Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Aust N Z J Psychiatry. 2023 Apr;57(4):511-519. doi: 10.1177/00048674221106677. Epub 2022 Jun 25.
Occupational surveys of doctors consistently show higher rates of depression and anxiety than reported in general population surveys, findings replicated in all other occupational groups, suggesting potential selection bias. We evaluated the comparative mental health of different occupations in Australia from the same sampling frame over the past 6 years and assessed whether COVID-19 differentially affected different occupational groups.
We analysed six annual data waves (2015-2020) from the nationally representative 'Household, Income, and Labour Dynamics in Australia' study. Mental health (Mental Health Inventory-5 from the 36-Item Short Form Survey) and life satisfaction scores of doctors over this period were compared with five other professions and all other employees. Regression models were adjusted for age, gender, income and work hours. Two-way analysis of variance examined the comparative changes in mental health among occupations between 2019 and after exposure to the COVID-19 pandemic in late 2020.
The sample of 15,174 employed respondents included 106 doctors. The 5-year mean mental health score for doctors (M = 78.7; SD = 13.1) was significantly higher than that for teachers ( = 75.6; SD = 14.9), nurses and midwives (M = 76.6; SD = 15.9), lawyers (M = 74.2; SD = 16.1), accountants (M = 74.2; SD = 16.5) and all other employed respondents (M = 73.1, SD = 16.7) ( < 0.001). Cognitive wellbeing comparisons were similar. There were no significant changes in professionals' mental health over this period except for an improvement in engineers and a decline for teachers. From 2019 to 2020, all occupations suffered mental health declines without any significant inter-occupational differences.
Australian doctors identified from a population-based sample rather than occupational surveys reported better levels of mental health and greater life satisfaction than most professions prior to COVID-19 without experiencing the worsening seen in the general employed population over the past 5 years. From 2020, there was a mental health decline in all of the employed population, not disproportionately affecting doctors. Although over-representing Australian trained general practitioners, the results from both this sample and other tentative findings challenge the discourse in medical advocacy, but need more formal comparative studies to confirm.
医生的职业调查显示，其抑郁和焦虑的发病率高于一般人群调查，这一发现也在所有其他职业群体中得到了证实，这表明可能存在选择性偏差。我们评估了过去 6 年来，来自相同抽样框架的澳大利亚不同职业的比较心理健康状况，并评估了 COVID-19 是否对不同职业群体产生了不同的影响。
我们分析了来自全国代表性的“澳大利亚家庭、收入和劳动力动态调查”的六个年度数据波（2015-2020 年）。在此期间，医生的心理健康（36 项简短健康调查问卷中的心理健康量表-5）和生活满意度评分与其他五个职业和所有其他员工进行了比较。回归模型调整了年龄、性别、收入和工作时间。双向方差分析检验了 2019 年和 2020 年末 COVID-19 大流行暴露后各职业之间心理健康的比较变化。
在 15174 名就业受访者中，有 106 名医生。医生的 5 年平均心理健康评分（M=78.7；SD=13.1）明显高于教师（M=75.6；SD=14.9）、护士和助产士（M=76.6；SD=15.9）、律师（M=74.2；SD=16.1）、会计师（M=74.2；SD=16.5）和所有其他就业受访者（M=73.1，SD=16.7）（<0.001）。认知健康的比较结果相似。在此期间，除工程师的心理健康状况有所改善和教师的心理健康状况有所下降外，专业人员的心理健康状况没有明显变化。从 2019 年到 2020 年，所有职业的心理健康都有所下降，但不同职业之间没有明显差异。
在 COVID-19 之前，从基于人群的样本而不是职业调查中确定的澳大利亚医生报告的心理健康水平和生活满意度高于大多数职业，但过去 5 年他们没有经历一般就业人群中所见的恶化。从 2020 年开始，所有就业人群的心理健康都有所下降，而医生并没有受到不成比例的影响。尽管该样本中过度代表了澳大利亚培训的全科医生，但来自该样本和其他初步发现的结果对医学倡导中的讨论提出了挑战，但需要更多的正式比较研究来证实。
