Residency Program Factors Associated With Depressive Symptoms in Internal Medicine Interns: A Prospective Cohort Study

Autor(es)

Pereira-Lima, Karina ^{[1, 2]} ; Gupta, Rahael R. ^[3] ; Guille, Constance ^[4] ; Sen, Srijan ^{[2, 5]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Neurosci & Behav, Ribeirao Preto, SP - Brazil

^[2] Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI - USA

^[3] Univ Michigan, Sch Med, Ann Arbor, MI - USA

^[4] Med Univ South Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 - USA

^[5] Univ Michigan, Sch Med, Mol & Behav Neurosci Inst, Ann Arbor, MI - USA

• Tipo de documento: Artigo Científico
• Fonte: ACADEMIC MEDICINE; v. 94, n. 6, p. 869-875, JUN 2019.
• Citações Web of Science: 3

Resumo

Purpose To investigate the associations between program-level variables such as organizational structure, workload, and learning environment and residents' development of depressive symptoms during internship. Method Between 2012 and 2015, 1,276 internal medicine interns from 54 U.S. residency programs completed the Patient Health Questionnaire-9 (PHQ-9) before internship, and then quarterly throughout the internship. The training environment was assessed via a resident questionnaire and average weekly work hours. The authors gathered program structural variables from the American Medical Association Fellowship and Residency Electronic Interactive Database (FREIDA online) and program research rankings from Doximity. Associations between program-level variables and change in depressive symptoms were determined using stepwise linear regression modeling. Results Mean program PHQ-9 scores increased from 2.3 at baseline to 5.9 during internship (mean difference 3.6; SD 1.4; P<.001), with the mean increase ranging from -0.3 to 8.8 (interquartile range 1.1) among included programs. In multivariable models, faculty feedback (beta= -0.37; 95% CI: -0.62, -0.12; P=.005), learning experience in inpatient rotations (beta= -0.28; 95% CI: -0.54, -0.02; P=.030), work hours (beta= 0.34; 95% CI: 0.13, 0.56; P=.002), and research ranking position (beta= -0.25; 95% CI: -0.47, -0.03; P=.036) were associated with change in depressive symptoms. Conclusions Poor faculty feedback and inpatient learning experience, long work hours, and high institutional research rankings were associated with increased depressive symptoms among internal medicine interns. These factors may be potential targets for interventions to improve wellness and mental health among these professionals. (AU)

• Processo FAPESP: 16/13410-0 - Condições organizacionais associadas a problemas de saúde mental em médicos residentes
• Beneficiário: Karina Pereira Lima
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado