Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers.

OBJECTIVE

To study stress, anxiety, and depression in a group of senior health service staff.

DESIGN

Postal survey.

SUBJECTS

81 hospital consultants, 322 general practitioners, and 121 senior hospital managers (total 524).

MAIN OUTCOME MEASURES

Scores on the general health questionnaire and the hospital anxiety and depression scale.

RESULTS

Sixty five (80%) consultants, 257 (80%) general practitioners, and 67 (56%) managers replied. Of all 389 subjects, 183 (47%) scored positively on the general health questionnaire, indicating high levels of stress. From scores on the hospital anxiety and depression scale only 178 (46%) would be regarded as free from anxiety, with 100 (25%) scoring as borderline cases and 111 (29%) likely to be experiencing clinically measurable symptoms. The findings for depression were also of some concern, especially for general practitioners, with 69 (27%) scoring as borderline or likely to be depressed. General practitioners were more likely to be depressed than managers (69 (27%) v 4 (6%) scored > or = 8 on hospital anxiety and depression scale-D; P = 0.004) with no significant difference between general practitioners and consultants. General practitioners were significantly more likely to show suicidal thinking than were consultants (36 (14%) v 3 (5%); P = 0.04) but not managers (9 (13%)). No significant difference could be found between the three groups on any other measure.

CONCLUSIONS

The levels of stress, anxiety, and depression in senior doctors and managers in the NHS seem to be high and perhaps higher than expected.