A Positive Depression Screen Is Associated with Emergency Medicine Resident Burnout and Is not Affected by the Implementation of a Wellness Curriculum

Williamson, Kelly; Lank, Patrick M.; Olson, Adriana Segura; Cheema, Navneet; Lovell, Elise

doi:10.5811/westjem.2021.9.52016

Cited by 3 publications

(7 citation statements)

References 29 publications

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“…Our rates of positive screens for depression/anxiety among emergency HCWs were within the range of that shown in previous studies during this period (anxiety [13%–44%], 6 , 9 , 10 , 12 , 21 depression [20%–50%], 5 , 6 burnout [30%–49%]). 6 , 10 , 22 , 23 Although limited and mainly measured in smaller populations, prepandemic studies have demonstrated high overall rates of burnout 24 and depression 25 among EPs, particularly among residents. Nurses also have high baseline rates of depression and burnout especially when hospital based.…”

Section: Discussionmentioning

confidence: 99%

The perceived work environment and well‐being: A survey of emergency health care workers during the COVID‐19 pandemic

Blanchard

Bentley

et al. 2022

Academic Emergency Medicine

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Background During the COVID‐19 pandemic, health care provider well‐being was affected by various challenges in the work environment. The purpose of this study was to evaluate the relationship between the perceived work environment and mental well‐being of a sample of emergency physicians (EPs), emergency medicine (EM) nurses, and emergency medical services (EMS) providers during the pandemic. Methods We surveyed attending EPs, resident EPs, EM nurses, and EMS providers from 10 academic sites across the United States. We used latent class analysis (LCA) to estimate the effect of the perceived work environment on screening positive for depression/anxiety and burnout controlling for respondent characteristics. We tested possible predictors in the multivariate regression models and included the predictors that were significant in the final model. Results Our final sample included 701 emergency health care workers. Almost 23% of respondents screened positive for depression/anxiety and 39.7% for burnout. Nurses were significantly more likely to screen positive for depression/anxiety (adjusted odds ratio [aOR] 2.04, 95% confidence interval [CI] 1.11–3.86) and burnout (aOR 2.05, 95% CI 1.22–3.49) compared to attendings. The LCA analysis identified four subgroups of our respondents that differed in their responses to the work environment questions. These groups were identified as Work Environment Risk Group 1, an overall good work environment; Risk Group 2, inadequate resources; Risk Group 3, lack of perceived organizational support; and Risk Group 4, an overall poor work environment. Participants in the two groups who perceived their work conditions as most adverse were significantly more likely to screen positive for depression/anxiety (aOR 1.89, 95% CI 1.05–3.42; and aOR 2.04, 95% CI 1.14–3.66) compared to participants working in environments perceived as less adverse. Conclusions We found a strong association between a perceived adverse working environment and poor mental health, particularly when organizational support was deemed inadequate. Targeted strategies to promote better perceptions of the workplace are needed.

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Section: Discussionmentioning

confidence: 99%

The perceived work environment and well‐being: A survey of emergency health care workers during the COVID‐19 pandemic

Blanchard

Bentley

et al. 2022

Academic Emergency Medicine

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“…At Months 3, 6, 9, and 12 of intern year, the prevalence of depression was 17.8%, 20.5%, 20.8%, and 18.8% respectively. Williamson et al 5 analyzed data from 382…”

Section: Discussionmentioning

confidence: 99%

“…At Months 3, 6, 9, and 12 of intern year, the prevalence of depression was 17.8%, 20.5%, 20.8%, and 18.8% respectively. Williamson et al 5 . analyzed data from 382 EM residents of all postgraduate years and found rates of positive depression screen ranging from 27.9% to 40% at various points of the year.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review and meta‐analysis revealed that 29% of residents experienced a major depressive episode during residency versus 8% of the general population 2 . Depression in residents is associated with motor vehicle accidents, 3 medical errors, 4 lower adherence to safety and practice standards, and burnout symptoms 4,5 …”

Section: Introductionmentioning

confidence: 99%

“…2 Depression in residents is associated with motor vehicle accidents, 3 medical errors, 4 lower adherence to safety and practice standards, and burnout symptoms. 4,5 Previous studies have identified program-level risk factors for resident depression such as long work hours 6 and frequent night shifts 7 as well as individual-level factors including high neuroticism, 8 perceived medical errors, 9 stressful life events, 10 low subjective well-being, 11 and identifying as female. 12 In fact, half of female physicians may experience a psychiatric illness, most likely depression, during their lifetime.…”

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confidence: 99%

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Depression and associated risk factors among emergency medicine interns: Results from a national longitudinal cohort study

Folk,

Brown,

Bissell

et al. 2024

AEM Education and Training

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ObjectiveDespite depression being common in residents, there are no published studies on the prevalence and risk factors for depression in emergency medicine (EM) interns. Our objectives were to explore the prevalence of depression among EM interns and to identify risk factors for depression including sleep, work hours, rotation type, race, ethnicity, sex, and age.MethodsThe Intern Health Study is a national longitudinal cohort study on intern mental health in all specialties. Secondary analysis was performed for EM interns only in this study. Data were collected from 2007 to 2021 and study participants completed a pre–intern year baseline survey and quarterly surveys throughout intern year, which included demographics and information on depressive symptoms, work hours, sleep, and rotation specifics. Depression severity was objectified using the Patient Health Questionnaire (PHQ9) with scores of 10 and higher meeting criteria for moderate to severe depression.ResultsA total of 1123 EM interns completed all surveys. The prevalence of moderate to severe depression among EM interns before starting internship was 4.8%. At Months 3, 6, 9, and 12 of intern year, the prevalence of moderate to severe depression was 17.8%, 20.5%, 20.8%, and 18.8%, respectively. PHQ9 scores were significantly higher at Month 3 of intern year compared to pre–intern year, but there were no differences at subsequent time points during intern year (p < 0.001). Females were more likely to have PHQ9 scores of 10 or above at all time points (p < 0.001). Clinical rotation type had a significant effect on PHQ9 scores, with intensive care unit rotations having a significantly higher PHQ9 score than other rotations (p < 0.001). Pearson's correlation revealed significant weak positive correlations between work hours and PHQ9 at each time point (r = 0.195, 0.200, 0.202, 0.243) and significant weak negative correlations between sleep hours and time off with PHQ9 (−0.162, −0.223, −0.180, −0.178; all p < 0.001).ConclusionsMany EM interns experience moderate to severe depression. Female EM interns are more likely to be depressed than male interns. Numerous factors influence depression scores for interns, many of which are modifiable.

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Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey

Yun,

Myung,

Kim

2023

Sci Rep

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Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September–October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.

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A Positive Depression Screen Is Associated with Emergency Medicine Resident Burnout and Is not Affected by the Implementation of a Wellness Curriculum

Cited by 3 publications

References 29 publications

The perceived work environment and well‐being: A survey of emergency health care workers during the COVID‐19 pandemic

The perceived work environment and well‐being: A survey of emergency health care workers during the COVID‐19 pandemic

Depression and associated risk factors among emergency medicine interns: Results from a national longitudinal cohort study

Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey

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