The impact of job stress and working conditions on mental health problems among junior house officers. A nationwide Norwegian prospective cohort study

Abstract

Context: Previous studies have shown that physicians have an increased risk of mental health problems such as depression, suicide and substance abuse.

Objectives: To study the prevalence of mental health problems during the first postgraduate year, and to investigate whether work-related factors in hospital are linked to these, when we control for gender, previous mental health problems, personality traits, stress in medical school and other possible predictors.

Design: Nationwide and prospective postal questionnaire survey.

Setting: University of Oslo.

Subjects: Medical students who answered questionnaires in their graduating semester, and 1 year later when they were junior house officers (n=371).

Results: Mental health problems (needing treatment) during internship were reported by 11%, with no gender difference. Adjusted predictors of mental health problems were: previous mental health problems, (odds ratio (OR)=5.1, 95% confidence interval (CI) 1.7 to 15.8); being married/cohabitant (OR=0.2, CI 0.1 to 0.7); the personality trait 'vulnerability' (OR=1.5, CI 1.1 to 2.0); negative life events during internship (OR=2.1, CI 1.2 to 3.5), and job stress as house officer (OR=1.05, CI 1.01 to 1.10). The job stress factor of emotional pressure/demands from patients was most important. Perceived study stress and lack of skills at the end of medical school were univariately related to mental health problems in internship, but not when other variables were adjusted. Gender, weekly working hours and lack of sleep were not linked to having problems.

Conclusion: Job stress is related to mental health problems among young doctors, even when the variables of previous mental health problems and personality traits are controlled for. More support during internship is needed.