Skip to main content
Top
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

Authors: Koji Wada, Toru Yoshikawa, Takahisa Goto, Aizan Hirai, Eisuke Matsushima, Yoshifumi Nakashima, Rie Akaho, Michiko Kido, Takashi Hosaka

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals.

Methods

A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables.

Results

Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men.

Conclusion

Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.
Literature
1.
go back to reference Wada K, Arimatsu M, Yoshikawa T, Oda S, Taniguchi H, Higashi T, Aizawa Y: Factors on working conditions and prolonged fatigue among physicians in Japan. Int Arch Occup Environ Health. 2008, 82: 59-66. 10.1007/s00420-008-0307-3.CrossRefPubMed Wada K, Arimatsu M, Yoshikawa T, Oda S, Taniguchi H, Higashi T, Aizawa Y: Factors on working conditions and prolonged fatigue among physicians in Japan. Int Arch Occup Environ Health. 2008, 82: 59-66. 10.1007/s00420-008-0307-3.CrossRefPubMed
2.
go back to reference Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, Laszlo J, Litts DA, Mann J, Mansky PA, Michels R, Miles SH, Proujansky R, Reynolds CF, Silverman MM: Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003, 289: 3161-3166. 10.1001/jama.289.23.3161.CrossRefPubMed Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, Laszlo J, Litts DA, Mann J, Mansky PA, Michels R, Miles SH, Proujansky R, Reynolds CF, Silverman MM: Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003, 289: 3161-3166. 10.1001/jama.289.23.3161.CrossRefPubMed
3.
go back to reference Tokuda Y, Hayano K, Ozaki M, Bito S, Yanai H, Koizumi S: The interrelationships between working conditions, job satisfaction, burnout, and mental health among hospital physicians in Japan: a path analysis. Ind Health. 2009, 47: 166-172. 10.2486/indhealth.47.166.CrossRefPubMed Tokuda Y, Hayano K, Ozaki M, Bito S, Yanai H, Koizumi S: The interrelationships between working conditions, job satisfaction, burnout, and mental health among hospital physicians in Japan: a path analysis. Ind Health. 2009, 47: 166-172. 10.2486/indhealth.47.166.CrossRefPubMed
4.
go back to reference Virtanen P, Oksanen T, Kivimäki M, Virtanen M, Pentti J, Vahtera J: Work stress and health in primary health care physicians and hospital physicians. Occup Environ Med. 2008, 65: 364-366. 10.1136/oem.2007.034793.CrossRefPubMed Virtanen P, Oksanen T, Kivimäki M, Virtanen M, Pentti J, Vahtera J: Work stress and health in primary health care physicians and hospital physicians. Occup Environ Med. 2008, 65: 364-366. 10.1136/oem.2007.034793.CrossRefPubMed
5.
go back to reference American Medical Association: The handbook of physician health. 2000, Chicago: American medical association American Medical Association: The handbook of physician health. 2000, Chicago: American medical association
6.
go back to reference Rosen IM, Gimotty PA, Shea JA, Bellini LM: Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy and burnout among interns. Acad Med. 2006, 81: 82-85. 10.1097/00001888-200601000-00020.CrossRefPubMed Rosen IM, Gimotty PA, Shea JA, Bellini LM: Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy and burnout among interns. Acad Med. 2006, 81: 82-85. 10.1097/00001888-200601000-00020.CrossRefPubMed
7.
go back to reference Goebert D, Thompson D, Takeshita J, Beach C, Bryson P, Ephgrave K, Kent A, Kunkel M, Schechter J, Tate J: Depressive symptoms in medical students and residents: a multischool study. Acad Med. 2009, 84: 236-241. 10.1097/ACM.0b013e31819391bb.CrossRefPubMed Goebert D, Thompson D, Takeshita J, Beach C, Bryson P, Ephgrave K, Kent A, Kunkel M, Schechter J, Tate J: Depressive symptoms in medical students and residents: a multischool study. Acad Med. 2009, 84: 236-241. 10.1097/ACM.0b013e31819391bb.CrossRefPubMed
8.
go back to reference Kleppa E, Sanne B, Tell GS: Working overtime is associated with anxiety and depression: the Hordaland Health Study. J Occup Environ Med. 2008, 50: 658-666. 10.1097/JOM.0b013e3181734330.CrossRefPubMed Kleppa E, Sanne B, Tell GS: Working overtime is associated with anxiety and depression: the Hordaland Health Study. J Occup Environ Med. 2008, 50: 658-666. 10.1097/JOM.0b013e3181734330.CrossRefPubMed
9.
