Tyssen Reidar, Vaglum Per
Department of Behavioural Sciences in Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Harv Rev Psychiatry. 2002 May-Jun;10(3):154-65. doi: 10.1080/10673220216218.
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.
先前的研究表明，医学界存在相对较高水平的某些心理健康问题，尤其是抑郁症，这可能导致药物滥用和自杀。我们回顾了过去20年发表的前瞻性研究，以调查医生在研究生阶段第一年心理健康问题的患病率及预测因素。我们选择临床相关的心理健康问题作为结果指标。我们找到了9项符合我们选择标准的队列研究。每项研究都有局限性，尤其是随访时的低应答率、小样本量和/或短观察期。大多数研究表明，心理健康问题的症状，尤其是抑郁症症状，在研究生阶段第一年最为严重。他们发现，个体因素，如家庭背景、人格特质（神经质和自我批评）以及一厢情愿的应对方式，以及情境因素，包括感知到的医学院压力、感知到的过度工作、情绪压力、在重症监护环境中工作以及工作之外的压力，往往是心理健康问题的预测因素。这些研究在性别方面得出了有些不一致的结果。我们讨论了这些发现的意义。
