G Fond1, A Bourbon2, J-A Micoulaud-Franchi3, P Auquier2, L Boyer2, C Lançon2. 1. Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etudeetde Recherche sur les Services de Santéetla Qualité de vie,27 Boulevard Jean Moulin, Marseille 13005, France. Electronic address: guillaume.fond@ap-hm.fr. 2. Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etudeetde Recherche sur les Services de Santéetla Qualité de vie,27 Boulevard Jean Moulin, Marseille 13005, France. 3. USR 3413, Centre National de la Recherche Scientifique, Sommeil, Addiction, et Neuropsychiatrie, Université de Bordeaux, Bordeaux, France.
Abstract
BACKGROUND: Physicians are at risk for burnout, anxiety and depression. OBJECTIVE: To explore the self-reported mental health status, substance use behavior and motives of a national sample of interns in psychiatry compared to other specialties. METHODS: Interns of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2018 and fulfilled internet anonymized questionnaires. RESULTS: Overall, 2165 interns (302 interns in psychiatry and 1863 in other specialties) mean aged 25.9 years (±2.8), 35% males were included in the present study. In multivariate analyses, interns in psychiatry were found to have higher rates of current tobacco smoking (aOR = 1.9 [1.4-2.5], p < 0.001), alcohol use disorder (aOR = 1.5 [1.2-2.0], p = 0.001), cannabis use disorder (aOR = 2.7 [1.8-4.2], p < 0.001)). They were more frequently followed by a psychiatrist and/ or a psychologist (aOR = 2.5 1.9-3.3], p < 0.001), they consumed more often antidepressants (aOR = 3.8 [2.2-6.6], p < 0.001) and anxiolytic (aOR = 1.8[1.2-2.8]; p = 0.006). They reported to have been more frequently exposed to sexual assault (aOR = 2.2 [1.1-4.8], p = 0.04) and physical assault (aOR = 1.9[1.3-2.9], p = 0.002), and to have lower vitality (β = 3.5 [0.6-6.4], p = 0.02). Interns in psychiatry reported to have more often experienced ecstasy (aOR = 1.6 [1.2-2.3], p = 0.004), mushrooms (aOR = 1.5 [1.1-2.2], p = 0.04), amphetamines (aOR = 1.9 [1.2-3.1], p = 0.009) and LSD (aOR = 1.8 [1.1-3.1], p = 0.04). Beyond classical motives for this consumption (party, group effect), interns in psychiatry reported to seek more frequently disinhibition (aOR = 1.7 [1.3-2.2], p < 0.001), dealing with anxiety (aOR = 1.7 [1.3-2.3], p = 0.001), and to seek both stimulant (aOR = 1.4 [1.1-1.9], p = 0.04) and sedative effects (aOR = 1.9[1.3-2.7], p = 0.001). CONCLUSIONS: Interns in psychiatry are more exposed to violence during medical studies, they report lower vitality and increased substance use behavior. Their motives for consumption suggest mental health problems associated with increased engagement in psychotherapy and self-medication of antidepressant/anxiolytic. This population should be targeted as a specific vulnerable population among interns in medicine to prevent ulterior bad health outcomes.
BACKGROUND: Physicians are at risk for burnout, anxiety and depression. OBJECTIVE: To explore the self-reported mental health status, substance use behavior and motives of a national sample of interns in psychiatry compared to other specialties. METHODS: Interns of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2018 and fulfilled internet anonymized questionnaires. RESULTS: Overall, 2165 interns (302 interns in psychiatry and 1863 in other specialties) mean aged 25.9 years (±2.8), 35% males were included in the present study. In multivariate analyses, interns in psychiatry were found to have higher rates of current tobacco smoking (aOR = 1.9 [1.4-2.5], p < 0.001), alcohol use disorder (aOR = 1.5 [1.2-2.0], p = 0.001), cannabis use disorder (aOR = 2.7 [1.8-4.2], p < 0.001)). They were more frequently followed by a psychiatrist and/ or a psychologist (aOR = 2.5 1.9-3.3], p < 0.001), they consumed more often antidepressants (aOR = 3.8 [2.2-6.6], p < 0.001) and anxiolytic (aOR = 1.8[1.2-2.8]; p = 0.006). They reported to have been more frequently exposed to sexual assault (aOR = 2.2 [1.1-4.8], p = 0.04) and physical assault (aOR = 1.9[1.3-2.9], p = 0.002), and to have lower vitality (β = 3.5 [0.6-6.4], p = 0.02). Interns in psychiatry reported to have more often experienced ecstasy (aOR = 1.6 [1.2-2.3], p = 0.004), mushrooms (aOR = 1.5 [1.1-2.2], p = 0.04), amphetamines (aOR = 1.9 [1.2-3.1], p = 0.009) and LSD (aOR = 1.8 [1.1-3.1], p = 0.04). Beyond classical motives for this consumption (party, group effect), interns in psychiatry reported to seek more frequently disinhibition (aOR = 1.7 [1.3-2.2], p < 0.001), dealing with anxiety (aOR = 1.7 [1.3-2.3], p = 0.001), and to seek both stimulant (aOR = 1.4 [1.1-1.9], p = 0.04) and sedative effects (aOR = 1.9[1.3-2.7], p = 0.001). CONCLUSIONS: Interns in psychiatry are more exposed to violence during medical studies, they report lower vitality and increased substance use behavior. Their motives for consumption suggest mental health problems associated with increased engagement in psychotherapy and self-medication of antidepressant/anxiolytic. This population should be targeted as a specific vulnerable population among interns in medicine to prevent ulterior bad health outcomes.
Authors: Philippe Nuss; Cedric Tessier; Marc Masson; Philippe Fossati; Raphaël Gaillard; Nathanaël Lapidus; David Gourion Journal: Front Psychiatry Date: 2020-05-07 Impact factor: 4.157