title: The mental health of primary care physicians in Rhineland-Palatinate, Germany: the prevalence of problems and identification of possible risk factors.
abstract: BACKGROUND
  The generally high job-related stress level among physicians may lead to various health impairments in the long run. Apart from job-related stress, stress during leisure time and certain personality traits might be risk factors for health impairments. However, very little research on the health situation of primary care physicians (PCPs) in Germany is available. Therefore, the objective of the present study was to systematically assess the stress experience and the health situation of German PCPs. One main focus was on mental health.
  
  
  METHODS
  In 2009, a state-wide survey among practice-based PCPs in the federal German state of Rhineland-Palatinate (cross-sectional study, n = 2092) was carried out in order to assess stress and strain as well as the health situation.
  
  
  RESULTS
  790 participants (37.7%) were eligible for the analyses. One in four PCPs exceeded the cut-off value ≥ 3 for depression in the PHQ-2 (PHQ, Patient Health Questionaire). Moreover, approximately one in six PCPs stated that he or she had used psychotropic drugs or other psychoactive substances at least once in the preceding year. Stress during leisure time, type D personality and low job satisfaction were associated with the presence of mental health impairments in the binary logistic regression analyses.
  
  
  CONCLUSIONS
  All in all, it appears that mental health impairments are a common health problem among the PCPs. Target-group-specific measures should be taken in order to reduce the subjective stress level, and to foster mental hygiene. Furthermore, the development of favorable personality profiles and the corresponding behavioral patterns should be supported.
authors.affiliation: Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz. unrathm@uni-muenster.de
authors.forename: Michael
authors.initials: M
authors.lastname: Unrath
authors.forename: Hajo
authors.initials: H
authors.lastname: Zeeb
authors.forename: Stephan
authors.initials: S
authors.lastname: Letzel
authors.forename: Matthias
authors.initials: M
authors.lastname: Claus
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Escobar Pinzón
mesh_terms: D005260:Female; D005858:Germany; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000523:psychology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data*