Mental health problems among young doctors: an updated review of prospective studies

Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.