Open Access Research

Symptoms of depression in ICU physicians

Nathalie Embriaco13, Sami Hraiech13, Elie Azoulay23, Karine Baumstarck-Barrau34, Jean-Marie Forel13, Nancy Kentish-Barnes23, Frédéric Pochard35, Anderson Loundou34, Antoine Roch13 and Laurent Papazian13*

Author Affiliations

1 Aix-Marseille University, URMITE CNRS-UMR 7278, 13005 Marseille, France; APHM, Hôpital Nord, Réanimation des détresses respiratoires et des infections sévères, 13015, Marseille, France

2 Famirea Study Group, AP-HP, Hôpital Saint-Louis, Medical ICU, Université Paris-Diderot, Sorbonne Paris-Cité, Faculté de médecine, 1 avenue Claude Vellefaux, 75010, Paris, France

3 Aix-Marseille University, Laboratoire de Santé Publique EA3279, 13005, Marseille, France

4 APHM, Hôpitaux Sud, Service de Santé Publique et d’Information Médicale, 13009, Marseille, France

5 Clinique du Chateau de Garches, Garches, France

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Annals of Intensive Care 2012, 2:34  doi:10.1186/2110-5820-2-34

Published: 27 July 2012

Abstract

Background

Work and family are the two domains from which most adults develop satisfaction in life. They also are responsible for stressful experiences. There is a perception in the community that work is increasingly the source of much of our stress and distress. Depressive symptoms may be related to repeated stressful experiences. Intensive care unit (ICU) physicians are exposed to major stressors. However, the existence of depressive symptoms in these doctors has been poorly studied. This study was designed to evaluate the prevalence and associated risk factors of depressive symptoms in junior and senior ICU physicians.

Method

A one-day national survey was conducted in adult intensive care units (ICU) in French public hospitals. Symptoms of depression were assessed using the Centers of Epidemiologic Studies Depression Scale (CES-D).

Results

A total of 189 ICUs participated, and 901 surveys were returned (75.8% response rate). Symptoms of depression were found in 23.8% of the respondents using the CES-D scale. Fifty-eight percent of these intensivists presenting symptoms of depression wished to leave their job compared with only 33% of those who did not exhibit signs of depression as assessed by the CES-D scale (p < 0.0001). Multiple logistic regression showed that organizational factors were associated with the presence of depressive symptoms. Workload (long interval since the last nonworking weekend, absence of relief of service until the next working day after a night shift) and impaired relationships with other intensivists were independently associated with the presence of depressive symptoms. A high level of burnout also was related to the presence of depressive symptoms. In contrast, no demographic factors regarding ICU physicians and no factor related to the severity of illness of patients were retained by the model. The quality of relationships with other physicians (from other departments) was associated with the absence of depressive symptoms (protective effect).

Conclusions

Approximately one of four intensivists presented symptoms of depression. The next step could be to test whether organization modification is associated with less depressive symptoms and less desire to leave the job.

Keywords:
Intensive care unit; Organizational management; Conflict; Burnout; Depression; Physicians