Prevalence and relationship between burnout and depression in our future doctors: a cross-sectional study in a cohort of preclinical and clinical medical students in Ireland
Prevalence and relationship between burnout and depression in our future doctors: a cross-sectional study in a cohort of preclinical and clinical medical students in Ireland
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DOI：
10.1136/bmjopen-2018-023297
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
McGarvey, Alice
中科院分区：
文献类型：
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作者：
Fitzpatrick, Orla;Biesma, Regien;McGarvey, Alice
目的 这项横断面研究旨在衡量医学生群体的倦怠及其对抑郁风险的影响，比较临床前和临床年份。 设计 我们使用贝克抑郁量表快速筛查 (BDI-FS)、Maslach 倦怠量表学生调查和评估使用心理健康服务意愿的项目，对爱尔兰皇家外科医学院的 269 名临床前和临床年份的医学院学生进行了调查。倦怠评分根据抑郁症的概率进行校准，并分为抑郁症的低风险（< 25%）、中度风险（25%-50%）和高风险（> 50%）。结果根据 BDI-FS 得分 >= 6，抑郁症患病率为 39%（95% CI 33% 至 45%）。临床和临床前年份之间的患病率没有显着差异。不同年份的倦怠率差异显着 (p=0.032)，临床年份中高倦怠类别的比例为 35%，而临床前年份为 26%。低倦怠类别的人抑郁症状总体患病率为 13%，中度倦怠类别的人抑郁症状患病率为 38%，高倦怠类别的人抑郁症状总体患病率为 66%。情绪疲惫的增加（OR 分数增加三分之二为 2.0，p=0.011）和学业效能的下降（OR 2.1，p=0.007）增加了不愿意寻求心理健康问题帮助的可能性（11%）。结论 虽然之前的研究报告了显着水平的倦怠和抑郁，但我们校准倦怠与抑郁的方法允许根据倦怠得分对心理健康的影响来解释倦怠得分。与之前的研究一致，这种高患病率表明迫切需要重新思考卫生专业教育的心理压力。
Objectives This cross-sectional study was designed to measure burnout and its impact on risk of depression in a medical student population, comparing the preclinical and clinical years.Design We conducted a survey of 269 medical school students in both preclinical and clinical years at the Royal College of Surgeons in Ireland, using the Beck Depression Inventory-Fast Screen (BDI-FS), the Maslach Burnout Inventory-Student Survey and items assessing willingness to use mental health services. Burnout scores were calibrated to probability of depression caseness and classified as low risk (< 25%), intermediate (25%-50%) and high risk (> 50%) of depression.Results There was a 39% (95% CI 33% to 45%) prevalence of depressive caseness based on a score of >= 6 on the BDI-FS. Prevalence did not vary significantly between clinical and preclinical years. The rate of burnout varied significantly between years (p=0.032), with 35% in the high-burnout category in clinical years compared with 26% in preclinical years. Those in the low burnout category had a 13% overall prevalence of depressive symptoms, those in the intermediate category had a 38% prevalence and those in the high category had a 66% prevalence of depressive symptoms. Increasing emotional exhaustion (OR for one-tertile increase in score 2.0, p=0.011) and decreasing academic efficacy (OR 2.1, p=0.007) increased the odds of being unwilling to seek help for mental health problems (11%).Conclusion While previous studies have reported significant levels of burnout and depression, our method of calibrating burnout against depression allows burnout scores to be interpreted in terms of their impact on mental health. The high prevalences, in line with previous research, point to an urgent need to rethink the psychological pressures of health professions education.