Drinking and depression in Norwegian doctors : a 15-year longitudinal study
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AbstractPhysicians have a greater risk of suicide than academics and other health professionals, and several studies have identified high levels of depressive symptoms among physicians. Alcohol problems and depression often co-occur and they increase the risk of suicide. Mental health problems can interfere with a physician’s care of his/her patients. The aim of this study was to provide more detailed information about the prevalence, courses, and individual risk factors of alcohol problems and depression. All medical students who graduated in 1993 and 1994 were followed in five stages over a 15-year period.
The results of this thesis showed that despite a decline in the prevalence of severe depressive symptoms, there was no decline in hazardous drinking during the follow-up period. Positive expectancy about the tension-reducing effects of alcohol predicted hazardous drinking six years later. Perceived inadequate maternal care during childhood predicted severe depressive symptoms several years after graduation. This relationship was partly explained by low self-esteem. Additional possible risk factors for severe depressive symptoms examined in an expanded model included parental bonding, age, sex, personality, perceived medical school stress, and perceived clinical skills and competence. Young age, neuroticism, and reality weakness (a pathological personality dimension) were found to be risk factors, as were earlier depressive symptoms.
Together, these results show that individual risk factors for both depressive symptoms and hazardous drinking can be identified early in a doctor’s medical career. Measures to prevent hazardous drinking and minimize depression among doctors should be implemented early in their careers.
List of papers. Papers I and II are removed from the thesis due to copyright restrictions.
Paper I Kjersti s. Grotmol, Per Vaglum, Øivind Ekeberg, Tore Gude Olaf G. Aasland and Reidar Tyssen Alcohol expectancy and hazardous drinking: a 6-year longitudinal and nationwide study of medical doctors European Addiction Research 2010 16:17–22. doi:10.1159/000253860
Paper II Kjersti S. Grotmol, Øivind Ekeberg, Arnstein Finset, Tore Gude, Torbjørn Moum, Per Vaglum and Reidar Tyssen Parental bonding and self-esteem as predictors of severe depressive symptoms: a 10-year follow-up study of Norwegian physicians The Journal of Nervous and Mental Disease 2010 198:22–27. doi:10.1097/NMD.0b013e3181c8189c
Paper III Kjersti S. Grotmol, Tore Gude, Torbjørn Moum, Per Vaglum and Reidar Tyssen Risk factors at medical school for later severe depression: a 15-year longitudinal, nationwide study (NORDOC) NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in: Journal of Affective Disorders 2012 Sep 24. pii: S0165-0327(12)00618-0 [Epub ahead of print] doi:10.1016/j.jad.2012.08.047