AccScience Publishing / JCBP / Online First / DOI: 10.36922/jcbp.3570
ORIGINAL RESEARCH ARTICLE

Assessment of depressive symptoms among medical students and doctors using PHQ-9

Kamile Pociute1,2 Sigita Lesinskiene1*
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1 Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
2 Mental Health Centre, Karoliniškės Polyclinic, Vilnius, Lithuania
Submitted: 3 May 2024 | Accepted: 6 June 2024 | Published: 5 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Medical students and doctors are at increased risk of experiencing depression. Doctors exhibit varying severity of depression symptoms at different stages of their careers. This study aimed to evaluate the prevalence of depressive symptoms among medical students and doctors using the Patient Health Questionnaire-9 (PHQ-9). We conducted a cross-sectional study in Lithuania from February to March 2024, using an anonymous online questionnaire that collected demographic data and included the PHQ-9. A score of ≥10 indicated criteria for depression. The questionnaire was completed by 146 respondents, comprising 77 medical students and 69 doctors or resident doctors. Overall, 40% of respondents met the criteria for depression, including 48% of medical students and 32% of doctors. Medical students had a higher mean PHQ-9 score compared to doctors, and the difference in PHQ-9 scores between students and doctors was significant (P = 0.045). No significant differences were found in PHQ-9 scores between genders (P = 0.430) or among respondents living in different city sizes (P = 0.780). Our data align with the literature findings that medical students exhibit higher depression scores than doctors. The study underscores the importance of regularly monitoring the emotional well-being of medical students and doctors and implementing interventions to improve their emotional health.

Keywords
Medical students
Doctors
Residents
PHQ-9
Depression
Prevalence
Funding
None.
References
  1. World Health Organisation. Depressive Disorder (Depression). Available from: https://www.who.int/news-room/fact-sheets/detail/depression [Last accessed on 2004 Jul 04].

 

  1. Chodavadia P, Teo I, Poremski D, Fung DS, Finkelstein EA. Prevalence and economic burden of depression and anxiety symptoms among Singaporean adults: Results from a 2022 web panel. BMC Psychiatry. 2023;23(1):104. doi: 10.1186/s12888-023-04581-7

 

  1. Esquerda M, Garcia-Estan J, Ruiz-Rosales A, Garcia- Abajo JM, Millan J. Academic climate and psychopathological symptomatology in Spanish medical students. BMC Med Educ. 2023;23(1):843. doi: 10.1186/s12909-023-04811-2

 

  1. Nazeema A, Lowton K, Tenea Z, Anic A, Jayrajh P. Study of burnout and depressive symptoms in doctors at a central level, state hospital. S Afr J Psychiatr. 2023;29:1866. doi: 10.4102/sajpsychiatry.v29i0.1866

 

  1. De Melo Silva Junior ML, Valenca MM, Rocha-Filho PA. Individual and residency program factors related to depression, anxiety and burnout in physician residents-a Brazilian survey. BMC Psychiatry. 2022;22(1):272. doi: 10.1186/s12888-022-03916-0

 

  1. Mirza AA, Baig M, Beyari GM, Halawani MA, Mirza AA. Depression and anxiety among medical students: A brief overview. Adv Med Educ Pract. 2021;12:393-398. doi: 10.2147/AMEP.S302897

 

  1. Nair M, Moss N, Bashir A, et al. Mental health trends among medical students. Proc (Bayl Univ Med Cent). 2023;36(3):408-410. doi: 10.1080/08998280.2023.2187207

 

  1. De Sa EC, Torres RV, Cotta KC, Ezequiel OD, Lucchetti G, Lucchetti AL. Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians. Int J Soc Psychiatry. 2023;69(5):1260-1267. doi: 10.1177/00207640231157258

 

  1. Shaikh AA, Shaikh A, Kumar R, Tahir A. Assessment of burnout and its factors among doctors using the abbreviated maslach burnout inventory. Cureus. 2019;11(2):e4101. doi: 10.7759/cureus.4101

 

  1. Martin SR, Fortier MA, Heyming TW, et al. Perfectionism as a predictor of physician burnout. BMC Health Serv Res. 2022;22(1):1425. doi: 10.1186/s12913-022-08785-7

 

  1. Byrne JP, Creese J, McMurray R, Costello RW, Matthews A, Humphries N. Feeling like the enemy: The emotion management and alienation of hospital doctors. Front Sociol. 2023;8:1232555. doi: 10.3389/fsoc.2023.1232555

 

  1. Yates SW. Physician stress and burnout. Am J Med. 2020;133(2):160-164. doi: 10.1016/j.amjmed.2019.08.034

 

