Depression, Stress, and Perceived Medical Errors in Singapore Psychiatry Residents

Doctors in training, especially psychiatrists, are at high risk of depression and burnout, which have been linked to increased medical errors. This study looks at prevalence and risk factors of depression and perceived stress among psychiatry residents in Singapore.

An anonymous online questionnaire was completed by 65.3% (47/72) of residents, which included the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale (PSS), and 2 burnout screening questions. They were asked if they were concerned about making a medical error.

Majority of residents (70.2%) slept 6-8 h/night, while 55.3% worked < 60 h/week. Based on PHQ-9 score ≥ 10, 38.3% had depression. Depression was associated with sleeping < 6 h/night (OR 13.62, 2.96-62.6; p = 0.0008) and working ≥ 60 h/week (OR 3.8, 1.096-13.18; p = 0.035). Six residents (12.8%) endorsed suicidal ideation. The mean score on the PSS scale was 23.89 ± 1.95. Higher PSS scores were associated with sleeping < 6 h/night (OR 4.92, 1.51-8.33; p = 0.007). One third of residents (34%) reported feeling burnt out fairly or very often. Residents who slept < 6 h/night were more likely to report feeling burnt out (OR 6.69, 1.69-26.45; p = 0.0068). PHQ scores correlated highly with PSS scores and burnout measures. Self-perceived medical errors were associated with depressive symptoms, suicidal thoughts, and < 6 h/night of sleep.

Less sleep and longer working hours were associated with higher risk of depression, suicidality, stress, and perceived medical errors in Singapore psychiatry residents. It is important to address depression and stress as it can affect physician well-being and patient care.