The Association of Experienced Long Working Hours and Depression, Anxiety, and Suicidal Ideation Among Chinese Medical Residents During the COVID-19 Pandemic: A Multi-Center Cross-Sectional Study

References

• Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the Global Burden of Disease study. J Psychiatr Res. 2019;126:134–140. doi:10.1016/j.jpsychires.2019.08.002
   PubMed Web of Science ®Google Scholar
• Stein MB, Sareen J. Generalized anxiety disorder. N Engl J Med. 2015;373:2059–2068. doi:10.1056/NEJMcp1502514
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
   Google Scholar
• Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both. Br J Psychiatry. 2013;202(1):22–27. doi:10.1192/bjp.bp.112.112169
   PubMed Web of Science ®Google Scholar
• Lasserre AM, Marti-Soler H, Strippoli MP, et al. Clinical and course characteristics of depression and all-cause mortality: a prospective population-based study. J Affect Disord. 2016;189:17–24. doi:10.1016/j.jad.2015.09.010
   PubMed Web of Science ®Google Scholar
• Sareen J, Jacobi F, Cox BJ, Belik SL, Clara I, Stein MB. Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions. Arch Intern Med. 2006;166:2109–2116. doi:10.1001/archinte.166.19.2109
   PubMed Web of Science ®Google Scholar
• Robinson J, Sareen J, Cox BJ, Bolton JM. Role of self-medication in the development of comorbid anxiety and substance use disorders: a longitudinal investigation. Arch Gen Psychiatry. 2011;68:800–807. doi:10.1001/archgenpsychiatry.2011.75
   PubMed Web of Science ®Google Scholar
• GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858. PMID: 30496104; PMCID: PMC6227754. doi:10.1016/S0140-6736(18)32279-7
   PubMed Web of Science ®Google Scholar
• Kessler RC, Berglund P, Demler O, et al.; NationalComorbidity Survey, R. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication(NCS-R). JAMA. 2003;289(23):3095–3105. doi:10.1001/jama.289.23.3095
   PubMed Web of Science ®Google Scholar
• Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43(5):897–910. PMID: 22781489. doi:10.1017/S003329171200147X
   PubMed Web of Science ®Google Scholar
• COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700–1712. DOI:10.1016/S0140-6736(21)02143-7
   PubMed Web of Science ®Google Scholar
• Farooq S, Tunmore J, Wajid Ali M, et al. Suicide, self-harm and suicidal ideation during COVID-19: a systematic review. Psychiatry Res. 2021;306:114228. doi:10.1016/j.psychres.2021.114228
   PubMed Web of Science ®Google Scholar
• Harvey SB, Epstein RM, Glozier N, et al. Mental illness and suicide among physicians. Lancet. 2021;398(10303):920–930. doi:10.1016/S0140-6736(21)01596-8
   PubMed Web of Science ®Google Scholar
• Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373–2383. PMID: 26647259; PMCID: PMC4866499. doi:10.1001/jama.2015.15845
   PubMed Web of Science ®Google Scholar
• Grande RAN, Berdida DJE, Paulino RRJC, Anies EA, Ebol RRT, Molina RR. The multidimensionality of anxiety among nursing students during COVID-19 pandemic: a cross-sectional study. Nurs Forum. 2022;57(2):267–276. PMID: 34811767; PMCID: PMC9011543. doi:10.1111/nuf.12675
   PubMed Web of Science ®Google Scholar
