Depression in Medical Interns: Part 2 of a Special 3-Part Series

Sen SrijanBackground
Last week, we examined the high rates of major depression and suicidal ideation (SI) in medical interns. In this week’s Research Connection, we’ll take a look at the second of three studies, in which Dr. Srijan Sen attempts to find out if a reduction in the number of hours interns were allowed to work, as part of a 2011 duty hour reform, changed the rate of depression and SI.

To find out more, Dr. Srijan Sen conducted three separate studies. For the first study, he followed first-year medical interns over time to document any change in either depression or SI.

The Study
This second study was performed involving 2,323 interns from the national Intern Health Study. Participants in this second study (or “sample”) were interns from 51 hospitals who started internships in 2009, 2010, and 2011.

Just as in the first study, the interns completed the commonly used Patient Health Questionnaire (PHQ-9) to assess depression and SI during the two months before their internship. Dr. Sen also included measures of neuroticism, resilience, perceived stress, social support, family functioning, cognitive styles, and demographic characteristics to see if these contributed to the outcomes. The interns completed the questions about perceived medical errors, hours of sleep, and stress at three, six, nine, and 12 months.

As we know from the first study, higher depression was associated with more hours of work, more perceived medical errors, and increased stress. As necessitated by the 2011 duty hour reform, interns’ average work time decreased but only by approximately 3 hours. The result? The findings were unchanged; fewer hours didn’t lead to lower rates of depression.

The increased rates of depression and SI among medical interns was not eliminated by a three hour reduction in work hours.

In the last of the three studies, we’ll find out if using web-based cognitive behavior therapy can be helpful in combating the high rates of depression and SI in first year medical interns.

Publication from AFSP grant
Sen S, Kranzler HR, Didwania AK, Schwartz AC, Amarnath S, Kolars JC, Dalack GW, Nichols B, Guille C. (2013) Effects of the 2011 Duty Hour Reforms on Interns and Their Patients: A Prospective Longitudinal Cohort Study Effects of the 2011 Duty Hour Reforms. JAMA Internal Medicine 173 (8), 657-662.


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