title: A survey on the impact of being depressed on the professional status and mental health care of physicians.
abstract: BACKGROUND
  Recent studies have addressed the need to better understand the nature and risk of depression and suicide in physicians.
  
  
  OBJECTIVE
  To assess the prevalence of depressive symptoms in a sample of practicing physicians, their perceptions of the impact of depression on their work lives, and their perceptions of the impact of being a physician on their pursuit of mental health care.
  
  
  METHODS
  An anonymous survey was mailed in April 2005 that included the Patient Health Questionnaire depression module (PHQ-9) and other Likert-style questions.
  
  
  METHODS
  Five thousand randomly selected practicing physicians in Michigan, from whom 1154 usable responses were received (23% response rate).
  
  
  METHODS
  The prevalence of depressive symptoms and the perceptions by respondents of the impact of depression on work roles and on their approach to seeking mental health care.
  
  
  RESULTS
  Moderate to severe depression scores were reported by 130 physicians (11.3%). Roughly one quarter of respondents reported knowing a physician whose professional standing had been compromised by being depressed. Physicians reporting moderate to severe depression were 2 to 3 times more likely to report substantial impact on their work roles compared to physicians with minimal to mild depression scores, including a decrease in work productivity (57.7% vs. 18.5%; p < .001) and a decrease in work satisfaction (90.8% vs. 36.2%; p < .001). The same physicians were 2 to 3 times more likely to report a wide range of dysfunctional and worrisome approaches to seeking mental health care compared to physicians with minimal to mild depression scores, including a higher likelihood that they would self-prescribe antidepressants (30.0% vs. 9.9%; p < .001) and a higher likelihood that they would avoid seeking treatment due to concerns about confidentiality (50.7% vs. 17.3%; p < .001).
  
  
  CONCLUSIONS
  Moderate to severe depression scores are reported by a substantial portion of practicing physicians in Michigan, with important influences on physician work roles and potential negative impact on licensing and medical staff status. The risk of being stigmatized may cause depressed physicians to alter their approach to seeking mental health care, including seeking care outside their medical community and self-prescribing antidepressants. Destigmatization of depression in physicians and interventions to improve the mental health care of physicians in ways that do not compromise their professional standing should receive more attention.
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor 48109-5239, USA. tschwenk@umich.edu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Schwenk
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Gorenflo
authors.forename: Loretta M
authors.initials: LM
authors.lastname: Leja
mesh_terms: D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011361:Professional Competence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology*