Prevalence of Depression and Burnout among Family Medicine Residents in Riyadh City, Saudi Arabia
Background
The mental health of healthcare workers, particularly family medicine residents, is an area of growing concern, more so in the context of the COVID-19 pandemic. High levels of burnout and depression among these professionals can affect their well-being and patients’ quality of care.
Objectives
The study aimed to determine the prevalence of depression and burnout among family medicine residents in Riyadh, Saudi Arabia.
Materials and Methods
A cross-sectional study was conducted among 213 family medicine residents, using a self-administered survey. The survey included the Maslach Burnout Inventory and the Patient Health Questionnaire (PHQ)-9 to assess burnout and depression. Descriptive statistics were used to summarize participants’ characteristics, and regression model was developed to explore predictors of burnout and depression.
Results
The mean age of participants was 26.85±1.42 years, and 53.3% were males. The study found a high prevalence of emotional exhaustion (EE) and depersonalization (DP) among participants, with mean scores of 21.10±9.38 and 15.44±7.69, respectively, indicating moderate to high levels. Similarly, a high level of personal accomplishment (PA) was reported, with a mean score of 11.46±6.33. Around 10% of participants reported moderately severe and severe depression, with a mean PHQ-9 scale score of 6.03±5.10. Gender and depression severity were significantly associated with burnout (p=0.001 and p<0.001, respectively).
Conclusion
The study underscores a significant prevalence of burnout and depression among family medicine residents in Riyadh, with notable variations across different demographic and professional characteristics. This necessitates tailored mental health interventions for this population, especially in challenging times like the ongoing pandemic.
1. World Health Organization. Burn-out an “Occupational Phenomenon”: International Classification of Diseases. Published 2019. Accessed June 22,2022. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
2. Shanafelt TD, Sinsky C, Dyrbye LN, Trockel M, West CP. Burnout among Physicians Compared with Individuals with a Professional or Doctoral Degree in a Field Outside of Medicine. Mayo Clinic Proceedings. 2019;94(3):549-551. doi:10.1016/j.mayocp.2018.11.035
3. Dyrbye LN, West CP, Satele D, et al. Burnout Among U.S. Medical Students, Residents, and Early Career Physicians Relative to the General U.S. Population. Academic Medicine. 2014;89(3):443-451. doi:10.1097/acm.0000000000000134
4. Medscape. 2022 Lifestyle: Burnout. Published 2022. Accessed June 22,2022. https://www.medscap e.com/slideshow/2022-lifestyle-burnout-6014664
5. Rodrigues H, Cobucci R, Oliveira A, et al. Burnout Syndrome among Medical Residents: A Systematic Review and Meta-Analysis. Junne FP, ed. PLoS ONE. 2018;13(11):e0206840. doi:10.1371/journal.pone.0206840
6. Aldubai SamiAR, Aljohani A, Alghamdi A, Alghamdi K, Ganasegeran K, Yenbaawi A. Prevalence and Associated Factors of Burnout among Family Medicine Residents in Al Madina, Saudi Arabia. J Family Med Prim Care. 2019;8(2):657. doi:10.4103/jfm pc.jfmpc 268 18
7. Nahar S, Al-Ghamdi M, Siddiqui A, Al-Saleem S. Burnout and its Correlates in Saudi Family Medicine Residents: An Observational Study from Aseer, Saudi Arabia. J Family Med Prim Care. 2021;10(5):1904. doi:10.4103/jfmpc.jfmpc 2146 20
8. Rothenberger DA. Physician Burnout and Well-Being: A Systematic Review and Framework for Action. Diseases of the Colon & Rectum. 2017;60(6):567-576. doi:10.1097/dcr.0000000000000844
9. Abdulla L, Al-Qahtani D, Al-Kuwari M. Prevalence and Determinants of Burnout Syndrome among Primary Healthcare Physicians in Qatar. South African Family Practice. 2011;53(4):380-383. doi:10.1080/20786204.2011.10874118
10. Shanafelt TD. Special Report: Suicidal Ideation among American Surgeons. Arch Surg. 2011;146(1):54. doi:10.1001/archsurg.2010.292
11. Panagioti M, Geraghty K, Johnson J, et al. Association between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: a Systematic Review and Meta-Analysis. JAMA Intern Med. 2018;178(10):1317. doi:10.1001/jamainternmed.2018.3713
12. Garcia C, Abreu L, Ramos J, et al. Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina. 2019;55(9):553. doi:10.3390/medicina55090553
