Common mental disorders related to incidents and behaviour in physicians

Occup Med (Lond). 2016 Oct;66(7):506-513. doi: 10.1093/occmed/kqw030.

Abstract

Background: Common mental disorders (CMD-burnout, stress, depression and anxiety disorders) are prevalent in physicians.

Aims: To investigate the relationship between CMD and medical incidents and/or unprofessional behaviour in hospital physicians.

Methods: PubMed was searched for all articles published between 2003 and 2013 that study a relationship between CMD and medical incidents and/or unprofessional behaviour in hospital physicians. The strength of evidence was assessed through five levels of evidence.

Results: We included 15 studies. We found strong evidence for a significant association between burnout and the occurrence of medical incidents, based on two longitudinal and seven cross-sectional studies with a positive association [odds ratio (OR) 1.07-5.5]; one longitudinal study found a non-significant association (strong evidence). For the association between depression and medical incidents, four longitudinal studies and three cross-sectional studies found a significant positive association (strong evidence; OR 2.21-3.29). For the association between fatigue and medical incidents, one longitudinal study and one cross-sectional study showed a significant positive association, but one cross-sectional study showed a non-significant association (strong evidence; OR 1.37). For the association between sleepiness and medical incidents, one longitudinal study and two cross-sectional studies showed a significant positive association (strong evidence; OR 1.10-1.37). No significant association was found between burnout and unprofessional behaviour (inconsistent evidence). Nor was any evidence found for the association between unprofessional behaviour and depression, fatigue or sleepiness.

Conclusions: CMD in hospital physicians were associated with the occurrence of self-reported medical incidents, but there was inconsistent evidence for unprofessional behaviour.

Keywords: Burnout; depression; fatigue; medical error; physician; resident..

Publication types

  • Review

MeSH terms

  • Adult
  • Burnout, Professional / etiology
  • Burnout, Professional / psychology
  • Depression / etiology
  • Depression / psychology
  • Fatigue / etiology
  • Fatigue / psychology
  • Humans
  • Mental Disorders / classification*
  • Mental Disorders / psychology*
  • Physicians / psychology*
  • Prevalence*
  • Problem Behavior / psychology
  • Professional Autonomy
  • Quality of Life / psychology
  • Stress, Psychological / complications
  • Stress, Psychological / etiology