Hospital Universitari Vall d'Hebron.
Adicciones. 2020 Nov 17;32(4):281-290. doi: 10.20882/adicciones.1253.
The post-graduate period as a resident doctor (MIR, in Spanish) is usually associated with high emotional distress due to new professional demands and to other psychosocial factors. The objective of this study is to determine the characteristics of dual diagnosis among MIRs. A systematic review was carried out in MEDLINE (PubMed), Web of Science and Google Scholar databases, selecting articles published in English and Spanish between 1984 and 2017. A total of 2,415 articles were obtained: 2,276 were excluded by their title, 105 by the abstract and 17 after a complete review of the article; 17 papers were finally included. The prevalence of depressive symptoms among MIRs ranges from 10.2% to 70%, while the prevalence of anxious symptoms varies from 13.2% to 33.9%, from 6.7% to 25% reported suicidal ideation, 20% hazardous drinking, 2%-13.4% self-prescribed psychotropics, and 2.7%-14% used other drugs. Most studies present important methodological limitations, thus complicating adequate understanding of the phenomenon. High variations in prevalence data are related to differences in the psychometric scales and to disparity in diagnosis criteria, among other limitations. However, most studies report that alcohol and drug use is correlated with severe distress among MIRs. More research is needed to ascertain the nature of dual diagnosis in this professional group in order to effectively prevent and treat its serious consequences.
住院医师（MIR）的研究生阶段通常与新的职业要求和其他社会心理因素相关，情绪困扰较高。本研究旨在确定 MIR 中双重诊断的特征。我们在 MEDLINE（PubMed）、Web of Science 和 Google Scholar 数据库中进行了系统综述，选择了 1984 年至 2017 年间发表的英文和西班牙文文章。共获得 2415 篇文章：2276 篇因标题被排除，105 篇因摘要被排除，17 篇因全文审查后被排除；最终纳入 17 篇论文。MIR 中抑郁症状的患病率从 10.2%到 70%不等，而焦虑症状的患病率从 13.2%到 33.9%不等，有 6.7%到 25%报告有自杀意念，20%有危险饮酒，2%-13.4%自我开处精神药物，2.7%-14%使用其他药物。大多数研究存在重要的方法学局限性，因此难以充分了解这一现象。患病率数据的高度差异与心理计量量表的差异以及诊断标准的差异等有关。然而，大多数研究报告称，酒精和药物使用与 MIR 中的严重困扰相关。需要进一步研究以确定该专业群体中双重诊断的性质，以便有效预防和治疗其严重后果。