13. American Psychological Association. APA Dictionary of Psychology. Published 2014. Accessed June 22,2022. https://dictionary.apa.org/depression
14. Torres F. What Is Depression? American Psychiatric Association. Published online 2020. http s://psychiatry.org/patients-families/depression/what-is-depression
15. World Health Organization. Depression. Published 2021. https://www.who.int/news-room/fac t-sheets/detail/depression
16. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress Among U.S. and Canadian Medical Students. Acad Med. 2006;81(4):354-373. doi:10.1097/00001888-200604000-00009
17. Sen S, Kranzler HR, Krystal JH, et al. A Prospective Cohort Study Investigating Factors Associated with Depression During Medical Internship. Arch Gen Psychiatry. 2010;67(6):557. doi:10.1001/archgenpsychiatry.2010.41
18. Mousa OY, Dhamon MS, Lander S, Dhamon AS. The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees. PLoS ONE. 2016;11(6):e0156554. doi:10.1371/journal.pone.0156554
19. Mata DA, Ramos MA, Bansal N, et al. Prevalence of Depression and Depressive Symptoms among Resident Physicians: A Systematic Review and Meta-Analysis. JAMA. 2015;314(22):2373. doi:10.1001/jam a.2015.15845
20. Alosaimi FD, Kazim SN, Almufleh AS, Aladwani BS, Alsubaie AS. Prevalence of Stress and its Determinants among Residents in Saudi Arabia. Saudi Med J. 2015;36(5):605-612. doi:10.15537/smj.2015.5.10814
21. Al-Dubai SAR et al. Factors Associated with Stress and Depression among Family Medicine Residents in Al Madinah, Saudi Arabia. Age. 2021;25(27):10.
22. Al-Maddah EM et al. Prevalence of Sleep Deprivation and Relation with Depressive Symptoms among Medical Residents in King Fahd University Hospital, Saudi Arabia. Sultan Qaboos Univ Med J. 2015;15(1):78.
23. Alshardi A, Farahat F. Prevalence and Predictors of Depression among Medical Residents in Western Saudi Arabia. J Clin Psychol Med Settings. 2019;27(4):746-752. doi:10.1007/s10880-019-09667-7
24. Lecrubier Y. The Burden of Depression and Anxiety in General Medicine. J Clin Psychiatry. 2001;62:4-11.
25. Bradvik L. Suicide Risk and Mental Disorders. Int J Environ Res Public Health. 2018;15(9):2028. doi:10.3390/ijerph15092028
26. Brunsberg KA, Landrigan CP, Garcia BM, et al. Association of Pediatric Resident Physician Depression and Burnout with Harmful Medical Errors on Inpatient Services. Acad Med. 2019;94(8):1150-1156. doi:10.1097/acm.0000000000002778
27. Al Khashan H, Abogazalah F, Alomary S, et al. Primary health care reform in Saudi Arabia: progress, challenges and prospects. East Mediterr Health J. 2021;27(10):1016-1026. doi:10.26719/emhj.21.042
28. Pokhrel NB, Khadayat R, Tulachan P. Depression, Anxiety, and Burnout among Medical Students and Residents of a Medical School in Nepal: A Cross-sectional Study. BMC Psychiatry. 2020;20(1):137. doi:10.1186/s12888-020-02645-6
29. Abdulla Let al. Depression, Anxiety and Stress among First Year Medical Students in a Tertiary Institution in Saudi Arabia. Asian J Psychiatr. 2019;41:99-102.
30. Faheem D et al. Prevalence and Severity of Depression among Medical Undergraduates in Al Madina, Saudi Arabia. J Taibah Univ Med Sci. 2019;14(4):335-340.
31. Dewa CS et al. Physician Mental Health and Well-Being: Research and Practice. Springer; 2017.
32. World Health Organization. International Statistical Classification of Diseases and Related Health Problems (11th Revision. Published 2018. Accessed June 22,2022. https://icd.who.int/browse11/1-m/en
33. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013. doi:10.1176/appi.books.9780890425596
34. Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of Burnout among Physicians: A Systematic Review. JAMA. 2018;320(11):1131. doi:10.1001/jama.2018.12777
35. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214. doi:10.1001/jama.2016.17324
36. Dyrbye LN et al. Burnout and Professional Satisfaction with Work-Life Integration among US Physicians in Specialties at High Risk for Burnout. Mayo Clin Proc. 2019;94(4):549-571.
37. Ey S et al. If You Build It, They Will Come: Attitudes of Medical Residents and Fellows about Seeking Services in a Resident Wellness Program. J Grad Med Educ. 2017;9(5):600.
38. Dyrbye L, Shanafelt T. A Narrative Review on Burnout Experienced by Medical Students and Residents. Med Educ. 2015;50(1):132-149. doi:10.1111/medu.12927