Depression and suicidal ideation high in Hong Kong doctors

A cross-sectional study in Hong Kong finds high prevalence of depressive symptoms and suicidal ideation among doctors in Hong Kong, although many remain undiagnosed of depression.

In the cross-sectional study conducted between January and April 2016, data were collected from 393 doctors (mean age, 32.8 years; male, 55.0 percent) who graduated from the University of Hong Kong in 1995–2014, through a self-administered questionnaire. A majority (84.5 percent) of respondents worked in the public sector, and 21.4 percent specialized in orthopaedic surgery, otorhinolaryngology, surgery, or ophthalmology. More than half (52.3 percent) were either single, separated or divorced. [Sci Rep 2021;doi:10.1038/s41598-021-98668-4]

The overall prevalence of depression (ie, Patient Health Questionnaire-9 [PHQ-9] score >9) and suicidal ideations and self-harm thoughts (as measured by positive response to the last item of PHQ-9) over the past 2 weeks was 16.0 percent and 15.3 percent, respectively, with a mean PHQ-9 score of 5.26.

Among those who screened positive for depression, less than half reported having been diagnosed of a mood disorder, indicating low mental health awareness and/or barriers in seeking mental health care among Hong Kong doctors with depression.

“Despite the high level of mental health morbidity, work satisfaction remained relatively high among the Hong Kong doctors. This potentially acted as a protective factor against leaving the profession or opting for early retirement,” the researchers noted.

A majority of respondents reported job satisfaction with their current job position (78.6 percent) and career choice (93.9 percent). However, 25.8 percent were classified as at-risk drinkers (ie, Alcohol Use Disorders Identification Test Version C [AUDIT-C] score ≥3), and only 75.8 percent had regular exercise (ie, ≥5 days per week for >10 min/day, or any vigorous or moderate physical activities). Respondents on average slept for only 6.7 hours per night, and 6.4 percent were previously diagnosed of a mood disorder.

Sleeping fewer hours per night was associated with an increase in PHQ-9 score (coefficient, -1.441; 95 percent confidence interval [Cl], -2.012 to -0.870; p<0.001), with every reduced hour of sleep associated with a 50 percent increase in the odds of having depression (odds ratio [OR], 0.499; 95 percent CI, 0.363 to 0.688; p<0.001)

The risk of having suicidal ideation and self-harm thoughts was reduced by 52.5 percent in respondents who were married (OR, 0.475; 95 percent CI, 0.266 to 0.849; p=0.012) and, on the other hand, increased by 31 percent in those sleeping an hour less (OR, 0.694; 95 percent CI, 0.509 to 0.948; p=0.022).

“Our study’s findings indicated high level of depressive symptoms and suicidal ideation among doctors in Hong Kong. Systems should be in place to support Hong Kong doctors to improve self-care with sufficient hours of sleep and encourage regular exercise, as poor mental health may pose a negative impact on quality of patient care,” the researchers suggested. “Physicians’ work schedules can be optimized, with well-being programmes promoted by healthcare institutions.”

“Implementing well-being curriculum in medical schools to support development of mental health self-awareness and self-care may help enhance mental health resilience and/or reduce stigma of mental health seeking among physicians,” they added. “Strategies to reduce barriers to accessing mental health care, such as introducing peer support or counselling schemes, should also be introduced.”