title: Work-related stress and depression among practicing emergency physicians: an international study.
abstract: OBJECTIVE
  To compare the levels of work-related stress and depression reported by practicing emergency physicians in three survey sites and to determine the effects of gender and marital status on the stress and depression experienced by these physicians.
  
  
  METHODS
  Cross-sectional mail surveys.
  
  
  METHODS
  Seven hundred sixty-four practicing emergency physicians from the United States, 91 fellows in full-time practice from Australasia, and 154 consultants and 47 senior registrars from the United Kingdom.
  
  
  METHODS
  Administration of questionnaires requesting demographic information and including an inventory to assess work-related stress and a scale to measure depressive symptomatology.
  
  
  RESULTS
  A 3 x 2 x 2 multivariate analysis of variance performed to compare scores on the stress inventory and depression scale simultaneously by survey site, gender, and marital status revealed significant differences in stress and depression by survey site and marital status. Univariate analyses of variance revealed significant differences in both stress and depression among the three survey sites and in depression by marital status. Adjusted means indicated that physicians from the United Kingdom reported higher levels of stress and depression than physicians from the United States and Australasia. Physicians from the United States and Australasia did not differ with respect to stress or depression. Physicians who were not married reported higher levels of depression than married physicians. No large mean differences, actual or adjusted, were found for any of the grouping factors.
  
  
  CONCLUSIONS
  Statistical differences among practicing emergency physicians from the United States, Australasia, and the United Kingdom were observed, but the actual levels of work-related stress and depression were similar and did not appear severe. Marriage was associated with lower levels of depressive symptomatology.
authors.affiliation: Office of Medical Education, East Carolina University School of Medicine, Greenville, NC.
authors.forename: T W
authors.initials: TW
authors.lastname: Whitley
authors.forename: E J
authors.initials: EJ
authors.lastname: Allison
authors.forename: M E
authors.initials: ME
authors.lastname: Gallery
authors.forename: R A
authors.initials: RA
authors.lastname: Cockington
authors.forename: P
authors.initials: P
authors.lastname: Gaudry
authors.forename: J
authors.initials: J
authors.lastname: Heyworth
authors.forename: D A
authors.initials: DA
authors.lastname: Revicki
mesh_terms: D000704:Analysis of Variance; D001315:Australia / Q000453:epidemiology; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003625:Data Collection; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D009520:New Zealand / Q000453:epidemiology; D010815:Physician Impairment / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D000078329:Workforce