title: Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns.
abstract: OBJECTIVE
  To explore the relationships between sleep deprivation and the evolution of mood disturbances, empathy, and burnout among a cohort of interns.
  
  
  METHODS
  In 2002-03, 47 interns in the internal medicine resident program at the University of Pennsylvania School of Medicine completed the following instruments at baseline and at year end: sleep quantities, Epworth Sleepiness Scale, the Beck Depression Inventory-Short Form, the Interpersonal Reactivity Index, and the Maslach Burnout Inventory-Human Services Survey. The prevalences of acute and chronic sleep deprivation, subjective sleepiness, burnout, empathy, and depression at the beginning of the year were compared to prevalences at the end of internship. Associations between sleep deprivation and mood, empathy, or burnout were explored.
  
  
  RESULTS
  The prevalence of chronic sleep deprivation, depression, burnout, and empathy increased from baseline to year end. Specifically, the prevalence of "high" scores changed for chronic sleep deprivation (9% to 43%, p = .0001). The prevalence of moderate depression increased from 4.3% to 29.8% (p = .0002). Only 4.3% reported a high level of burnout initially compared with 55.3% at year end (p < .0001). Scores that were originally more favorable than general population norms (p < .001) approached norms at the end of the year for empathic concern (p = .15). There was an association between becoming chronically sleep deprived and becoming depressed (OR = 7, p = .014).
  
  
  CONCLUSIONS
  Given the association between chronic sleep deprivation and mood disturbances during internship, outcome assessment is warranted to see if duty-hour reform will translate into more hours slept or fewer hours worked, coincident with improved mood.
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. Ilene.Rosen@uphs.upenn.edu
authors.forename: Ilene M
authors.initials: IM
authors.lastname: Rosen
authors.forename: Phyllis A
authors.initials: PA
authors.lastname: Gimotty
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bellini
mesh_terms: D000704:Analysis of Variance; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000453:epidemiology; D004645:Empathy; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D010561:Personnel Staffing and Scheduling; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000523:psychology; D018709:Statistics, Nonparametric