1
|
Petrie K, Sanatkar S, Shand F, Harvey SB. Common mental disorder and suicidality among doctors: differences by specialty. Occup Med (Lond) 2023; 73:249-256. [PMID: 37261470 DOI: 10.1093/occmed/kqad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Common mental disorders (CMDs) and suicidal ideation (SI) are prevalent among doctors, yet limited evidence exists investigating the relationship of specialty area to these outcomes. AIMS This study aimed to determine the prevalence of likely CMD and SI among doctors and to investigate whether likelihood of these outcomes varied by area of medical specialty. METHODS A secondary analysis of a representative national survey of 12,252 Australian doctors was conducted. Demographic and work-related variables, SI and CMD (GHQ-28), were assessed among doctors (n = 7037; 57%) working in a range of specialty areas. Logistic regression was used to examine the association between specialty and mental health outcomes in unadjusted and adjusted models. RESULTS Almost one-quarter of doctors (n = 1560; 23%) reported symptom levels indicating likely CMD whilst 9% (n = 667) reported SI in the last year. Doctors in surgery (adjusted odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.54-0.97, P = 0.03) were at significantly lower risk of CMD than General Practitioners (GPs), whilst doctors in anaesthetics (adjusted OR = 1.45; 95% CI 1.09-1.93, P = 0.01) and paediatrics (adjusted OR = 1.88; 95% CI 1.02-3.47, P = 0.04) were at significantly higher risk of experiencing SI compared to GPs after accounting for confounders. CONCLUSIONS Results demonstrated that doctors in Australia working in certain specialties, specifically anaesthetics and paediatrics, were at significantly greater risk of suicidal ideation compared to GPs after accounting for confounders. Interventions to address CMD and SI among doctors in all specialties remain urgently needed.
Collapse
Affiliation(s)
- K Petrie
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S Sanatkar
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - F Shand
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| |
Collapse
|
2
|
Huang CLC. Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic. World J Psychiatry 2023; 13:131-140. [PMID: 37123097 PMCID: PMC10130963 DOI: 10.5498/wjp.v13.i4.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.
Collapse
Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 710, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| |
Collapse
|
3
|
Sun M, Li X, Yao J, Huang X, Kang Y, Li Z. Psychological status of medical staff dedicated to nucleic acid collection in COVID-19 epidemic during closed-loop management: A cross-sectional study. Front Public Health 2023; 11:1131971. [PMID: 36969671 PMCID: PMC10036577 DOI: 10.3389/fpubh.2023.1131971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundTo investigate the depression, anxiety and somnipathy situation occurred in the nucleic acid collection staff during the closed-loop management period of COVID-19. And try to understand the influencing factors of related psychological status.MethodsA cross-sectional study of 1,014 nucleic acid collection staff from seven Chinese hospitals was conducted. Various investigation methods were involved in the questionnaires to collect data, including 12-items self-made questionnaire survey of basic demographic information, 9-items patient health questionnaire depression scale (PHQ-9), 7-items generalized anxiety disorder scale (GAD-7) and Pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS version 26.0 and Excel software. Mann-Whitney U-test, Chi-square test, correlation analysis, mono-factor analysis and binary logistic regression were applied accordingly for further analysis.ResultsThe positive rate of depression, anxiety and sleep disorder of 1,014 nucleic acid collectors under closed-loop management were 33.5, 27.2, and 50.1%, respectively. Depression was significantly positively correlated with anxiety and sleep (P < 0.05). The scores of depression scale were positively correlated with the age and the fear for infection (r = 0.106, 0.218, both P < 0.05); The scores of anxiety scale were also positively correlated with the age and the fear for infection (r = 0.124, 0.225, both P < 0.05); The length of service, collection time and the degree of worry about infection and was positively correlated with the score of sleep scale (r = 0.077, 0.074, 0.195, both P < 0.05); Education level had a significant negative association with PHQ-9, GAD-7 and PSQI (r = −0.167,−0.172, both P < 0.05). Binary logistic regression analysis showed that age, technical title, education level, collection time, collection frequency, collection location, fear for infection and external environment were important influencing factors of depression, anxiety and sleep disorders.ConclusionThe results of this study suggested that when carrying out nucleic acid collection mission, managers should intervene to optimize the collection location, control the duration of each collection mission, replace the collection staff in time and pay close attention to the psychological state of the collection staff.
