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Higher Work Hours Linked to Depressive Symptoms for Interns

Estimated change from baseline in the PHQ-9 score increased with increasing work hours

THURSDAY, Oct. 27, 2022 (HealthDay News) — For interns, higher work hours are associated with increased depressive symptoms, according to a letter to the editor published in the Oct. 20 issue of the New England Journal of Medicine.

Yu Fang, from the University of Michigan Medical School in Ann Arbor, and colleagues examined the association between work-hour levels and change in depressive symptoms during the first year of residency among 17,082 participants from the Intern Health Sample, recruited from April through June during 2009 to 2020. Depressive symptoms were measured using the Patient Health Questionnaire 9-item version (PHQ-9) at baseline before the start of internship and quarterly throughout the internship.

The researchers found that the interns’ mean PHQ-9 total score was 2.7 ± 3.1 points at baseline, and the mean work hours were 63 ± 19 per week. Interns’ PHQ-9 total scores more often fell within higher categories of severity of depression at higher work-hour levels; at a level of more than 90 work hours per week, 33.4 percent of the interns met PHQ-9 criteria for depression. The estimated change from baseline in the PHQ-9 score increased with increasing work-hour levels after standardization, consistent with a dose-response relationship. The estimated increase from baseline in the PHQ-9 score was 1.8 and 5.2 points for the work-hour categories of more than 40 and up to 45 hours and more than 90 hours per week, respectively.

“Our findings suggest that limiting the number of hours worked per week by residents has the potential to reduce rates of depression among early-career trainees,” the authors write.

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