  1. Arnsten AF, Shanafelt T. Physician distress and burnout: The neurobiological perspective. Mayo Clin Proc. 2021;96(3):763-769. doi: 10.1016/j.mayocp.2020.12.027

 

  1. Elliott RA, Camacho E, Jankovic D, Sculpher MJ, Faria R. Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Qual Saf. 2021;30(2):96-105. doi: 10.1136/bmjqs-2019-010206

 

  1. Kong X, Tao X, Li L, et al. Global trends and partial forecast of adverse effects of medical treatment from 1990 to 2019: An epidemiological analysis based on the global burden of disease study 2019. BMC Public Health. 2024;24(1):295. doi: 10.1186/s12889-023-17560-0

 

  1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. doi: 10.1046/j.1525-1497.2001.016009606.x

 

  1. Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the patient health questionnaire (PHQ-9): A meta-analysis. CMAJ. 2012;184(3):E191-E196. doi: 10.1503/cmaj.110829

 

  1. Levis B, Benedetti A, Thombs BD, DEPRESsion Screening Data (DEPRESSD) Collaboration. Accuracy of patient health questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. BMJ. 2019;365:11476. doi: 10.1136/bmj.l1476

 

  1. Ryan E, Hore K, Power J, Jackson T. The relationship between physician burnout and depression, anxiety, suicidality and substance abuse: A mixed methods systematic review. Front Public Health. 2023;11:1133484. doi: 10.3389/fpubh.2023.1133484

 

  1. He C, Levis B, Riehm KE, et al. The accuracy of the patient health questionnaire-9 algorithm for screening to detect major depression: An individual participant data meta-analysis. Psychother Psychosom. 2020;89(1):25-37. doi: 10.1159/000502294

 

  1. Rogoza D, Strumila R, Klivickaite E, Dirzius E, Cenaite N. Depressive symptoms, help-seeking, and barriers to mental healthcare among healthcare professionals in lithuania. Acta Med Litu. 2021;28(1):59-76. doi: 10.15388/Amed.2020.28.1.3

 

  1. Stanyte A, Podlipskyte A, Milasauskiene E, et al. Mental health and wellbeing in lithuanian medical students and resident doctors during COVID-19 pandemic. Front Psychiatry. 2022;13:871137. doi: 10.3389/fpsyt.2022.871137

 

  1. Oficialiosios Statistikos Portalas. Lietuvos Gyventojų Sveikata. Savo Sveikatos Vertinimas; 2020. Available from: https://osp.stat.gov.lt/lietuvos-gyventoju-sveikata-2020/ savo-sveikatos-vertinimas [Last accessed on 2024 Jul 04].

 

  1. Shin C, Lee SH, Han KM, Yoon HK, Han C. Comparison of the usefulness of the PHQ-8 and PHQ-9 for screening for major depressive disorder: Analysis of psychiatric outpatient data. Psychiatry Investig. 2019;16(4):300-305. doi: 10.30773/pi.2019.02.01

 

  1. Wu Y, Levis B, Riehm KE, et al. Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: A systematic review and individual participant data meta-analysis. Psychol Med. 2020;50(8):1368-1380. doi: 10.1017/S0033291719001314

 

  1. Al-Imam A, Motyka MA, Hoffmann B, Basil S, Al-HemiaryN. Suicidal Ideation in iraqi medical students based on research using PHQ-9 and SSI-C. Int J Environ Res Public Health. 2023;20(3):1795. doi: 10.3390/ijerph20031795

 

  1. Adhikari A, Sujakhu E, Sandervee GC, Zoowa S. Depression among medical students of a Medical College in Nepal during COVID-19 pandemic: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2021;59(239):645-648. doi: 10.31729/jnma.5441

 

  1. Isara AR, Nwokoye OI, Odaman AO. Prevalence and risk factors of depression among undergraduate medical students in a Nigerian university. Ghana Med J. 2022;56(4):303-310. doi: 10.4314/gmj.v56i4.9

 

  1. Mhata NT, Ntlantsana V, Tomita AM, Mwambene K, Saloojee S. Prevalence of depression, anxiety and burnout in medical students at the University of Namibia. S Afr J Psychiatr. 2023;29:2044. doi: 10.4102/sajpsychiatry.v29i0.2044

 

  1. Drożak P, Duda P, Bryliński Ł, et al. Depression among Polish medical students and its lifestyle-linked predictors. J Educ Health Sport. 2021;11(7):156-166. doi: 10.12775/JEHS.2021.11.07.014

 

