title: Rates of medication errors among depressed and burnt out residents: prospective cohort study.
abstract: OBJECTIVE
  To determine the prevalence of depression and burnout among residents in paediatrics and to establish if a relation exists between these disorders and medication errors.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three urban freestanding children's hospitals in the United States.
  
  
  METHODS
  123 residents in three paediatric residency programmes.
  
  
  METHODS
  Prevalence of depression using the Harvard national depression screening day scale, burnout using the Maslach burnout inventory, and rate of medication errors per resident month.
  
  
  RESULTS
  24 (20%) of the participating residents met the criteria for depression and 92 (74%) met the criteria for burnout. Active surveillance yielded 45 errors made by participants. Depressed residents made 6.2 times as many medication errors per resident month as residents who were not depressed: 1.55 (95% confidence interval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001). Burnt out residents and non-burnt out residents made similar rates of errors per resident month: 0.45 (0.20 to 0.98) compared with 0.53 (0.21 to 1.33, P=0.2).
  
  
  CONCLUSIONS
  Depression and burnout are major problems among residents in paediatrics. Depressed residents made significantly more medical errors than their non-depressed peers; however, burnout did not seem to correlate with an increased rate of medical errors.
authors.affiliation: Harvard Medical School, Department of Medicine, Children's Hospital Boston, Boston, MA 02115, USA. amy.fahrenkopf@tch.harvard.edu
authors.forename: Amy M
authors.initials: AM
authors.lastname: Fahrenkopf
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Sectish
authors.forename: Laura K
authors.initials: LK
authors.lastname: Barger
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Sharek
authors.forename: Daniel
authors.initials: D
authors.lastname: Lewin
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Chiang
authors.forename: Sarah
authors.initials: S
authors.lastname: Edwards
authors.forename: Bernhard L
authors.initials: BL
authors.lastname: Wiedermann
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Landrigan
mesh_terms: D002055:Burnout, Professional / Q000150:complications*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications*; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000193:education; D011446:Prospective Studies