title: Prevalence and associated factors of depressive symptoms among Chinese doctors: a cross-sectional survey.
abstract: OBJECTIVE
  Doctors, the major workforce in hospitals, are doing heavy emotional and physical work which may lead to depressive symptoms. However, in China, few studies are available pertaining to the prevalence and associated factors of depressive symptoms among doctors. The aim of this study was to evaluate the prevalence of depressive symptoms and to explore its associated factors among Chinese doctors in public hospitals.
  
  
  METHODS
  This cross-sectional study was performed during the period of September/October 2008. The study population comprised of 1,890 doctors registered and working in the 20 national hospitals in Liaoning province, northeast of China. A questionnaire that comprised depressive symptoms assessed by the Chinese Version of the Center for Epidemiologic Studies Depression Scale (CES-D), demographic factors, work conditions, occupational stress, and coping strategies was distributed to these doctors. A total of 1,488 effective respondents became our subjects (effective response rate 78.7%). Multivariate logistic regression was used to explore the factors related to depressive symptoms.
  
  
  RESULTS
  The prevalence of depressive symptoms among doctors was 65.3%. Multivariate logistic analyses showed that high role insufficiency (OR 2.15, 95% CI 1.66-2.78), worse doctor-patient relationship (OR 2.07, 95% CI 1.62-2.64), having a chronic disease (OR 1.73, 95% CI 1.31-2.27), serious role boundary (OR 1.54, 95% CI 1.21-2.00), and role overload (OR 1.42, 95% CI 1.11-1.81) were positively associated with depressive symptoms; whereas adequate rational coping (OR 0.58, 95% CI 0.45-0.76) and social support (OR 0.75, 95% CI 0.57-0.98) were negatively associated with depressive symptoms.
  
  
  CONCLUSIONS
  Most Chinese doctors probably have depressive symptoms. Role insufficiency, doctor-patient relationship, and rational coping seemed to be crucial in relation to depressive symptoms. Efficient interventions such as taking further education course, improving communications with patients, and improving the ability of rational coping should be considered by health administrators aiming at improving the quality of Chinese doctors' mental health from the view point of depressive symptoms.
authors.affiliation: Department of Social Medicine, School of Public Health, China Medical University, No. 92 Beier Road, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
authors.forename: Jia-Na
authors.initials: JN
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.forename: Tie-Shuang
authors.initials: TS
authors.lastname: Chi
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
authors.forename: Lie
authors.initials: L
authors.lastname: Wang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires