The prevalence and risk factors for major depression and suicidal ideation in medical residents based on a large multi-center cross-sectional study using the propensity score-matched method

Abstract

Introduction: We determined the prevalence of major depression and suicidal ideation, and the associated risk factors in a large sample of Chinese resident physicians.

Methods: This multi-center cross-sectional study was conducted from December 2019 to February 2020 and involved 1343 residents from eight centers. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depression, perceived organization support, psychological capital, and burnout. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression.

Results: Of the residents enrolled in the study, 12.90% suffered from major depression and 9.70% suffered from suicidal ideation. Four overlapped independent risk factors were identified for major depression and suicidal ideation: poor sleep quality (OR = 1.317, OR = 1.200); lower optimism of psychological capital (OR = 0.899, OR = 0.835); higher depersonalization, (OR = 1.086, OR = 1.097); and reduced personal accomplishment (OR = 0.963, OR = 0.962). The inappropriate working duration weekly (< 40 h vs. 40-60 h; OR = 2.812, > 60 h vs. 40-60 h; OR = 1.945), and higher emotional exhaustion (OR = 1.121) were the only risk factors for major depression. Higher hope of psychological capital (OR = 1.077) was only for suicidal ideation.

Conclusion: This study revealed a substantial prevalence of major depression and suicidal ideation in Chinese residents, and identified several shared risk factors for major depression and suicidal ideation. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional studies that investigate intervention strategies that can address the mental health in residents.

Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027707. Registered 24 Nov. 2019, http://www.chictr.org.cn/index.aspx.

Keywords: Burnout; Depression; Resident; Risk factors; Sleep quality.