Evaluation of mental health and occupational stress in Mexican medical residents
##plugins.themes.bootstrap3.article.main##
Abstract
Objetive. To compare the frequency of psychopathology in residents according to sociodemographic and clinical characteristics.
Method. We conducted a cross-sectional study evaluating the presence of psychopathology, as well as sociodemographic and clinical characteristics in 644 residents through online questionnaires.
Results. Among participants, 55.7% reported a psychiatric disorder at some point and 29.2% a current one; only 41.5% were under treatment. Additionally, 8.1% had attempted suicide, of which 32.4% attempted it during residency. We found that 6.5% of women and 3.3% of men presented “risk of psychopathology,” with a higher percentage of men presenting “severe psychopathology.” Individuals with “risk of psychopathology” presented significantly higher scores on all of the questionnaires, compared to those with “absence of psychopathology.”
Discussion and conclusion. Residents with occupational stress also presented higher risks of psychopathology, suicide, and substance use. Being under psychiatric treatment significantly improved the scores on the different scales. Because residency is a period that may increase the probability of suffering psychopathology, interventions should be aimed at reducing occupational stress and bringing specialized care.
Downloads
References
Adams, E. F., Lee, A. J., Pritchard, C. W., & White, R. J. (2010). What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession. International Journal of Social Psychiatry, 56(4), 359-370. doi: 10.1177/0020764008099123
Afifi M. (2007). Gender differences in mental health. Singapore Medical Journal, 48(5), 385-391.
Australian Medical Association. (2011). Health and wellbeing of doctors and medical students - 2011. Canberra: AMA. Retrieved from https://ama.com.au/position-statement/health-and-wellbeing-doctors-and-medical-students-2011
A’Brook, M. F., Hailstone, J. D., & McLauchlan, I. E. (1967). Psychiatric illness in the medical profession. The British Journal of Psychiatry, 113(502), 1013-1023. doi: 10.1192/bjp.113.502.1013
Becker, J. L., Milad, M. P., & Klock, S. C. (2006). Burnout, depression, and career satisfaction: Cross-sectional study of obstetrics and gynecology residents. American Journal of Obstetrics and Gynecology, 195(5), 1444-1449. doi: 10.1016/j.ajog.2006.06.075
Boyd, A., Van de Velde, S., Vilagut, G., de Graaf, R., O’Neill, S., Florescu, S., Alonso, J., & Kovess-Masfety, V. (2015). Gender differences in mental disorders and suicidality in Europe: Results from a large cross-sectional population-based study. Journal of Affective Disorders, 173, 245-254. doi: 10.1016/j.jad.2014.11.002
Brooks, E., Gendel, M. H., Early, S. R., & Gundersen, D. C. (2018) When doctors struggle: Current stressors and evaluation recommendations for physicians contemplating suicide. Archives of Suicide Research, 22(4), 519-528. doi: 10.1080/13811118.2017.1372827
Brooks, S. K., Chalder, T., & Gerada, C. (2011). Doctors vulnerable to psychological distress and addictions: Treatment from the Practitioner Health Programme. Journal of Mental Health, 20(2), 157-164. doi: 10.3109/09638237.2011.556168
Caruso, C. C. (2014). Negative impacts of shiftwork and long work hours. Rehabilitation Nursing, 39(1), 16-25. doi: 10.1002/rnj.107
Center, C., Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., … Silverman, M. M. (2003). Confronting depression and suicide in physicians: A consensus statement. JAMA, 289(23), 3161-3166. doi: 10.1001/jama.289.23.3161
Coentre, R., & Figueira, M. L. (2015) Depression and suicidal behavior in medical students: A systematic review. Current Psychiatry Reviews, 11(2), 86-101. doi: 10.2174/1573400510666140807005141
Coentre, R., Faravelli, C., & Figueira, M. L. (2016). Assessment of depression and suicidal behaviour among medical students in Portugal. International Journal of Medical Education, 7, 354-363. doi: 10.5116/ijme.57f8.c468
Cottler, L. B., Ajinkya, S., Merlo, L. J., Nixon, S. J., Ben Abdallah, A., & Gold, M. S. (2013). Lifetime psychiatric and substance use disorders among impaired physicians in a physicians health program: Comparison to a general treatment population: Psychopathology of impaired physicians. Journal of Addiction Medicine, 7(2), 108-112. doi: 10.1097/ADM.0b013e31827fadc9
Cruz Fuentes, C. S., López Bello, L., Blas García, C., González Macías, L., & Chávez Balderas, R. A. (2005). Datos sobre la validez y confiabilidad de la Symptom Check List 90 (SCL 90) en una muestra de sujetos mexicanos. Salud Mental, 28(1), 72-81.
