Depression During Internship Associated with Medical Errors

More than 25% of medical interns suffer from depression during their internships, and depressed interns are more likely to make medical errors, a study published online April 5 in the Archives of General Psychiatry reported.

In addition, interns who commit frequent medical errors may be more likely to become depressed than their colleagues who commit fewer, according to the study, the largest prospective study of depression during medical internship to date.

“Depressive symptoms that are present before internship predicted reported errors during internship, indicating that depression results in increased medical errors,” Dr. Srijan Sen of the University of Michigan, Ann Arbor, and colleagues wrote. “Controlling for the baseline level of depressive symptoms, a strong correlation between errors and depression persisted, indicating that errors may also cause depression and that the association between depression and reported medical errors is bidirectional.”

The authors followed 740 interns, assessing them for depressive symptoms and genetic risk prior to internship and then for symptoms and potential stressors at 3-month intervals throughout their internships.

They found a dramatic increase in depression between the last year of medical school and internship. The rate of depression rose from less than 4% prior to internship to an average of more than 25% during the internship year, according to the investigators (Arch. Gen. Psychiatry. 2010;67[doi:10.1001/archgenpsychiatry.2010.41]).

Most subjects who met the criteria for depression were moderately depressed, and few subjects met the standards for moderately severe or severe depression, the investigators wrote.

Women, and interns of either gender with history of depression, neuroticism, and a difficult early family environment, were more likely to suffer from depression, they found.

Depression during internship also was associated with a U.S. medical school education and with fewer depressive symptoms before the beginning of the internship, the investigators wrote. However, age and the medical specialty chosen had no effect on rates of depression during internship.

The data could be useful in preventing depressive symptoms among medical interns, they wrote.

“With effective interventions to help prevent the onset of depression now available, the predictive factors identified herein could allow at-risk interns to take steps before the onset of symptoms to lower their chances of developing depression,” according to Dr. Sen and colleagues.

The study was funded by grants from the Donaghue Foundation, the Department of Veterans Affairs, the American Foundation for Suicide Prevention, and the Substance Abuse and Mental Health Services Administration.

Two of the study authors reported consulting arrangements with a variety of pharmaceutical manufacturers, and one of these reported he also is a cosponsor on pending patents related to new drugs for psychiatric disorders, including depression.

_{Image above courtesy Flickr Creative Commons user "Psychedelic Tuna."}

More than 25% of medical interns suffer from depression during their internships, and depressed interns are more likely to make medical errors, a study published online April 5 in the Archives of General Psychiatry reported.

In addition, interns who commit frequent medical errors may be more likely to become depressed than their colleagues who commit fewer, according to the study, the largest prospective study of depression during medical internship to date.

“Depressive symptoms that are present before internship predicted reported errors during internship, indicating that depression results in increased medical errors,” Dr. Srijan Sen of the University of Michigan, Ann Arbor, and colleagues wrote. “Controlling for the baseline level of depressive symptoms, a strong correlation between errors and depression persisted, indicating that errors may also cause depression and that the association between depression and reported medical errors is bidirectional.”

The authors followed 740 interns, assessing them for depressive symptoms and genetic risk prior to internship and then for symptoms and potential stressors at 3-month intervals throughout their internships.

They found a dramatic increase in depression between the last year of medical school and internship. The rate of depression rose from less than 4% prior to internship to an average of more than 25% during the internship year, according to the investigators (Arch. Gen. Psychiatry. 2010;67[doi:10.1001/archgenpsychiatry.2010.41]).

Most subjects who met the criteria for depression were moderately depressed, and few subjects met the standards for moderately severe or severe depression, the investigators wrote.

Women, and interns of either gender with history of depression, neuroticism, and a difficult early family environment, were more likely to suffer from depression, they found.

Depression during internship also was associated with a U.S. medical school education and with fewer depressive symptoms before the beginning of the internship, the investigators wrote. However, age and the medical specialty chosen had no effect on rates of depression during internship.

The data could be useful in preventing depressive symptoms among medical interns, they wrote.

“With effective interventions to help prevent the onset of depression now available, the predictive factors identified herein could allow at-risk interns to take steps before the onset of symptoms to lower their chances of developing depression,” according to Dr. Sen and colleagues.

The study was funded by grants from the Donaghue Foundation, the Department of Veterans Affairs, the American Foundation for Suicide Prevention, and the Substance Abuse and Mental Health Services Administration.

Two of the study authors reported consulting arrangements with a variety of pharmaceutical manufacturers, and one of these reported he also is a cosponsor on pending patents related to new drugs for psychiatric disorders, including depression.

_{Image above courtesy Flickr Creative Commons user "Psychedelic Tuna."}

More than 25% of medical interns suffer from depression during their internships, and depressed interns are more likely to make medical errors, a study published online April 5 in the Archives of General Psychiatry reported.

In addition, interns who commit frequent medical errors may be more likely to become depressed than their colleagues who commit fewer, according to the study, the largest prospective study of depression during medical internship to date.

“Depressive symptoms that are present before internship predicted reported errors during internship, indicating that depression results in increased medical errors,” Dr. Srijan Sen of the University of Michigan, Ann Arbor, and colleagues wrote. “Controlling for the baseline level of depressive symptoms, a strong correlation between errors and depression persisted, indicating that errors may also cause depression and that the association between depression and reported medical errors is bidirectional.”

The authors followed 740 interns, assessing them for depressive symptoms and genetic risk prior to internship and then for symptoms and potential stressors at 3-month intervals throughout their internships.

They found a dramatic increase in depression between the last year of medical school and internship. The rate of depression rose from less than 4% prior to internship to an average of more than 25% during the internship year, according to the investigators (Arch. Gen. Psychiatry. 2010;67[doi:10.1001/archgenpsychiatry.2010.41]).

Most subjects who met the criteria for depression were moderately depressed, and few subjects met the standards for moderately severe or severe depression, the investigators wrote.

Women, and interns of either gender with history of depression, neuroticism, and a difficult early family environment, were more likely to suffer from depression, they found.

Depression during internship also was associated with a U.S. medical school education and with fewer depressive symptoms before the beginning of the internship, the investigators wrote. However, age and the medical specialty chosen had no effect on rates of depression during internship.

The data could be useful in preventing depressive symptoms among medical interns, they wrote.

“With effective interventions to help prevent the onset of depression now available, the predictive factors identified herein could allow at-risk interns to take steps before the onset of symptoms to lower their chances of developing depression,” according to Dr. Sen and colleagues.

The study was funded by grants from the Donaghue Foundation, the Department of Veterans Affairs, the American Foundation for Suicide Prevention, and the Substance Abuse and Mental Health Services Administration.

Two of the study authors reported consulting arrangements with a variety of pharmaceutical manufacturers, and one of these reported he also is a cosponsor on pending patents related to new drugs for psychiatric disorders, including depression.

_{Image above courtesy Flickr Creative Commons user "Psychedelic Tuna."}