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Increased Depression Among Medical Interns Assessed

Genetic, individual, internship factors contribute to markedly higher rate

WEDNESDAY, April 7 (HealthDay News) -- There is a marked increase in depressive symptoms among medical interns, and there are specific genetic, individual and internship factors associated with this increase, according to research published online April 5 in the Archives of General Psychiatry.

Srijan Sen, M.D., of the University of Michigan in Ann Arbor, and colleagues conducted a prospective cohort study of 740 interns entering residency programs at 13 U.S. hospitals. They assessed the subjects for depressive symptoms prior to their internships and then assessed them for depressive symptoms and potential stressors at three-month intervals during the internships.

The researchers found an increase in the Patient Health Questionnaire-9 depression score from 2.4 before internship to 6.4 during internship; the proportion of participants meeting criteria for depression went from 3.9 to 25.7 percent. Many factors measured prior to internship -- including female sex, difficult early family environment and U.S. medical education -- were associated with a larger increase in depressive symptoms during internship, as were several factors measured during internship -- increased work hours, perceived medical errors and stressful life events. Interns with at least one copy of a less-transcribed 5-HTTLPR allele reported a greater increase in symptoms.

"Because the development of major depression has been linked to a higher risk of future depressive episodes and greater long-term morbidity risk, future studies should examine how the rate of depression changes as training physicians progress through their careers beyond internship and the possible effects of depression on the general health of physicians," the authors write.

Two authors reported financial relationships with several pharmaceutical companies.

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