Collapse
Affiliation(s)
- Mingzhu Sun
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xiaowei Li
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
- *Correspondence: Xiaowei Li
| | - Jie Yao
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xi Huang
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yujuan Kang
- Department of Nursing, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Zixuan Li
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| |
Collapse
|
4
|
Chen G, Huang R, Sun B, Zhu J, Zhang H, Chen J. Multimodality Functional Magnetic Resonance Imaging Assisted Treatment of Primary Insomnia and Anxiety and Depression. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Based on multimodal functional magnetic resonance imaging technology, explore the changes of local brain function in the whole brain range of patients with primary insomnia at rest, and conduct correlation analysis to explore the relationship between this locality and function and clinical
features. Provide further imaging evidence for the exploration of the neural mechanism of primary insomnia. Using multimodal functional magnetic resonance imaging, self-rating anxiety scale, self-rating depression scale to assess the status anxiety factor and trait anxiety of STAI in patients
with primary insomnia (88 cases) and normal sleepers (82 cases). Factors and total scores, depressive mental disorders and total scores were statistically significantly different from the normal sleep group. The study found that patients with primary insomnia under the multimodal functional
magnetic resonance imaging assisted treatment have abnormal local functional activities in multiple brain regions such as emotions and sensorimotor regions. We explored the brain of patients with primary insomnia from the perspective of functional differentiation. Changes in nerve activity
are conducive to further understanding the characteristics of nerve activity in primary insomnia.
Collapse
Affiliation(s)
- Guanfeng Chen
- Department of Radiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Risheng Huang
- Department of Radiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Bingqing Sun
- Department of Radiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Jingfa Zhu
- Department of Emergency, Quanzhou First Hospital Affiliated Fujian Medical University, Quanzhou, 362000, China
| | - Hongchun Zhang
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Jieyun Chen
- Department of Radiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| |
Collapse
|
5
|
Liou YF, Li SF, Ho CC, Lee MW. Risk of insomnia and hypnotics use among emergency physicians. INDUSTRIAL HEALTH 2021; 59:99-106. [PMID: 33298645 PMCID: PMC8010163 DOI: 10.2486/indhealth.2020-0217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
This study investigated the risk of insomnia and hypnotics use among emergency physicians. This cross-sectional study recruited physicians working in Taiwanese hospitals in 2015 and the general population as the participants. Data from 1,097 emergency physicians obtained from the National Health Insurance Research Database were grouped into the case group, whereas 14,112 nonemergency physicians and 4,388 people from the general population were categorized into the control groups. This study used logistic regression and conditional logistic regression to compare the risks of insomnia between emergency and nonemergency physicians and between emergency physicians and the general population, respectively. The prevalence of insomnia among emergency physicians, nonemergency physicians and general population was 5.56%, 4.08%, and 1.73%, respectively. Compared with nonemergency physicians and the general population, emergency physicians had a significantly higher risk of insomnia. The proportions of emergency physicians, nonemergency physicians, and general population using hypnotics were 19.96%, 18.24%, and 13.26%, respectively. Among emergency physicians who used hypnotics, 49.77%, 25.57%, and 24.66% used only benzodiazepines, only nonbenzodiazepines, and both benzodiazepines and nonbenzodiazepines, respectively. Nonpharmacological interventions to improve insomnia and reminder of safe use of hypnotics to emergency physicians can serve as references for hospitals in developing health-promoting activities.
