INDIVIDUAL AND ORGANIZATIONAL PREDICTORS OF DEPRESSION IN GENERAL-PRACTITIONERS

Background. High levels of stress and depression are seen in both gene ral practitioners (GPs) and hospital doctors, and this has implication s for patient care. It is therefore important to discover the individu al and organizational causes of elevated symptoms so they can be tackl ed. Aim. To discover the relative importance of individual characteris tics measured 10 years earlier compared with current organizational st ressors in predicting depression in GPs. Method. Longitudinal question naire study, using data from those of the original cohort of 318 medic al students who are now GPs (n = 131), considering perceptions of curr ent stressors and comparing Through regression analyses the relative s trength of early personality and mood with current organizational fact ors of sleep, hours worked, and practice size in predicting current de pression levels. Results. There were 22 (17%) stressors scoring above threshold for depression. Relationships with senior doctors and patien ts are the main reported stressors, followed by making mistakes and co nflict of career with personal life. The predictors of symptom levels varied for men and women. In men, depression and self-criticism as stu dents, and current sleep levels; and in women, sibling rivalry and cur rent alcohol use, were the main predictors: in men, 27% of the varianc e was accounted for by early dispositional factors alone compared with 14% in women. A model is suggested linking sleep loss with workplace stressors, self-critical cognitions, and depression. Conclusion. inter ventions can be made throughout training, targeting self-criticism and recognizing early depression, while later addressing the organization al stressors, particularly work relationships and sleep patterns.