• Berdida DJE, Grande RAN. Academic stress, COVID-19 anxiety, and quality of life among nursing students: the mediating role of resilience. Int Nurs Rev. 2023;70(1):34–42. PMID: 35639606; PMCID: PMC9347892. doi:10.1111/inr.12774
   PubMed Web of Science ®Google Scholar
• Chang Q, Xia Y, Bai S, et al. Association between Pittsburgh sleep quality index and depressive symptoms in Chinese resident physicians. Front Psychiatry. 2021;12:564815. doi:10.3389/fpsyt.2021.564815
   PubMed Web of Science ®Google Scholar
• Fang H, Zhao X, Yang H, et al. Depressive symptoms and workplace-violence-related risk factors among otorhinolaryngology nurses and physicians in Northern China: a cross-sectional study. BMJ Open. 2018;8:e019514. doi:10.1136/bmjopen-2017-019514
   PubMedGoogle Scholar
• West CP, Huschka MM, Novotny PJ, et al. of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071–1078. doi:10.1001/jama.296.9.1071
   PubMed Web of Science ®Google Scholar
• Virtanen M, Ferrie JE, Singh-Manoux A, et al. Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study. Psychol Med. 2011;41(12):2485–2494. PMID: 21329557; PMCID: PMC3095591. doi:10.1017/S0033291711000171
   PubMed Web of Science ®Google Scholar
• Bannai A, Tamakoshi A. The association between long working hours and health: a systematic review of epidemiological evidence. Scand J Work Environ Health. 2014;40(1):5–18. PMID: 24100465. doi:10.5271/sjweh.3388
   PubMed Web of Science ®Google Scholar
• Axelrod L, Shah DJ, Jena AB. The European Working Time Directive: an uncontrolled experiment in medical care and education. JAMA. 2013;309(5):447–448. doi:10.1001/jama.2012.148065
   PubMed Web of Science ®Google Scholar
• Pattani R, Wu PE, Dhalla IA. Resident duty hours in Canada: past, present and future. CMAJ. 2014;186(10):761–765. doi:10.1503/cmaj.131053
   PubMed Web of Science ®Google Scholar
• National Health and Family Planning Commission, State Commission Office for Public Sector Reform (SCOPSR), National Development and Reform Commission, Ministry of Education, Ministry of Finance, Ministry of Human Resources and Social Security, State Administration of Traditional Chinese Medicine. Guiding opinions on establishing the standardised residency training system; 2013. Available from: http://www.moh.gov.cn/qjjys/s3593/201401/032c8cdf2eb64a369cca4f9b76e8b059.shtml. Accessed November 15, 2015.
   Google Scholar
• Crisp N, Chen L. Global supply of health professionals. N Engl J Med. 2014;370:950–957. doi:10.1056/NEJMra1111610
   PubMed Web of Science ®Google Scholar
• Wu LX, Qi L, Li Y. Challenges faced by young Chinese doctors. Lancet. 2016;387(10028):1617. PMID: 27116071. doi:10.1016/S0140-6736(16)30202-1
   PubMed Web of Science ®Google Scholar
• Chen S, Pan Y, Yao Q, et al. Publication pressure on Chinese doctors--another view. Lancet. 2014;384:956. doi:10.1016/S0140-6736(14)61630-5
   PubMed Web of Science ®Google Scholar
• Shan HP, Yang XH, Zhan XL, et al. Overwork is a silent killer of Chinese doctors: a review of Karoshi in China 2013–2015. Public Health. 2017;147:98–100. doi:10.1016/j.puhe.2017.02.014
   PubMed Web of Science ®Google Scholar
• Ma Q. An analysis of the causes of frequent cases of violent injuries. Natl Med J China. 2014;94:1368–1370.