Collapse
Affiliation(s)
- Yih-Farng Liou
- Department of Internal Medicine, Feng Yuan Hospital, Ministry of Health and Welfare, Taiwan (R.O.C.)
- Institute of Medicine, Chung Shan Medical University, Taiwan (R.O.C.)
| | - Shu-Fen Li
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan (R.O.C.)
| | - Chin-Chih Ho
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan (R.O.C.)
| | - Mei-Wen Lee
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan (R.O.C.)
| |
Collapse
|
6
|
Osório FL, Silveira ILM, Pereira-Lima K, Crippa JADS, Hallak JEC, Zuardi AW, Loureiro SR. Risk and Protective Factors for the Mental Health of Brazilian Healthcare Workers in the Frontline of COVID-19 Pandemic. Front Psychiatry 2021; 12:662742. [PMID: 34393843 PMCID: PMC8355424 DOI: 10.3389/fpsyt.2021.662742] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/07/2021] [Indexed: 12/18/2022] Open
Abstract
The objective was to compare the mental health indicators of health workers providing care to individuals with COVID-19 in Brazil, considering sociodemographic and occupational variables and the risk perception of contamination by the Sars-CoV-2 of workers from different professions, identifying risk and protective factors. A sample of 916 health workers was assessed: physicians, nursing workers, and workers from other professions (psychologists, physical therapists, nutritionists, speech therapists, occupational therapists, dentists, pharmacists, and social workers). REDCAP software was used to collect data online, using standardized instruments to assess anxiety, depression, posttraumatic stress, and insomnia, and one questionnaire addressed risk and protective variables. Statistical techniques for comparing groups were used along with logistic regression analysis. The results revealed that all the groups presented indicators of significant mental health problems (>36%), especially the nursing group. A larger percentage of participants, regardless of the profession, presented a high rate of insomnia disorders, while posttraumatic stress was the least expressive. Occupational variables stand out as risk factors for mental health, with specificities among the different groups. A protective factor for all the groups was having positive professional prospects. The protective factors for the physicians group included support provided by co-workers, being older and a man, while being satisfied with physical protective measures implemented by the employing institution was a protective factor for the groups composed of nursing workers and other professionals. These findings are relevant for devising mental health care strategies.
Collapse
Affiliation(s)
- Flávia L Osório
- Medical School of Ribeirão Preto, São Paulo University, São Paulo, Brazil.,National Institute for Science and Techonology, Translational Medicine, National Council for Scientific and Technological Development, Brasília, Brazil
| | | | - Karina Pereira-Lima
- Department of Psychiatry and Medical Psychology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - José Alexandre de Souza Crippa
- Medical School of Ribeirão Preto, São Paulo University, São Paulo, Brazil.,National Institute for Science and Techonology, Translational Medicine, National Council for Scientific and Technological Development, Brasília, Brazil
| | - Jaime Eduardo Cecílio Hallak
- Medical School of Ribeirão Preto, São Paulo University, São Paulo, Brazil.,National Institute for Science and Techonology, Translational Medicine, National Council for Scientific and Technological Development, Brasília, Brazil
| | - Antônio Waldo Zuardi
- Medical School of Ribeirão Preto, São Paulo University, São Paulo, Brazil.,National Institute for Science and Techonology, Translational Medicine, National Council for Scientific and Technological Development, Brasília, Brazil
| | - Sonia Regina Loureiro
- Medical School of Ribeirão Preto, São Paulo University, São Paulo, Brazil.,National Institute for Science and Techonology, Translational Medicine, National Council for Scientific and Technological Development, Brasília, Brazil
| |
Collapse
|
7
|