DuPont, R. L., McLellan, A. T., Carr, G., Gendel, M., & Skipper, G. E. (2009). How are addicted physicians treated? A national survey of physician health programs. Journal of Substance Abuse Treatment, 37(1), 1-7. doi: 10.1016/j.jsat.2009.03.010
Dutheil, F., Aubert, C., Pereira, B., Dambrun, M., Moustafa, F., Mermillod, M., … Navel, V. (2019). Suicide among physicians and health-care workers: A systematic review and meta-analysis. PloS One, 14(12), e0226361. doi: 10.1371/journal.pone.0226361
Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81(4), 354-373. doi: 10.1097/00001888-200604000-00009
Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., … Shanafelt, T. D. (2008). Burnout and suicidal ideation among U.S. medical students. Annals of Internal Medicine, 149(5), 334-341. doi: 10.7326/0003-4819-149-5-200809020-00008
Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014). Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Academic Medicine, 89(3), 443-451. doi: 10.1097/ACM.0000000000000134
Dyrbye, L., & Shanafelt, T. (2016). A narrative review on burnout experienced by medical students and residents. Medical Education, 50(1), 132-149. doi: 10.1111/medu.12927
Elliot, L., Tan, J., & Norris, S. (2010). The mental health of doctors: A systematic literature review. Australia: Beyond Blue. Retrieved from http://resources.beyondblue.org.au/prism/file?token=BL/0823
Gold, K. J., Sen, A., & Schwenk, T. L. (2013). Details on suicide among US physicians: data from the National Violent Death Reporting System. General Hospital Psychiatry, 35(1), 45-49. doi: 10.1016/j.genhosppsych.2012.08.005
Hassan, T. M., Ahmed, S. O., White, A. C., & Galbraith, N. (2009). A postal survey of doctors’ attitudes to becoming mentally ill. Clinical Medicine, 9(4), 327-332. doi: 10.7861/clinmedicine.9-4-327
Hernández González, A. I., Ortega Andeane, R. P., & Reidl Martínez, L. M. (2012). Validación del Instrumento de Estrés Laboral para Médicos Mexicanos. En-Claves del Pensamiento, 6(11), 113-129. Retrieved from http://www.redalyc.org/articulo.oa?id=141125357007
Hochberg, M. S., Berman, R. S., Kalet, A. L., Zabar, S. R., Gillespie, C., & Pachter, H. L. (2013). The stress of residency: recognizing the signs of depression and suicide in you and your fellow residents. American Journal of Surgery, 205(2), 141-146. doi: 10.1016/j.amjsurg.2012.08.003
Instituto Nacional de Estadística y Geografía. (2019). Estadísticas a propósito del día mundial para la prevención del suicidio (10 de septiembre de 2019). Comunicado de prensa Num. 455/19. Mexico: INEGI. Retrieved from https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2019/suicidios2019_Nal.docx
Jiménez-López, J. L., Arenas-Osuna, J., & Angeles-Garay, U. (2015). Síntomas de depresión, ansiedad y riesgo de suicidio en médicos residentes durante un año académico. Revista Médica del Instituto Mexicano del Seguro Social, 53(1), 20-28. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25680640
Jin, H. M., & Guo, L. L. (2018). Suicide in Medical Doctors: A Review from Mainland China, 2008-2016. Neuropsychiatry, 8(3), 970-976. Retrieved from http://www.jneuropsychiatry.org/peer-review/suicide-in-medical-doctors-a-review-from-mainland-china-20082016-12601.html
Martínez-Lanz, P., Medina-Mora, M. E., & Rivera, E. (2005). Adicciones, depresión y estrés en médicos residentes. Rev Fac Med UNAM, 48(5), 191-197.
Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E., & Sen, S. (2015). Prevalence of depression and depressive symptoms among resident physicians: A systematic review and meta-analysis. JAMA, 314(22), 2373-2383. doi: 10.1001/jama.2015.15845
Melo-Carrillo, A., Van Oudenhove, L., & Lopez-Avila, A. (2012). Depressive symptoms among Mexican medical students: High prevalence and the effect of a group psychoeducation intervention. Journal of Affective Disorders, 136(3), 1098-1103. doi: 10.1016/j.jad.2011.10.040
Mingote Adan, J. C., Crespo Hervás, D., Hernández Álvarez, M., Navío, M., & García-Pando, C. R. (2013). Prevención del suicidio en médicos. Medicina y Seguridad del Trabajo, 59(231), 176-204. doi: 10.4321/s0465-546x2013000200002
Nayak, M. S. D. P., & Narayan, K. A. (2019). Strengths and Weakness of Online Surveys. IOSR Journal of Humanities and Social Science, 24(5), 31-38. doi: 10.9790/0837-2405053138
Olagunju, A. T., Ogundipe, O. A., Lasebikan, V. O., Coker, A. O., & Asoegwu, C. N. (2016). Pattern of anxiety psychopathology experienced among postgraduate medical trainees. Bangladesh Journal of Medical Science, 15(1), 25-32. doi: 10.3329/bjms.v15i1.20497
Prieto-Miranda, S. E., Jiménez-Bernardino, C. A., Cázares-Ramírez G, Vera-Haro, M, J., & Esparza-Pérez, R. I. (2015). Workdays and their impact on medical residents in a second-level hospital. Medicina Interna de México, 31(6), 669-679.
Quince, T. A., Wood, D. F., Parker, R. A., & Benson, J. (2012). Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open, 2(4), e001519. doi: 10.1136/bmjopen-2012-001519
Reséndiz Escobar, E., Bustos Gamino, M. N., Mujica Salazar, R., Soto Hernández, I. S., Cañas Martínez, V., Fleiz Bautista, C., ... Villatoro Velázquez, J. A. (2018). National trends in alcohol consumption in Mexico: results of the National Survey on Drug, Alcohol and Tobacco Consumption 2016-2017. Salud Mental, 41(1), 7-15. doi: 10.17711/SM.0185-3325.2018.003
Romo-Nava, F., Bobadilla-Espinosa, R. I., Tafoya, S. A., Guízar-Sánchez, D. P., Gutiérrez, J. R., Carriedo, P., & Heinze, G. (2019). Major depressive disorder in Mexican medical students and associated factors: A focus on current and past abuse experiences. Journal of Affective Disorders, 245, 834-840. doi: 10.1016/j.jad.2018.11.083
Santana-Campas, M. A., & Santoyo Telles, F. (2018). Propiedades psicométricas de la escala riesgo suicida de Plutchik en una muestra de jóvenes mexicanos privados de la libertad. Avances en Psicología, 26(1), 57-64. doi: 10.33539/avpsicol.2018.v26n2.1127
Schwenk, T. L., Davis, L., & Wimsatt, L. A. (2010). Depression, stigma, and suicidal ideation in medical students. JAMA, 304(11), 1181-1190. doi: 10.1001/jama.2010.1300
Shanafelt, T. D., Sinsky, C., Dyrbye, L. N., Trockel, M., & West, C. P. (2019). Burnout among physicians compared with individuals with a professional or doctoral degree in a field outside of medicine. Mayo Clinic Proceedings, 94(3), 549-551. doi: 10.1016/j.mayocp.2018.11.035
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476-493. doi: 10.1093/ije/dyu038
Tiburcio Sainz, M., Rosete-Mohedano, M. G., Natera Rey, G., Martínez Vélez, N. A., Carreño García, S., & Pérez Cisneros, D. (2016). Validity and Reliability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in University Students. Adicciones, 28(1), 19-27. doi: 10.20882/adicciones.786
van der Heijden, F., Dillingh, G., Bakker, A., & Prins, J. (2008). Suicidal thoughts among medical residents with burnout. Archives of Suicide Research, 12(4), 344-346. doi: 10.1080/13811110802325349
Veldenz, H. C., Scott, K. K., Dennis, J. W., Tepas, J. J. 3rd., & Schinco, M. S. (2003). Impaired residents: identification and intervention. Current Surgery, 60(2), 214-217. doi: 10.1016/S0149-7944(02)00780-8
Wang, W., Ren, H., Tian, Q., Tang, C., & Meng, W. (2019). Effects of Occupational Stress on Blood Lipids, Blood Sugar and Immune Function of Doctors. Iranian Journal of Public Health, 48(5), 825-833.
White, A., Shiralkar, P., Hassan, T., Galbraith, N., & Callaghan, R. (2006). Barriers to mental healthcare for psychiatrists. Psychiatric Bulletin, 30(10), 382-384. doi: 10.1192/pb.30.10.382
