Risks of Treated Insomnia, Anxiety, and Depression in Health Care-Seeking Physicians: A Nationwide Population-Based Study

摘要

High occupational stress and burnout among physicians can lead to sleep problems, anxiety, depression, and even suicide. Even so, the actual risk for these behavioral health problems in health care-seeking physicians has been seldom explored. The aim of this study was to determine whether physicians have higher odds of treated insomnia, anxiety, and depression than the normal population. This is a nationwide population-based case–control study using the National Health Insurance Research Database in Taiwan for the years 2007 to 2011. Physicians were obtained from the Registry for Medical Personnel in 2009. Hospital physicians who had at least 3 coded ambulatory care claims or 1 inpatient claim with a principal diagnosis of insomnia, anxiety, or depression were identified. A total of 15,150 physicians and 45,450 matched controls were enrolled. Odd ratios (ORs) of insomnia, anxiety, and depression between physicians and their control counterparts were measured. The adjusted ORs for treated insomnia, anxiety, and depression among all studied physicians were 2.028 (95% confidence interval [CI], 1.892–2.175), 1.103 (95% CI, 1.020–1.193), and 0.716 (95% CI, 0.630–0.813), respectively. All specialties of physicians had significantly higher ORs for treated insomnia; among the highest was the emergency specialty. The adjusted ORs for treated anxiety among male and female physicians were 1.136 (95% CI, 1.039–1.242) and 0.827 (95% CI, 0.686–0.997), respectively. Among specialties, psychiatry and “others” had significantly higher risks of anxiety. Obstetrics and gynecology and surgery specialties had significantly lower risks of anxiety. The adjusted ORs for treated depression among physicians in age groups 35 to 50 years and >50 years were 0.560 (95% CI, 0.459–0.683) and 0.770 (95% CI, 0.619–0.959), respectively. Those in the psychiatry specialty had significantly higher risks of depression; internal and surgery specialties had significant lower risks of depression. Hospital physicians have lower odds of treated depression than the general population, although they have higher odd of treated insomnia and anxiety. Undertreatment was noted in some sex, age, and specialty subgroups of physicians. Additional studies are needed to determine how to eliminate barriers to their use of psychiatry resources.