Wang J, Wang W, Laureys S, Di H. Burnout syndrome in healthcare professionals who care for patients with prolonged disorders of consciousness: a cross-sectional survey. BMC Health Serv Res 2020; 20:841. [PMID: 32894132 PMCID: PMC7487695 DOI: 10.1186/s12913-020-05694-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/31/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Burnout is more common among healthcare professionals, that is an important problem of professional distress that can seriously affect healthcare professionals' emotional state, health, medical quality and doctor-patient relationship. However, only few studies researched the burnout status of healthcare professionals who care for patients with prolonged disorders of consciousness. The aim of this study was to evaluate the level of burnout and related contributing personal and environment factors in healthcare professionals managing these patients. METHODS Institution-based cross-sectional study. Maslach Burnout Inventory-Human Services Survey was used to evaluate burnout in professionals who specially care for patients with prolonged disorders of consciousness in the neurorehabilitation department. RESULTS A total of 200 questionnaires were distributed, 121 were collected, among them 93 questionnaires could be used for further analysis. In this study, 61 participants (65.6%) showed burnout (55.2% physicians and 82.9% nurses). For the risks and Maslach Burnout Inventory scores, emotional exhaustion and depersonalization were correlated with age, gender, occupation, marital status, years of practice, and education level. Reduced personal accomplishment was correlated with marital status. The variables of age (< 29 years old), occupation (nurses), marital status (unmarried), years of practice (< 5 years), and educational level (≤ Undergraduate) were associated with high levels of burnout. CONCLUSIONS Healthcare professionals who care for patients with disorders of consciousness experienced high levels of burnout. Especially those who were younger, nurse, unmarried, less practice experience or lower educational levels were more likely to experience high burnout.
Collapse
Affiliation(s)
- Jing Wang
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, 310036, China
| | - Wenting Wang
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, 310036, China
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University and University Hospital of Liège, Liège, Belgium
| | - Haibo Di
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, 310036, China.
| |
Collapse
|
8
|
Alnajashi SS, Alayed SA, Al-Nasher SM, Aldebasi B, Khan MM. Will surgeries performed at night lead to worse outcomes? Findings from a trauma center in Riyadh. Medicine (Baltimore) 2020; 99:e20273. [PMID: 32769860 PMCID: PMC7593025 DOI: 10.1097/md.0000000000020273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
As surgeries are performed around the clock, the time of surgery might have an impact on outcomes. Our aim is to investigate the impact of daytime and nighttime shifts on surgeons and their performance. We believe that such studies are important to enhance the quality of surgeries and their outcomes and help understand the effects of time of the day on surgeons and the surgeries they perform.A retrospective cohort study was conducted using the database from the King Abdulaziz Medical City trauma center. We selected 330 cases of patients between 2015 and 2018, who underwent a trauma intervention surgery within 24 hours after admission. Patients were aged 15 years and above who underwent 1 or more of the following trauma interventions: neurosurgery, general surgery, plastic surgery, vascular surgery, orthopedics, ophthalmology, and/or otolaryngology. We divided the work hours into 3 shifts: 8 AM to 3:59 PM, 4 PM to 11:59 PM, and midnight to 7:59 AM.Participants' mean age was 31.4 (standard deviation ± 13) years. Most surgeries occurred on weekdays (68.4%). Complications were one and a half times more on weekends, with 5 complicated cases on weekends (1.55%) and 3 (0.9%) on weekdays. Half of all surgeries were performed in the morning (152 cases, 53.15%); 73 surgeries (25.5%) were performed in the evening and 61 (21.3%) were performed late at night. Surgeries performed during late-night shifts were marginally better. Complications occurred in 4 out of 152 morning surgeries (2.6%), 2 out of 73 evening surgeries (2.7%), and only 1 out of 61 late-night surgeries (1.6%). The earlier comparison scored a P-value of >.99, suggesting that patients in morning and evening surgeries were twice more likely to experience complications than late-night surgeries.This study may support previous research that there is little difference in outcomes between daytime and nighttime surgeries. The popular belief that rested physicians are better physicians requires further assessment and research.
Collapse
Affiliation(s)
| | | | | | - Bader Aldebasi
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | |
Collapse
|
9
|
Sun GW, Yang YL, Yang XB, Wang YY, Cui XJ, Liu Y, Xing CZ. Preoperative insomnia and its association with psychological factors, pain and anxiety in Chinese colorectal cancer patients. Support Care Cancer 2019; 28:2911-2919. [PMID: 31758321 DOI: 10.1007/s00520-019-05151-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/24/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Sleep disturbances are common in cancer patients, but little is known about preoperative insomnia and its associated factors in colorectal cancer (CRC) patients. The aim of this study was to clarify the relationship between preoperative insomnia and its associated factors (i.e., pain, anxiety, self-esteem, and coping styles) in CRC patients. METHODS A cross-sectional study was conducted in consecutive CRC inpatients (N = 434), who were required to complete the questionnaires about insomnia, pain, anxiety, self-esteem, and coping styles (acceptance/resignation, confrontation, avoidance) before the day of surgery. Hierarchical regression analyses were conducted to explore the relationships between preoperative anxiety and its associated factors. RESULTS Based on the cutoff value of Athens Insomnia Scale (scores ≥ 6) in Chinese cancer patients, the prevalence of insomnia was 38.2% before surgery. Pain (β = 0.087, p = 0.015) and anxiety (β = 0.372, p < 0.001) were positively associated with preoperative insomnia, while self-esteem (β = - 0.479, p < 0.001) and confrontation coping (β = - 0.124, p = 0.003) showed protective effects on preoperative insomnia when putting them together into hierarchical regression. The associated factors together accounted for an additional variance of preoperative insomnia (47.6%). CONCLUSIONS In line with previous findings, the detrimental effects of pain and anxiety on preoperative insomnia were also observed in our study. More importantly, our main new findings were that self-esteem and confrontation coping played important roles in alleviating preoperative insomnia among CRC patients. Clinicians should take these results into account when developing cancer care management to relieve preoperative insomnia.
Collapse
Affiliation(s)
- Guang-Wei Sun
- Department of Anorectal, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yi-Long Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Xue-Bin Yang
- Dalian Seventh People's Hospital, Dalian, Liaoning, PR China
| | - Yin-Yin Wang
- Dalian Seventh People's Hospital, Dalian, Liaoning, PR China
| | - Xue-Jiao Cui
- Psychological Clinic, The Second Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ying Liu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
| | - Cheng-Zhong Xing
- Department of Anorectal, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
| |
Collapse
|
10
|
Huang CLC, Wu MP, Ho CH, Wang JJ. Risks of treated anxiety, depression, and insomnia among nurses: A nationwide longitudinal cohort study. PLoS One 2018; 13:e0204224. [PMID: 30252873 PMCID: PMC6155527 DOI: 10.1371/journal.pone.0204224] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 09/05/2018] [Indexed: 01/15/2023] Open
Abstract
The high level of occupational stress and burnout among nurses can lead to insomnia, anxiety, and depression. However, the actual risks for healthcare-seeking for these stress-related mental health problems among nurses are still unclear. The aim of this study was to explore the risks and influencing factors of treated anxiety, depression, and insomnia among nurses. We used claims data obtained from the 2010 National Health Insurance Research Database (NHIRD) in Taiwan. Hospital nurses who had at least 3 coded ambulatory care claims or 1 inpatient claim with a principal diagnosis of anxiety, depression, or insomnia were identified. A cohort of 46,120 nurses and 92,240 matched controls were included. All the study subjects were followed up until the onset of any of the aforementioned outcomes, death, or the end of 2012. Results showed that the adjusted hazard ratios (HRs) for treated anxiety, depression, and insomnia among all the nurses were 0.91 (95% CI, 0.88–0.95), 0.59 (95% CI, 0.55–0.63), and 1.43 (95% CI, 1.38–1.48), respectively. Furthermore, the risks of these psychiatric problems in healthcare-seeking nurses were affected by age, gender, hospital level, and job tenure. Our findings suggest that hospital nurses have lower hazards of treated anxiety and depression than the general population, although they have a higher hazard of treated insomnia. There may be undertreatment in some subgroups of nurses with different demographic and working characteristics.
