Thomas L. Schwenk, MD; Daniel W. Gorenflo, PhD; and Loretta M. Leja, MD
Context: Recent studies have adressed the need to better understand the nature and risk of depression and suicide in physicians.
Objective: To assess the prevalence of depressive symptoms in
a sample of practicing physicians, their perceptions of the impact of
depression on their work lives, and their perceptions of the impact of being a
physician on their pursuit of mental health care.
Design: An anonymous survey was mailed in April 2005 that
included the Patient Health Questionnaire depression module (PHQ-9) and other
Likert-style questions.
Participants: Five thousand randomly selected practicing
physicians in Michigan, from whom 1154 usable responses were received (23%
response rate).
Main Outcome Measures: The prevalence of depressive symptoms
and the perceptions by respondents of the impact of depression on work roles
and on their approach to seeking mental health care.
Results: Moderate to severe depression scores were reported by
130 physicians (11.3%). Roughly one quarter of respondents reported knowing a
physician whose professional standing had been compromised by being depressed.
Physicians reporting moderate to severe depression were 2 to 3 times more
likely to report substantial impact on their work roles compared to physicians
with minimal to mild depression scores, including a decrease in work
productivity (57.7% vs. 18.5%; p < .001) and a decrease in work satisfaction
(90.8% vs. 36.2%; p < .001). The same physicians were 2 to 3 times more likely
to report a wide range of dysfunctional and worrisome approaches to seeking
mental health care compared to physicians with minimal to mild depression
scores, including a higher likelihood that they would self-prescribe
antidepressants (30.0% vs. 9.9%; p < .001).
Conclusions: Moderate to severe depression scores are reported
by a substantial portion of practicing physicians in Michigan, with important
influences on physician work roles and potential negative impact on licensing
and medical staff status. The risk of being stigmatized may cause depressed
physicians to alter their approach to seeking mental health care, including
seeking care outside their medical community and self-prescribing
antidepressants. Destigmatization of depression in physicians and interventions
to improve the mental health care of physicians in ways that do not compromise
their professional standing should receive more attention.
J Clin Psychiatry 2008;69(4):617-620
© Copyright 2008 Physicians Postgraduate Press, Inc.