BackgroundMultiple studies have reported high burnout rates among residents, including psychiatry. There is a paucity of studies examining the relationship between burnout and learning context, stress levels, resilience, stigma in healthcare providers and coping methods concurrently within the same cohort.ObjectiveWe examined the rate of burnout among our psychiatry residents in a cross-sectional study and hypothesised that burnout is associated with poorer perception of learning environment, greater perceived stress, stigma levels, lower resilience and specific coping strategies during training.MethodsNinety-three out of 104 psychiatry residents (89.4%) within our National Psychiatry Residency Programme participated in the study from June 2016 to June 2018. Relevant scales were administered to assess the perception of learning environment, burnout, stress, resilience, stigma levels and coping methods, respectively. We performed comparisons of the above measures between groups (burnout vs no burnout) and within-group correlations for these same measures.ResultsOverall, 54.8% of the sample met criteria for burnout. Residents with burnout had poorer perception of the learning environment, greater stress levels (both p<0.001), were less willing to disclose/seek help and employed greater active-avoidance coping strategies. Within the burnout group, greater perceived stress was correlated with poorer perception of learning environment (rs=−0.549) and greater use of active-avoidance coping (rs=0.450) versus additional use of problem-focussed coping within the non-burnout group.ConclusionsBurnout was related to both environment and learner factors. These findings viewed within the transactional, sequential and imbalance models of burnout suggest the need to address stressors, beef up coping, provide continual support and develop resilience among our learners.

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Background: The use of benzodiazepines and z-drugs in clinical practice is a double-edged sword. There is a paucity of literature studying the prescribing trends of benzodiazepines and z-drugs in Singapore. Objective: The objective of this study is evaluate the outpatient prescribing trends of oral benzodiazepines and z-drugs in a general hospital in Singapore over a 9 years period, from 2005 to 2013. Methods: Data was obtained from the electronic records of all outpatient benzodiazepine and z-drug prescriptions over the study period. The parameters studied were daily dose (in mg/day), duration (in days) and total dose (in mg) of the drug of interest in each prescription. Stratification of these parameters by age groups and gender of patients was performed. A multivariate linear regression model was used to analyze the prescribing patterns across time while adjusted for confounders. Results: There was a significant drop in the number of benzodiazepine and z-drug prescriptions between 2011 and 2013. The specified parameters of Alprazolam, Diazepam and Lorazepam prescriptions showed steep drops between 2011 and 2013, while those of Midazolam increased considerably over the same period. Full Linear regression analysis for mean total dose showed negative coefficients for Alprazolam, Diazepam, Lorazepam, Zopiclone and Zolpidem prescriptions and a positive coefficient for Midazolam prescriptions. Conclusion: There is preliminary evidence for an overall drop in the prescribing trend of benzodiazepines and z-drugs; this study is a stepping-stone for much needed future research in this area.