Collapse
Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
- Department of Social Work, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
- * E-mail:
| | - Ming-Ping Wu
- Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan
- Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| |
Collapse
|
11
|
Lin YC, Lai CC, Chien CC, Chen CM, Chiang SR, Ho CH, Weng SF, Cheng KC. Is insomnia a risk factor for new-onset asthma? A population-based study in Taiwan. BMJ Open 2017; 7:e018714. [PMID: 29187415 PMCID: PMC5719310 DOI: 10.1136/bmjopen-2017-018714] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To determine whether insomnia at baseline is a risk factor for new-onset asthma. METHODS We recruited 48 871 patients with insomnia (insomnia group) newly diagnosed between 2002 and 2007, and 97 742 matched controls without insomnia (control group) from Taiwan's Longitudinal Health Insurance Database 2000. All of the patients were followed up for 4 years to see whether new-onset asthma developed. Patients with previous asthma or insomnia were excluded. The Poisson regression was used to estimate the incidence rate ratios (IRRs) and 95% CIs of asthma. Cox proportional hazard regression was used to calculate the risk of asthma between the two groups. RESULTS After a 4-year follow-up, 424 patients in the insomnia group and 409 in the control group developed asthma. The incidence rate of asthma was significantly higher in the insomnia group (22.01vs10.57 per 10 000 person-years). Patients with insomnia have a higher risk of developing new-onset asthma during the 4-year follow-up (HR: 2.08, 95% CI 1.82 to 2.39). The difference remained significant after adjustment (adjusted HR: 1.89, 95% CI 1.64 to 2.17). CONCLUSIONS This large population-based study suggests that insomnia at baseline is a risk factor for developing asthma.
Collapse
Affiliation(s)
- Yu-Chieh Lin
- Department of Family Medicine, Jiannren Hospital, Kaohsiung, Taiwan
| | - Chih-Cheng Lai
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan
| | - Chih-Chiang Chien
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
| | - Chin-Ming Chen
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shyh-Ren Chiang
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
- Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
- Department of Safety, Health, and Environmental Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan
| |
Collapse
|
12
|
Chen PJ, Huang CLC, Weng SF, Wu MP, Ho CH, Wang JJ, Tsai WC, Hsu YW. Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study. Sleep Med 2017; 38:122-129. [PMID: 29031746 DOI: 10.1016/j.sleep.2017.07.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/23/2017] [Accepted: 07/03/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. METHODS Participants were identified from National Health Insurance enrollees in Taiwan during 2002-2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. RESULTS Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42-26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p < 0.0001). CONCLUSION Our findings reinforce the clinical predictor role of insomnia in the future onset of anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes.
Collapse
Affiliation(s)
- Ping-Jen Chen
- Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Charles Lung-Cheng Huang
- Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan; Department of Social Work, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Ping Wu
- Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Wan-Chi Tsai
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Wen Hsu
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| |
Collapse
|
13
|
Depressive symptoms and correlates among village doctors in China. Asian J Psychiatr 2017; 28:188-192. [PMID: 28711838 DOI: 10.1016/j.ajp.2017.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/09/2017] [Accepted: 07/02/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Village doctors are primary care physicians at the grass root-level of rural medical and health institutions in China. Their depression can increase medical errors and affect quality of medical care services. This study aims to examine depressive symptoms and their correlates among Chinese village doctors. METHODS A total of 616 village doctors were recruited from Zoucheng County of Shandong province. The Center for Epidemiologic Studies Depression Scale (CES-D), the Duke Social Support Index (DSSI) and the Simplified Coping Style Questionnaire (SCSQ) were used to measure depressive symptoms in the last week, social support and coping styles, respectively. Logistic regression model was conducted to identify the associated factors of depressive symptoms among village doctors. RESULTS The prevalence rate of depressive symptoms was 27.4% (28.54% for males, 24.69% for females). Logistic regression analysis found that body mass index (BMI), poor physical health, low educational level, and negative coping styles were associated with increased risk of depressive symptoms. Positive coping styles were associated with decreased risk of depressive symptoms in village doctors. CONCLUSIONS Depressive symptoms are prevalent among village doctors in China. They need to adopt more positive coping strategies to respond to negative emotions. More professional and medical trainings may be important to reduce risk of depressive symptoms and improve their quality of healthcare among village doctors in China.