  1. Eleftheriou A, Rokou A, Arvaniti A, Nena E, Steiropoulos P. Sleep quality and mental health of medical students in greece during the COVID-19 pandemic. Front Public Health. 2021;9:775374. doi: 10.3389/fpubh.2021.775374

 

  1. Valaine L, Ancane G, Utinans A, Brigis G. Mental health and associated demographic and occupational factors among health care workers during the COVID-19 pandemic in Latvia. Medicina (Kaunas). 2021;57(12):1381. doi: 10.3390/medicina57121381

 

  1. Nair N, Ng CG, Sulaiman AH. Depressive symptoms in residents of a tertiary training hospital in Malaysia: The prevalence and associated factors. Asian J Psychiatr. 2021;56:102548. doi: 10.1016/j.ajp.2021.102548

 

  1. Briciu V, Leucuta DC, Tokes GE, Colcear D. Burnout, depression, and job stress factors in healthcare workers of a Romanian COVID-19 dedicated hospital, after two pandemic years. Int J Environ Res Public Health. 2023;20(5):4118. doi: 10.3390/ijerph20054118

 

  1. Johns G, Samuel V, Freemantle L, Lewis J, Waddington L. The global prevalence of depression and anxiety among doctors during the covid-19 pandemic: Systematic review and meta-analysis. J Affect Disord. 2022;298(Pt A):431-441. doi: 10.1016/j.jad.2021.11.026

 

  1. Li W, Mao X, Li J, et al. Anxiety and depression among imaging doctors in post-COVID-19 period. SN Compr Clin Med. 2020;2(12):2595-2599. doi: 10.1007/s42399-020-00654-w

 

  1. Elhadi M, Msherghi A, Elgzairi M, et al. The mental well-being of frontline physicians working in Civil Wars under coronavirus disease 2019 pandemic conditions. Front Psychiatry. 2020;11:598720. doi: 10.3389/fpsyt.2020.598720

 

  1. Olaya B, Perez-Moreno M, Bueno-Notivol J, Gracia- Garcia P, Lasheras I, Santabarbara J. Prevalence of depression among healthcare workers during the COVID- 19 outbreak: A systematic review and meta-analysis. J Clin Med. 2021;10(15):3406. doi: 10.3390/jcm10153406

 

  1. Zhu J, Sun L, Zhang L, et al. Prevalence and influencing factors of anxiety and depression symptoms in the first-line medical staff fighting against COVID-19 in Gansu. Front Psychiatry. 2020;11:386. doi: 10.3389/fpsyt.2020.00386

 

  1. Liu Y, Wang L, Chen L, Zhang X, Bao L, Shi Y. Mental health status of paediatric medical workers in China during the COVID-19 outbreak. Front Psychiatry. 2020;11:702. doi: 10.3389/fpsyt.2020.00702

 

  1. Alrashed FA, Alsubiheen AM, Alshammari H, et al. Strents: Prevalence and association with sleep disorders. Sustainability. 2022;14(18):11320. doi: 10.3390/su141811320

 

  1. Chen Y, Shen X, Feng J, et al. Prevalence and predictors of depression among emergency physicians: A national cross-sectional study. BMC Psychiatry. 2022;22(1):69. doi: 10.1186/s12888-022-03687-8

 

  1. Ouazzani Housni Touhami Y, Maiouak M, Ouraghene A, et al. The prevalence and associated factors of depression, anxiety, and PTSD among Moroccan medical doctors in the COVID-19 pandemic: A national study. Psychol Health Med. 2023;28(1):211-224. doi: 10.1080/13548506.2022.2067574

 

  1. Khatri B, Gupta B, Santosh BK, et al. Depression among medical students of a medical college: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2023;61(259) 245-248. doi: 10.31729/jnma.7869

 

  1. Xu J, Liu N, Polemiti E, et al. Effects of urban living environments on mental health in adults. Nat Med. 2023;29(6):1456-1467. doi: 10.1038/s41591-023-02365-w

 

  1. Xu C, Miao L, Turner D, DeRubeis R. Urbanicity and depression: A global meta-analysis. J Affect Disord. 2023;340:299-311. doi: 10.1016/j.jad.2023.08.030

 

  1. Stier AJ, Schertz KE, Rim NW, et al. Evidence and theory for lower rates of depression in larger US urban areas. Proc Natl Acad Sci U S A. 2021;118(31):e2022472118. doi: 10.1073/pnas.2022472118

 

  1. Forrest LN, Waschbusch DA, Pearl AM, et al. Urban vs. Rural differences in psychiatric diagnoses, symptom severity, and functioning in a psychiatric sample. PLoS One. 2023;18(10):e0286366. doi: 10.1371/journal.pone.0286366

 

