The prevalence of depression or depressive disorder among resident physicians was estimated at 29% and increased with calendar year, according to a review and meta-analysis of data from 31 cross-sectional studies (n=9,447) and 23 longitudinal studies (n=8,113). The study determined:

• The overall pooled prevalence of depression or depressive symptoms was 29% (4,969/17,560 individuals).

• Prevalence estimates ranged from 21% to 43% depending on the instrument used, and increased with calendar year.

• In a secondary analysis of 7 longitudinal studies, median absolute increase in depressive symptoms with the onset of residency training was 16% (RR=4.5).

• Further research is needed to identify effective strategies for preventing and treating depression among physicians in training.

Citation: Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians. A systematic review and meta-analysis. JAMA 2015;314(22):2373-2383. doi: 10.1001/jama.2015.15845.

Commentary: In the general population, the annual incidence of depression is 7% per year, and our residents have an incidence of depression that appears to be four-fold higher. There is an urgent need to address this problem, but how to address it is less clear. Residents work hard, often geographically distant from their social supports, helping patients through emotionally difficult choices and experiences. They do this having entered the profession as compassionate, sensitive, young adults who feel for the difficulties of the patients that they see. While the system has made important strides in having made limits to the hours worked per week, we must now look at the rest of the environment to see how systematic changes and supports may be put in place to address the emotional and spiritual needs of our residents. The goal is to make residency an experience that remains filled with excitement and challenge, but also filled with the supports that are important in facilitating the development of resilient, compassionate, satisfied, and emotionally intact physicians. —Neil Skolnik, MD