De meesten daarvan hadden een matige depressie waardoor ook hun dagelijkse functioneren behoorlijk werd aangetast. Hoe meer uren ze moesten werken, hoe depressiever ze bleken te zijn.
In die periode was de wet al wat strenger geworden, maar het gebeurde nog steeds dat artsen-in-opleiding tot 80 uur per week dienden te werken.
Verder bleek er een relatie te zijn tussen 'meer depressief zijn' en 'het maken van medische fouten'...
En tenslotte is al langer dan vandaag bekend dat eenmaal een depressie oplopen, een behoorlijke risicofactor is om in de toekomst nog episodes van depressie door te maken.
Ik weet dat tot enkele jaren geleden assistenten in opleiding vaak slavenarbeid dienden te verrichten, ondermeer doordat 80 uur werken per week zeker geen uitzondering was. In België is er al een tijdje het één en ander lopende om dat maximum aantal uren te limiteren. Maar ik vrees dat er tot op heden voor assistenten zelf nog maar weinig veranderd is. Misschien zal een studie zoals deze (zelfs al is die dan uitgevoerd in de VS) de politici wat meer wakker schudden. Vooral als ze beseffen dat ook zijzelf (als ze bv. eens op spoed terecht komen bij een assistent die de afgelopen 6 maanden bijna niet geslapen heeft) wel eens het 'slachtoffer' kunnen worden van deze praktijken.
uit (full text): Sen S., et al. (2010). A Prospective Cohort Study Investigating Factors Associated With Depression During Medical Internship. Arch Gen Psychiatry, 67(6)In this study, we found that the rate of depression increased dramatically during the internship year, from 3.9% of subjects meeting PHQ-9 criteria for depression before internship to an average of 25.3% of subjects meeting criteria at quarterly assessments during the internship year. Most subjects who met criteria for depression were classified as moderately depressed, with few subjects meeting PHQ-9 criteria for moderately severe or severe depression. Because the development of major depression has been linked to a higher risk of future depressive episodes and greater long-term morbidity risk, future studies should examine how the rate of depression changes as training physicians progress through their careers beyond internship and the possible effects of depression on the general health of physicians.
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The baseline factors that were associated with the development of depression in this study include some that have been implicated in prior residency studies (female sex, difficult early family environment, neuroticism, and a prior history of depression) and other factors not previously identified (US medical education and lower baseline depressive symptoms).
It is also interesting to note that a number of factors, such as medical specialty and age, were not associated with the development of depression.
As with baseline factors, we identified within-internship factors that were previously implicated as well as novel factors associated with the development of depression. Our finding that medical errors are associated with depression supports the findings of 2 recent studies. Herein, we extend the association identified in prior studies by demonstrating that depressive symptoms that are present before internship predicted reported errors during internship, indicating that depression results in increased medical errors. Controlling for the baseline level of depressive symptoms, a strong correlation between errors and depression persisted, indicating that errors may also cause depression and that the association between depression and reported medical errors is bidirectional.
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In addition to building on previous work exploring the relationship between medical errors and depression, this is the first study to demonstrate a direct association between the number of hours worked and risk of depression in medical interns. In contrast to our finding with medical errors, we found no evidence that depressive symptom score before internship predicted ones work hours during internship. These findings suggest that increased work hours lead to increased depressive symptoms during internship. Future studies could explore whether systemic changes designed to improve patient safety, such as additional safeguards against medical errors and further resident work hours' restrictions, reduce the development of depression among interns.
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Dido
