Depression is reported to be prevalent amongst doctors and can have serious implications on the individual and on patient care. Previous studies have demonstrated an association between occupational stress (OS) and depressive symptoms amongst doctors. This study assessed the association between OS and depressive symptoms in hospital doctors in Ireland.Methods
In this randomised cross-sectional survey, 1749 doctors (950 consultants, 799 trainees) provided data on demographics (age, sex) and work (specialty, grade, working hours). Effort Reward Imbalance questionnaire was used to assess OS (effort-reward ratio [ERR], overcommitment [OC]). The WHO-5 Wellbeing index was used to assess depressive symptoms (two categories: ‘normal/mild’ vs ‘likely depression’). Chi-square tests and t-tests were used to test differences in depressive symptoms and OS for sex, work grade and specialty. Binary logistic regression was performed to determine the association between OS and depressive symptoms, while controlling for sex, age, grade, specialty and mean hours worked.Results
Compared to males, females reported higher mean ERR and OC. Trainees reported higher mean ERR, OC and higher prevalence of ‘likely depression’ compared with consultants (27.4% -v- 17.8%, p=0.000). Those in the upper ERR tertile were more likely to experience depressive symptoms than those in the lowe tertile (OR=3.723; CI: 2.634 to 5.263; p=0.000). Those in the upper OC tertile were significantly more likely to experience depressive symptoms than those in the lowest tertile (OR=4.003; CI: 2.87 to 5.884; p=0.000). Mean hours worked (OR=1.02; CI; 1.009 to 1.03; p=0.000) and grade (consultants [OR=0.496; CI: 0.292 to 0.843; p=0.01]) were significantly associated with depressive symptoms, whereas age, sex and specialty were not. The model explained 18% of variance.Discussion
OS and work conditions are associated with depressive symptoms in hospital doctors in Ireland. Efforts to reduce OS, such as review of work conditions or occupational social support, should be undertaken to improve psychological wellbeing.