title: Systematic review of interventions to improve the psychological well-being of general practitioners.
abstract: BACKGROUND
  The health of doctors who work in primary care is threatened by workforce and workload issues. There is a need to find and appraise ways in which to protect their mental health, including how to achieve the broader, positive outcome of well-being. Our primary outcome was to evaluate systematically the research evidence regarding the effectiveness of interventions designed to improve General Practitioner (GP) well-being across two continua; psychopathology (mental ill-health focus) and 'languishing to flourishing' (positive mental health focus). In addition we explored the extent to which developments in well-being research may be integrated within existing approaches to design an intervention that will promote mental health and prevent mental illness among these doctors.
  
  
  METHODS
  Medline, Embase, Cinahl, PsychINFO, Cochrane Register of Trials and Web of Science were searched from inception to January 2015 for studies where General Practitioners and synonyms were the primary participants. Eligible interventions included mental ill-health prevention strategies (e.g. promotion of early help-seeking) and mental health promotion programmes (e.g. targeting the development of protective factors at individual and organizational levels). A control group was the minimum design requirement for study inclusion and primary outcomes had to be assessed by validated measures of well-being or mental ill-health. Titles and abstracts were assessed independently by two reviewers with 99% agreement and full papers were appraised critically using validated tools.
  
  
  RESULTS
  Only four studies (with a total of 997 GPs) from 5392 titles met inclusion criteria. The studies reported statistically significant improvement in self-reported mental ill-health. Two interventions used cognitive-behavioural techniques, one was mindfulness-based and one fed-back GHQ scores and self-help information.
  
  
  CONCLUSIONS
  There is an urgent need for high quality, controlled studies in GP well-being. Research on improving GP well-being is limited by focusing mainly on stressors and not giving systematic attention to the development of positive mental health.
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT 12 6BA, UK. mmurray881@qub.ac.uk.
authors.forename: Marylou
authors.initials: M
authors.lastname: Murray
authors.affiliation: School of Public Health, Health Education North West, Regatta Place, Summers Road, Liverpool, L3 4BL, UK.
authors.forename: Lois
authors.initials: L
authors.lastname: Murray
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT 12 6BA, UK.|UKCRC Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Sciences, Royal Victoria Hospital, Belfast, BT 12 6BA, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Donnelly
mesh_terms: D058005:General Practitioners / Q000523:psychology*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008603:Mental Health; D016272:Occupational Health
keywords: General practitioners; Mental health; Primary care; Well-being