PREVALENCE OF DEPRESSION, DEPRESSIVE SYMPTOMS, AND SUICIDAL IDEATION AMONG MEDICAL STUDENTS: A NARRATIVE REVIEW
Main Article Content
Keywords
Medical trainees, Physician well-being, Depression, Anxiety, Burnout, Psychological distress, Patient safety
Abstract
Background: Depression, anxiety, and psychological distress are increasingly recognized among medical trainees and physicians, affecting personal well-being and professional performance.
Objective: This review synthesizes evidence from cross-sectional surveys, cohort studies, and systematic reviews to examine the prevalence, risk factors, and consequences of psychological distress in medical education and practice.
Findings: Early studies identified high rates of depression and anxiety among interns and residents, with subsequent large-scale surveys confirming these issues across different cultural and geographic settings. Systematic reviews highlighted widespread psychological distress among medical students and residents, driven by workload, fatigue, and training pressures. Prospective cohort studies demonstrated associations between depression, burnout, and medical errors, reduced empathy, and compromised patient safety. Cross-national surveys further emphasized the global nature of the problem, including in low-resource countries.
Conclusion: Psychological distress is prevalent and consequential in medical training and practice. Structured interventions, institutional support, and policy reforms are urgently needed to protect physician well-being and ensure patient safety.
References
2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593-602.
3. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354-73.
4. Sen S, Kranzler HR, Krystal JH, et al. A prospective cohort study investigating factors associated with depression during medical internship. Arch Gen Psychiatry. 2010;67(6):557-65.
5. Joules N, Williams DM, Thompson AW. Depression in resident physicians: a systematic review. Open J Depress. 2014;3(3):89-100.
6. West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071-8.
7. Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008;336(7642):488-91.
8. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294-300.
9. Buddeberg-Fischer B, Klaghofer R, Buddeberg C. Stress at work and well-being in junior residents [in German]. Z Psychosom Med Psychother. 2005;51(2):163-78.
10. Yousuf A, Ishaque S, Qidwai W. Depression and its associated risk factors in medical and surgical postgraduate trainees at a teaching hospital: a cross sectional survey from a developing country. J Pak Med Assoc. 2011;61(10):968-73.
11. Hsu K, Marshall V. Prevalence of depression and distress in a large sample of Canadian residents, interns, and fellows. Am J Psychiatry. 1987;144(12):1561-6.
12. Kirsling RA, Kochar MS, Chan CH. An evaluation of mood states among first-year residents. Psychol Rep. 1989;65(2):355-66.
13. Hsieh YH, Hsu CY, Liu CY, Huang TL. The levels of stress and depression among interns and clerks in three medical centers in Taiwan: a cross-sectional study. Chang Gung Med J. 2011;34(3):278-85.
14. Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med. 2003;114(6):513-9.
15. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2009;3(3):e123-30.