross-sectional nature of the study, results should be confirmed by longitudinal studies. Response rate was variable but the outcome variables did not statistically significantly differ between countries with response rates of more or less than 50%.

Conclusion: Depression rates among psychiatric residents in this study were lower than previously reported data, while suicide ideation rates were similar to previous reports. Poor working and training conditions were associated with worse outcomes. Training programmes should include effective help for residents experiencing mental health problems so that they could progress through their career to the benefit of their patients and wider society.

Keywords: Depression; Psychiatry; Residents; Suicide attempt; Suicide ideation; Trainees.

MeSH terms

Adult
Cross-Sectional Studies
Depression / epidemiology
Depression / psychology*
Female
Humans
Male
Mental Disorders / epidemiology
Mental Disorders / psychology*
Mental Health / statistics & numerical data*
Mental Health Services / organization & administration
Middle Aged
Risk Factors
Suicidal Ideation
Suicide / psychology*
Suicide, Attempted / psychology