  1. Zafar M, Zaidi TH, Zaidi NH, et al. Attitude towards seeking professional help for mental health among medical students In Karachi, Pakistan. Future Sci OA. 2024;10(1):FSO916. doi: 10.2144/fsoa-2023-0114

 

  1. Wijeratne C, Johnco C, Draper B, Earl J. Doctors’ reporting of mental health stigma and barriers to help-seeking. Occup Med (Lond). 2021;71(8):366-374. doi: 10.1093/occmed/kqab119

 

  1. Goksel P, Ay R, Kilincel O. Psychological attitudes of physicians in seeking help and associated factors. Psychiatry Clin Psychopharmacol. 2023;33(4):287-291. doi: 10.5152/pcp.2023.23692

 

  1. Kumar S, Kota S, Kayarpady A, Gopal A, Rudra PN. A cross-sectional study of coping strategies and resilience and its association with psychological symptoms of doctors working in a dedicated COVID-19 care center. Ind Psychiatry J. 2023;32(1):31-36. doi: 10.4103/ipj.ipj_128_21

 

  1. Ng AP, Chin WY, Wan EY, Chen J, Lau CS. Prevalence of depression and suicide ideation in Hong Kong doctors: A cross-sectional study. Sci Rep. 2021;11(1):19366. doi: 10.1038/s41598-021-98668-4

 

  1. Gupta S, Prasad AS, Dixit PK, Padmakumari P, Gupta S, Abhisheka K. Survey of prevalence of anxiety and depressive symptoms among 1124 healthcare workers during the coronavirus disease 2019 pandemic across India. Med J Armed Forces India. 2021;77(Suppl 2):S404-S412. doi: 10.1016/j.mjafi.2020.07.006

 

  1. Lin RT, Lin YT, Hsia YF, Kuo CC. Long working hours and burnout in health care workers: Non-linear dose-response relationship and the effect mediated by sleeping hours-A cross-sectional study. J Occup Health. 2021;63(1):e12228. doi: 10.1002/1348-9585.12228

 

  1. Feng B, Bian H, Zhang K, et al. The workload change and depression among emergency medical staff after the open policy during COVID-19: A cross-sectional survey in Shandong, China. Front Public Health. 2023;11:1281787. doi: 10.3389/fpubh.2023.1281787

 

  1. Mohd Fauzi MF, Mohd Yusoff H, Muhamad Robat R, Mat Saruan NA, Ismail KI, Mohd Haris AF. Doctors’ mental health in the midst of COVID-19 pandemic: The roles of work demands and recovery experiences. Int J Environ Res Public Health. 2020;17(19):7340. doi: 10.3390/ijerph17197340

 

  1. Chen L, Zhao Z, Wang Z, et al. Prevalence and risk factors for depression among training physicians in China and the United States. Sci Rep. 2022;12(1):8170. doi: 10.1038/s41598-022-12066-y

 

  1. Garcia LC, Shanafelt TD, West CP, et al. Burnout, depression, career satisfaction, and work-life integration by physician race/ethnicity. JAMA Netw Open. 2020;3(8):e2012762. doi: 10.1001/jamanetworkopen.2020.12762

 

  1. Polujanski S, Rotthoff T, Nett U, Schindler AK. First-year medical students’ varying vulnerability to developing depressive symptoms and its predictors: A latent profile analysis. Acad Psychiatry. 2023;47(2):143-151. doi: 10.1007/s40596-023-01757-x

 

  1. Ridout KK, Ridout SJ, Guille C, Mata DA, Akil H, Sen S. Physician-training stress and accelerated cellular aging. Biol Psychiatry. 2019;86(9):725-730. doi: 10.1016/j.biopsych.2019.04.030

 

  1. Sletta C, Tyssen R, Lovseth LT. Change in subjective well-being over 20 years at two Norwegian medical schools and factors linked to well-being today: A survey. BMC Med Educ. 2019;19(1):45. doi: 10.1186/s12909-019-1476-3

 

  1. COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700-1712. doi: 10.1016/S0140-6736(21)02143-7

 

  1. Liu C, Chen H, Cao X, et al. Effects of mindfulness meditation on doctors’ mindfulness, patient safety culture, patient safety competency and adverse event. Int J Environ Res Public Health. 2022;19(6):3282. doi: 10.3390/ijerph19063282

 

  1. Monfries N, Sandhu N, Millar K. A smartphone app to reduce burnout in the emergency department: A pilot randomized controlled trial. Workplace Health Saf. 2023;71(4):181-187. doi: 10.1177/21650799221123261
Conflict of interest
The authors declare that they have no competing interests.
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