   Google Scholar
• Weaver MD, Landrigan CP, Sullivan JP, et al. The association between resident physician work-hour regulations and physician safety and health. Am J Med. 2020;133(7):e343–e354. PMID: 32061733; PMCID: PMC7469904. doi:10.1016/j.amjmed.2019.12.053
   PubMed Web of Science ®Google Scholar
• Volpp KG, Rosen AK, Rosenbaum PR, et al. Mortality among hospitalized Medicare beneficiaries in the first 2 years following ACGME resident duty hour reform. JAMA. 2007;298(9):975–983. PMID: 17785642. doi:10.1001/jama.298.9.975
   PubMed Web of Science ®Google Scholar
• Poulose BK, Ray WA, Arbogast PG, et al. Resident work hour limits and patient safety. Ann Surg. 2005;241(6):847–56;discussion 856–60. PMID: 15912034; PMCID: PMC1357165. doi:10.1097/01.sla.0000164075.18748.38
   Web of Science ®Google Scholar
• Craig CL, Marshall AL, Sjöström M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–1395. doi:10.1249/01.MSS.0000078924.61453.FB
   PubMed Web of Science ®Google Scholar
• Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213. doi:10.1016/0165-1781(89)90047-4
   PubMed Web of Science ®Google Scholar
• Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. doi:10.1001/archinte.166.10.1092
   PubMed Web of Science ®Google Scholar
• Fu Y, Schwebel DC, Hu G. Physicians’ Workloads in China: 1998–2016. Int J Environ Res Public Health. 2018;15:1649. doi:10.3390/ijerph15081649
   PubMed Web of Science ®Google Scholar
• Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. doi:10.1046/j.1525-1497.2001.016009606.x
   PubMed Web of Science ®Google Scholar
• Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192:98–105. doi:10.1192/bjp.bp.107.040113
   PubMed Web of Science ®Google Scholar
• Cao Y. Doctors’ Karoshi into the pain of industry. China Hosp CEO. 2015;2:52e4. in Chinese.
   Google Scholar
• Virtanen M, Jokela M, Madsen IE, et al. Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data. Scand J Work Environ Health. 2018;44(3):239–250. PMID: 29423526. doi:10.5271/sjweh.3712
   PubMed Web of Science ®Google Scholar
• Ogawa R, Seo E, Maeno T, Ito M, Sanuki M, Maeno T. The relationship between long working hours and depression among first-year residents in Japan. BMC Med Educ. 2018;18(1):50. PMID: 29587738; PMCID: PMC5870810. doi:10.1186/s12909-018-1171-9
   PubMed Web of Science ®Google Scholar
• Pereira-Lima K, Gupta RR, Guille C, Sen S. Residency program factors associated with depressive symptoms in internal medicine interns: a prospective cohort study. Acad Med. 2019;94(6):869–875. PMID: 30570500; PMCID: PMC6538448. doi:10.1097/ACM.0000000000002567
   PubMed Web of Science ®Google Scholar
• Nair N, Ng CG, Sulaiman AH. Depressive symptoms in residents of a tertiary training hospital in Malaysia: the prevalence and associated factors. Asian J Psychiatr. 2021;56:102548. PMID: 33454562. doi:10.1016/j.ajp.2021.102548
   PubMed Web of Science ®Google Scholar
• Jovanović N, Beezhold J, Tateno M, et al. Depression and suicidality among psychiatric residents - results from a multi-country study. J Affect Disord. 2019;249:192–198. PMID: 30772747. doi:10.1016/j.jad.2019.02.023
   PubMed Web of Science ®Google Scholar
• Griep RH, Almeida MDCC, Barreto SM, et al. Working from home, work-time control and mental health: results from the Brazilian longitudinal study of adult health (ELSA-Brasil). Front Psychol. 2022;13:993317. PMID: 36262442; PMCID: PMC9574257. doi:10.3389/fpsyg.2022.993317
   PubMed Web of Science ®Google Scholar
• Pariante CM, Lightman SL. The HPA axis in major depression: classical theories and new developments. Trends Neurosci. 2008;31(9):464–468. doi:10.1016/j.tins.2008.06.006
   PubMed Web of Science ®Google Scholar
• Ursin R. Serotonin and sleep. Sleep Med Rev. 2002;6:55–69. doi:10.1053/smrv.2001.0174
   PubMed Web of Science ®Google Scholar
• Mahar I, Bambico FR, Mechawar N, Nobrega JN. Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects. Neurosci Biobehav Rev. 2014;38:173–192. doi:10.1016/j.neubiorev.2013.11.009
   PubMed Web of Science ®Google Scholar