go back to reference Baldwin DC, Daugherty SR: Sleep deprivation and fatigue in residency training: results of a national survey of first-and second- year residents. Sleep. 2004, 27: 217-223.PubMed Baldwin DC, Daugherty SR: Sleep deprivation and fatigue in residency training: results of a national survey of first-and second- year residents. Sleep. 2004, 27: 217-223.PubMed
10.
go back to reference Fletcher KE, Underwood W, Davis SQ, Mangrulkar RS, McMahon LF, Saint S: Effects of work hour reduction on residents'lives: a systematic review. JAMA. 2005, 294: 1088-1100. 10.1001/jama.294.9.1088.CrossRefPubMed Fletcher KE, Underwood W, Davis SQ, Mangrulkar RS, McMahon LF, Saint S: Effects of work hour reduction on residents'lives: a systematic review. JAMA. 2005, 294: 1088-1100. 10.1001/jama.294.9.1088.CrossRefPubMed
11.
go back to reference Hiyama T, Yoshihara M: New occupational threats to Japanese physicians: karoshi (death due to overwork) and karojisatsu (suicide due to over work). Occup Environ Med. 2008, 65: 428-429. 10.1136/oem.2007.037473.CrossRefPubMed Hiyama T, Yoshihara M: New occupational threats to Japanese physicians: karoshi (death due to overwork) and karojisatsu (suicide due to over work). Occup Environ Med. 2008, 65: 428-429. 10.1136/oem.2007.037473.CrossRefPubMed
12.
go back to reference Wada K, Arimatsu M, Higashi T, Yoshikawa T, Oda S, Taniguchi H, Kawashima M, Aizawa Y: Physician job satisfaction and working conditions in Japan. J Occup Health. 2009, 51: 261-266. 10.1539/joh.O8023.CrossRefPubMed Wada K, Arimatsu M, Higashi T, Yoshikawa T, Oda S, Taniguchi H, Kawashima M, Aizawa Y: Physician job satisfaction and working conditions in Japan. J Occup Health. 2009, 51: 261-266. 10.1539/joh.O8023.CrossRefPubMed
15.
go back to reference Myers MF, Gabbard GO: The physician as patient: a clinical handbook for mental health professionals. 2008, Arlington: American Psychiatric Publishing Inc Myers MF, Gabbard GO: The physician as patient: a clinical handbook for mental health professionals. 2008, Arlington: American Psychiatric Publishing Inc
16.
go back to reference Komatsu H: Collapsing health care services (Iryouhoukai) (in Japanese). 2006, Tokyo: Asahi News Press Komatsu H: Collapsing health care services (Iryouhoukai) (in Japanese). 2006, Tokyo: Asahi News Press
17.
go back to reference Heponiemi T, Kouvonen A, Vänskä J, Halila H, Sinervo T, Kivimäki M, Elovainio M: Effects of active on- call hours on physicians turnover intentions and well- being. Scand J Work Environ Health. 2008, 34: 356-363.CrossRefPubMed Heponiemi T, Kouvonen A, Vänskä J, Halila H, Sinervo T, Kivimäki M, Elovainio M: Effects of active on- call hours on physicians turnover intentions and well- being. Scand J Work Environ Health. 2008, 34: 356-363.CrossRefPubMed
18.
go back to reference Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, Markowitz JC, Ninan PT, Kornstein S, Manber R, Thase ME, Kocsis JH, Keller MB: The 16- item Quick Inventory of Depressive Symptomatology (QIDS) clinician rating (QIDS- C) and self- report (QIDS- SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003, 54: 573-583. 10.1016/S0006-3223(02)01866-8.CrossRefPubMed Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, Markowitz JC, Ninan PT, Kornstein S, Manber R, Thase ME, Kocsis JH, Keller MB: The 16- item Quick Inventory of Depressive Symptomatology (QIDS) clinician rating (QIDS- C) and self- report (QIDS- SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003, 54: 573-583. 10.1016/S0006-3223(02)01866-8.CrossRefPubMed
19.
go back to reference Fujisawa D, Nakagawa A, Tajima M, Sado M, Kikuchi T, Iba M, Watanabe Y, Yamaguchi Y, Henomatsu K, Eto R, Hanaoka M, Yoshimura K, Ono Y: The reliability and validity of the Japanese version Quick Inventory of Depressive Symptomatology. Journal of Japanese Society of Psychiatry and Neurology. 2008, S-324- Fujisawa D, Nakagawa A, Tajima M, Sado M, Kikuchi T, Iba M, Watanabe Y, Yamaguchi Y, Henomatsu K, Eto R, Hanaoka M, Yoshimura K, Ono Y: The reliability and validity of the Japanese version Quick Inventory of Depressive Symptomatology. Journal of Japanese Society of Psychiatry and Neurology. 2008, S-324-
20.
go back to reference SPSS: SPSS for Windows version 15.0. 2007, Chicago: SPSS Inc SPSS: SPSS for Windows version 15.0. 2007, Chicago: SPSS Inc
22.
