The impact of job stress and working conditions on mental health problems among junior house officers. A nationwide Norwegian prospective cohort study

Context Previous studies have shown that physicians have an increased risk of mental health problems such as depression, suicide and substance abuse. Objectives To study the prevalence of mental health problems during the fir st postgraduate year, and to investigate whether work-related factors in ho spital are linked to these, when we control for gender, previous mental hea lth problems, personality traits, stress in medical school and other possib le predictors. Design Nationwide and prospective postal questionnaire survey. Setting University of Oslo. Subjects Medical students who answered questionnaires in their graduating s emester, and 1 year later when they were junior house officers (n=371). Results Mental health problems (needing treatment) during internship were r eported by 11%, with no gender difference. Adjusted predictors of mental he alth problems were: previous mental health problems, (odds ratio (OR)=5.1, 95% confidence interval (CI) 1.7 to 15.8); being married/cohabitant (OR=0.2 , CI 0.1 to 0.7); the personality trait 'vulnerability' (OR=1.5, CI 1.1 to 2.0); negative life events during internship (OR=2.1, CI 1.2 to 3.5), and j ob stress as house officer (OR=1.05, CI 1.01 to 1.10). The job stress facto r of emotional pressure/demands from patients was most important. Perceived study stress and lack of skills at the end of medical school were univaria tely related to mental health problems in internship, but not when other va riables were adjusted. Gender, weekly working hours and lack of sleep were not linked to having problems. Conclusion Job stress is related to mental health problems among young doct ors, even when the variables of previous mental health problems and persona lity traits are controlled for. More support during internship is needed.