Assessment of Adverse Childhood Experiences, Adverse Professional Experiences, Depression, and Burnout in US Physicians

Mickey T Trockel; Colin P West; Liselotte N Dyrbye; Christine A Sinsky; Michael Tutty; Hanhan Wang; Lindsey E Carlasare; Nikitha K Menon; Tait D Shanafelt

doi:10.1016/j.mayocp.2023.03.021

Assessment of Adverse Childhood Experiences, Adverse Professional Experiences, Depression, and Burnout in US Physicians

Mayo Clin Proc. 2023 Dec;98(12):1785-1796. doi: 10.1016/j.mayocp.2023.03.021.

Authors

Mickey T Trockel¹, Colin P West², Liselotte N Dyrbye³, Christine A Sinsky⁴, Michael Tutty⁴, Hanhan Wang⁵, Lindsey E Carlasare⁶, Nikitha K Menon⁷, Tait D Shanafelt⁸

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA. Electronic address: [email protected].
² Department of Medicine and Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
³ Department of Medicine, University of Colorado School of Medicine, Aurora, IL.
⁴ Professional Satisfaction and Practice Sustainability, American Medical Association, Chicago, IL.
⁵ WellMD & WellPhD Center, Stanford University School of Medicine, Palo Alto, CA.
⁶ Health Care Research and Policy Analysis, American Medical Association, Chicago, IL.
⁷ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA.
⁸ Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.

PMID: 38043996
DOI: 10.1016/j.mayocp.2023.03.021

Abstract

Objective: To assess associations of adverse childhood experiences (ACEs) and adverse occupational experiences (AOEs) with depression and burnout in US physicians.

Participants and methods: We performed a secondary analysis of data from a representative sample survey of US physicians conducted between November 20, 2020, and March 23, 2021, and from a probability-based sample of other US workers. The ACEs, AOEs, burnout, and depression were assessed using previously published measures.

Results: Analyses included data from 1125 of the 3671 physicians (30.6%) who received a mailed survey and 6235 of 90,000 physicians (6.9%) who received an electronic survey. The proportion of physicians age 29-65 who had lived with a family member with substance misuse during childhood (673 of 5039[13.4%]) was marginally lower (P <.001) than that of workers in other professions (448 of 2505 [17.9%]). The proportion of physicians age 29-65 who experienced childhood emotional abuse (823 of 5038 [16.3%]) was similar to that of workers in other professions (406 of 2508 [16.2%]). The average physician depression T-score was 49.60 (raw score ± SD, 6.48±3.15), similar to the normed US average. The AOEs were associated with mild to severe depression, including making a recent significant medical error (odds ratio [OR], 1.64; 95% CI, 1.33 to 2.02, P<.001), being named in a malpractice suit (OR, 1.30; 95% CI, 1.07 to 1.59, P=.008), and experiencing one or more coronavirus disease 2019-related AOEs (OR, 1.76; 95% CI, 1.56 to 1.99, P<.001). Having one or more ACEs was associated with mild to severe depression (OR, 1.58; 95% CI, 1.38 to 1.79, P<.001). The ACEs, coronavirus disease 2019-related AOEs, and medical errors were also associated with burnout.

Conclusion: Assessing ACEs and AOEs and implementing selective primary prevention interventions may improve population health efforts to mitigate depression and burnout in physicians.

MeSH terms

Adult
Adverse Childhood Experiences*
Aged
Burnout, Professional* / epidemiology
Burnout, Professional* / psychology
COVID-19* / epidemiology
Depression / epidemiology
Humans
Middle Aged
Physicians* / psychology