Assessment of the Prevalence and Trajectory of Depressive Symptoms by Sexual Orientation During Physician Training

Patel, Tejal; Cleary, Johanna; Zhuo, Zhao; Ross, Katherine E T; Sen, Srijan; Frank, Elena

doi:10.1001/jamahealthforum.2022.0812

Cited by 2 publications

(2 citation statements)

References 6 publications

(19 reference statements)

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“…Emerging evidence indicates that sexual minority (ie, bisexual or homosexual) individuals in medical training experience higher levels of depression than their heterosexual counterparts . Previous studies involving IHS participants reported that sexual minority individuals enter residency with higher PHQ-9 scores than their heterosexual peers and experience a more pronounced increase in depressive symptoms throughout their internship . As inclusivity in our profession increases, there is an ongoing need to support this diverse workforce appropriately.…”

Section: Discussionmentioning

confidence: 99%

“… 25 Previous studies involving IHS participants reported that sexual minority individuals enter residency with higher PHQ-9 scores than their heterosexual peers and experience a more pronounced increase in depressive symptoms throughout their internship. 26 As inclusivity in our profession increases, there is an ongoing need to support this diverse workforce appropriately.…”

Section: Discussionmentioning

confidence: 99%

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Duration of New-Onset Depressive Symptoms During Medical Residency

Kim,

Sinco,

Zhao

et al. 2024

JAMA Netw Open

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ImportanceThe implications of new-onset depressive symptoms during residency, particularly for first-year physicians (ie, interns), on the long-term mental health of physicians are unknown.ObjectiveTo examine the association between and persistence of new-onset and long-term depressive symptoms among interns.Design, Setting, and ParticipantsThe ongoing Intern Health Study (IHS) is a prospective annual cohort study that assesses the mental health of incoming US-based resident physicians. The IHS began in 2007, and a total of 105 residency programs have been represented in this national study. Interns enrolled sequentially in annual cohorts and completed follow-up surveys to screen for depression using the 9-item Patient Health Questionnaire-9 (PHQ-9) throughout and after medical training. The data were analyzed from May 2023 to March 2024.ExposureA positive screening result for depression, defined as an elevated PHQ-9 score of 10 or greater (indicating moderate to severe depression) at 1 or more time points during the first postgraduate year of medical training (ie, the intern year).Main Outcomes and MeasuresThe main outcomes assessed were mean PHQ-9 scores (continuous) and proportions of physicians with an elevated PHQ-9 score (≥10; categorical or binary) at the time of the annual follow-up survey. To account for repeated measures over time, a linear mixed model was used to analyze mean PHQ-9 scores and a generalized estimating equation (GEE) was used to analyze the binary indicator for a PHQ-9 score of 10 or greater.ResultsThis study included 858 physicians with a PHQ-9 score of less than 10 before the start of their internship. Their mean (SD) age was 27.4 (9.0) years, and more than half (53.0% [95% CI, 48.5%-57.5%]) were women. Over the follow-up period, mean PHQ-9 scores did not return to the baseline level assessed before the start of the internship in either group (those with a positive depression screen as interns and those without). Among interns who screened positive for depression (PHQ-9 score ≥10) during their internship, mean PHQ-9 scores were significantly higher at both 5 years (4.7 [95% CI, 4.4-5.0] vs 2.8 [95% CI, 2.5-3.0]; P &lt; .001) and 10 years (5.1 [95% CI, 4.5-5.7] vs 3.5 [95% CI, 3.0-4.0]; P &lt; .001) of follow-up. Furthermore, interns with an elevated PHQ-9 score (≥10) demonstrated a higher likelihood of meeting this threshold during each year of follow-up.Conclusions and RelevanceIn this cohort study of IHS participants, a positive depression screening result during the intern year had long-term implications for physicians, including having persistently higher mean PHQ-9 scores and a higher likelihood of meeting this threshold again. These findings underscore the pressing need to address the mental health of physicians who experience depressive symptoms during their training and to emphasize the importance of interventions to sustain the health of physicians throughout their careers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Duration of New-Onset Depressive Symptoms During Medical Residency

Kim,

Sinco,

Zhao

et al. 2024

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

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Use of an Opt-Out vs Opt-In Strategy Increases Use of Residency Mental Health Services

Guldner,

Siegel,

Broadbent

et al. 2024

Journal of Graduate Medical Education

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Background Residents report high levels of distress but low utilization of mental health services. Prior research has shown several barriers that prevent residents from opting into available mental health services. Objective To determine the impact of a mental health initiative centered around an opt-out versus an opt-in approach to help-seeking, on the use of psychotherapy. Methods Resident use of psychotherapy was compared between 2 time frames. During the first time frame (July 1, 2020 to January 31, 2021), residents were offered access to therapy that they could self-initiate by calling to schedule an appointment (opt-in). The second time frame (February 1, 2021 to April 30, 2021) involved the switch to an opt-out structure, during which the same residents were scheduled for a session but could choose to cancel. Additional changes were implemented to reduce stigma and minimize barriers. The outcome was psychotherapy use by residents. Results Of the 114 residents, 7 (6%) self-initiated therapy during the opt-in period. When these same residents were placed in an opt-out context, 59 of the remaining 107 residents (55%) kept their initial appointment, and 23 (39%) self-initiated additional sessions. Altogether, across both phases, a total of 30 of the 114 residents initiated therapy (ie, 7 during the opt-in and 23 during the opt-out). The differences in therapy use between the 2 phases are statistically significant (P<.001 by McNemar’s test). Conclusions There was a substantial increase in residents’ use of psychotherapy after the opt-out initiative that included efforts to reduce stigma and encourage mental health services.

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Assessment of the Prevalence and Trajectory of Depressive Symptoms by Sexual Orientation During Physician Training

Abstract: This cohort study uses survey data to assess the prevalence and development of depressive symptoms among sexual minority and heterosexual physicians during residency training.

Cited by 2 publications

References 6 publications

Duration of New-Onset Depressive Symptoms During Medical Residency

Duration of New-Onset Depressive Symptoms During Medical Residency

Use of an Opt-Out vs Opt-In Strategy Increases Use of Residency Mental Health Services

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