[Anxiety and depression in residents - results of a Swiss longitudinal study].
OBJECTIVE
The study investigates the development of anxiety and depression during residents' postgraduate training as well as the symptom patterns and the prediction of these patterns of impaired affectivity by personality factors. It furthermore regards the differences between these patterns in workplace- and career-related factors as well as in worklife balance.


METHODS
In a prospective cohort study (2001-2007), 390 junior physicians of various specialties (54.9% females, 45.1% males) were investigated with respect to the percentage of participants with elevated anxiety and depression scores at the beginning of the second, fourth, and sixth year of residency, respectively. Symptom patterns were evaluated by two-step cluster analysis. The prediction of the assignment to the symptom patterns was investigated by logistic regression analysis. The differences in further factors between the two patterns was analyzed by t-tests.


RESULTS
In the second year of residency, relevant anxiety symptoms were found in 30% of the physicians, and in the fourth and sixth year in 20%; relevant depression symptoms were found in 15% and 10%, respectively. The cluster analysis revealed two symptom patterns: Type A (n = 135, 34.6%) with continuously elevated anxiety and depression symptoms; and type B (n = 255, 65.4%) with continuously low values. Personality factors such as the sense of coherence, self-esteem, occupational self-efficacy expectation, and overcommitment significantly predicted the assignment to the symptom patterns. Also in terms of workload, mentoring experience, career satisfaction, and worklife balance, persons of type A differ from those of type B.


CONCLUSIONS
Personality factors play an important role in physicians' ability to cope with job demands. Persons with an elevated vulnerability for anxiety and depression should be continuously supported and counselled by a mentor during residency.
Abteilung Psychosoziale Medizin, Universitätsspital Zürich, Haldenbachstr. 18, CH-8091 Zürich. barbara.buddeberg@usz.ch
Barbara
B
Buddeberg-Fischer
Martina
M
Stamm
Claus
C
Buddeberg
Richard
R
Klaghofer
D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002605:Character; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D007588:Job Satisfaction; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D013557:Switzerland; D014434:Type A Personality; D016526:Workload / Q000523:psychology