go back to reference Frank E, Dingle AD: Self- reported depression and suicide attempts among U.S. women physician. Am J Psychiatry. 1999, 156: 1887-1894.PubMed Frank E, Dingle AD: Self- reported depression and suicide attempts among U.S. women physician. Am J Psychiatry. 1999, 156: 1887-1894.PubMed
23.
go back to reference Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, Edwards S, Wiedermann BL, Landrigan CP: Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008, 336: 488-491. 10.1136/bmj.39469.763218.BE.CrossRefPubMedPubMedCentral Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, Edwards S, Wiedermann BL, Landrigan CP: Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008, 336: 488-491. 10.1136/bmj.39469.763218.BE.CrossRefPubMedPubMedCentral
24.
go back to reference West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD: Association of resident fatigue and distress with perceived medical errors. JAMA. 2009, 302: 1294-1300. 10.1001/jama.2009.1389.CrossRefPubMed West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD: Association of resident fatigue and distress with perceived medical errors. JAMA. 2009, 302: 1294-1300. 10.1001/jama.2009.1389.CrossRefPubMed
25.
go back to reference Adler DA, McLaughlin TJ, Rogers WH, Chang H, Lapitsky L, Lerner D: Job performance deficits due to depression. Am J Psychiatry. 2006, 163: 1569-1576. 10.1176/appi.ajp.163.9.1569.CrossRefPubMedPubMedCentral Adler DA, McLaughlin TJ, Rogers WH, Chang H, Lapitsky L, Lerner D: Job performance deficits due to depression. Am J Psychiatry. 2006, 163: 1569-1576. 10.1176/appi.ajp.163.9.1569.CrossRefPubMedPubMedCentral
26.
27.
go back to reference Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA, Harvard Work Hours, Health, and Safety Group: Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med. 2005, 352: 125-134. 10.1056/NEJMoa041401.CrossRefPubMed Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA, Harvard Work Hours, Health, and Safety Group: Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med. 2005, 352: 125-134. 10.1056/NEJMoa041401.CrossRefPubMed
28.
go back to reference Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA: Effect of reducing interns work hours on serious medical errors in intensive care units. N Engl J Med. 2004, 351: 1838-1848. 10.1056/NEJMoa041406.CrossRefPubMed Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA: Effect of reducing interns work hours on serious medical errors in intensive care units. N Engl J Med. 2004, 351: 1838-1848. 10.1056/NEJMoa041406.CrossRefPubMed
30.
go back to reference Wada K, Satoh T, Tsunoda M, Aizawa Y, Japan Work Stress and Health Cohort Study Group: Associations of health behaviors on depressive symptoms among employed men in Japan. Ind Health. 2006, 44: 486-492. 10.2486/indhealth.44.486.CrossRefPubMed Wada K, Satoh T, Tsunoda M, Aizawa Y, Japan Work Stress and Health Cohort Study Group: Associations of health behaviors on depressive symptoms among employed men in Japan. Ind Health. 2006, 44: 486-492. 10.2486/indhealth.44.486.CrossRefPubMed
31.
go back to reference Veasey S, Rosen R, Barzansky B, Rosen I, Owens J: Sleep loss and fatigue in residency training: a reappraisal. JAMA. 2002, 288: 1116-1124. 10.1001/jama.288.9.1116.CrossRefPubMed Veasey S, Rosen R, Barzansky B, Rosen I, Owens J: Sleep loss and fatigue in residency training: a reappraisal. JAMA. 2002, 288: 1116-1124. 10.1001/jama.288.9.1116.CrossRefPubMed
32.
go back to reference Owens JA, Veasey SC, Rosen RC: Physician, heal thyself: sleep, fatigue, and medical education. Sleep. 2001, 24: 493-495.PubMed Owens JA, Veasey SC, Rosen RC: Physician, heal thyself: sleep, fatigue, and medical education. Sleep. 2001, 24: 493-495.PubMed
33.
go back to reference Iglehart JK: Revisiting duty- hour limits-- IOM recommendations for patient safety and resident education. N Engl J Med. 2008, 359: 2633-2635. 10.1056/NEJMp0808736.CrossRefPubMed Iglehart JK: Revisiting duty- hour limits-- IOM recommendations for patient safety and resident education. N Engl J Med. 2008, 359: 2633-2635. 10.1056/NEJMp0808736.CrossRefPubMed
Metadata
Title
National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study
Authors
Koji Wada
Toru Yoshikawa
Takahisa Goto
Aizan Hirai
Eisuke Matsushima
Yoshifumi Nakashima
Rie Akaho
Michiko Kido
Takashi Hosaka
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-127

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue