Depressive symptoms increase during medical internships for both men and women, but the increase is greater among women, according to a study published in JAMA Internal Medicine.

In a prospective longitudinal cohort study, Constance Guille, MD, from the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, and colleagues recruited 3121 interns across all specialties from 44 medical institutions during the 2015/2016 academic year. Participants reported the degree to which work responsibilities interfered with family life, using the Work Family Conflict Scale, and reported depressive symptoms using the Patient Health Questionnaire-9.

The mean increase in depressive symptoms as measured by the Patient Health Questionnaire-9 was 2.50 for men vs 3.20 for women. However, when work-family conflict was accounted for, the disparity between the sexes decreased by 36%.

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Study limitations include self-report of depressive symptoms rather than diagnostic evaluation. However, this method was chosen to preserve anonymity to accurately determine the presence of depression among medical professionals. It is also possible that response patterns biased the results, as only 61% of invited interns responded, and among those, 68% completed the follow-up assessment. However, baseline and follow-up response rates were similar to or higher than those of previous studies of residents and interns.

The investigators note that depression among physicians is associated with poorer patient care and career attrition, and that efforts to reduce depression among healthcare professionals may lead to better patient care. The authors suggest that greater consideration of work-life balance and family responsibilities may help to create a medical education system that provides rigorous medical training but also promotes good mental health.


Guille C, Frank E, Zhao Z, et al. Work-family conflict and the sex difference in depression among training physicians [published online October 30, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.5138