Collapse
|
14
|
Chen TY, Hsu CC, Feng IJ, Wang JJ, Su SB, Guo HR, Huang CC, Lin HJ. Higher risk for thyroid diseases in physicians than in the general population: a Taiwan nationwide population-based secondary analysis study. QJM 2017; 110:163-168. [PMID: 27521582 DOI: 10.1093/qjmed/hcw140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Physicians have high work stress, responsibility for night shifts and chances of exposure to medical radiation, which may increase the risk for thyroid diseases. AIM We conducted this study to assess the risk for thyroid diseases in physicians, which remain unclear. DESIGN We used a secondary analysis of the Taiwan National Health Insurance Research Database for this study. METHODS After excluding thyroid diseases occurring before 2006 and residents, physicians and general population were identified by matching with age and sex in 2009 in a 1:2 ratio. The risk for thyroid diseases was compared between the physicians and general population and among physicians by tracing their medical histories between 2006 and 2012. RESULTS In total, 28,649 physicians and 57,298 general population were identified. Physicians had a higher risk for overall thyroid diseases than the general population [odds ratio (OR): 1.27; 95% confidence interval (CI): 1.10-1.47], including individual thyroid disease: thyroid cancer (OR: 1.89; 95% CI: 1.22-2.95), hypothyroidism (OR: 1.64; 95% CI: 1.23-2.18) and thyroiditis (OR: 1.48; 95% CI: 1.00-2.19). CONCLUSIONS We showed that physicians had a significantly higher risk for thyroid diseases than the general population. This reminds us to pay more attention to thyroid diseases in physicians. Further studies about the underlying mechanisms are warranted.
Collapse
Affiliation(s)
- T-Y Chen
- From the Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan 710, Taiwan
- Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan 711, Taiwan
| | - C-C Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
| | - I-J Feng
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - J-J Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - S-B Su
- Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Medical Research, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan
| | - H-R Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - C-C Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan 710, Taiwan
| | - H-J Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
- Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan
| |
Collapse
|
15
|
Lee YS, Hsu CC, Weng SF, Lin HJ, Wang JJ, Su SB, Huang CC, Guo HR. Cancer Incidence in Physicians: A Taiwan National Population-based Cohort Study. Medicine (Baltimore) 2015; 94:e2079. [PMID: 26632715 PMCID: PMC5058984 DOI: 10.1097/md.0000000000002079] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76-0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73-0.94); and female physicians did not (HR 1.29, 95% CI 0.88-1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12-2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11-3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms.
Collapse
Affiliation(s)
- Yu-Sung Lee
- From the Department of Emergency Medicine, Chi-Mei Medical Center (Y-SL, C-CH, H-JL, C-CH); Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan (C-CH, H-JL); Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung (S-FW); Department of Emergency Medicine, Taipei Medical University, Taipei (H-JL); Department of Medical Research, Chi-Mei Medical Center (J-JW); Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology (S-BS); Department of Occupational Medicine, Chi-Mei Medical Center (S-BS, C-CH); Department of Medical Research, Chi-Mei Medical Center, Liouying (S-BS); Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University (C-CH, H-RG); Department of Child Care and Education, Southern Taiwan University of Science and Technology (C-CH); Department of Geriatrics and Gerontology, Chi-Mei Medical Center (C-CH); and Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan (H-RG)
| | | | | | | | | | | | | | | |
Collapse
|