title: Depressive symptoms in junior doctors: a follow-up study on work-related determinants.
abstract: OBJECTIVE
  The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors-a professional group that is vulnerable to depression.
  
  
  METHODS
  We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3.
  
  
  RESULTS
  The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25-1.50) and negatively by professional tenure (0.54; 0.31-0.96), free weekends (0.52; 0.28-0.97), and job autonomy (0.35; 0.18-0.65).
  
  
  CONCLUSIONS
  After controlling for demographic and working time influences, findings suggest that junior doctors' perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice.
authors.affiliation: Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany. matthias.weigl@med.lmu.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Weigl
authors.forename: Severin
authors.initials: S
authors.lastname: Hornung
authors.forename: Raluca
authors.initials: R
authors.lastname: Petru
authors.forename: Jürgen
authors.initials: J
authors.lastname: Glaser
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D016017:Odds Ratio; D011446:Prospective Studies; D057566:Self Report