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首页> 外文期刊>Archives of general psychiatry. >A prospective cohort study investigating factors associated with depression during medical internship.
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A prospective cohort study investigating factors associated with depression during medical internship.

机译：前瞻性群组研究调查的因素在医疗与抑郁症有关实习。

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CONTEXT: Although the prevalence of depression among medical interns substantially exceeds that of the general population, the specific factors responsible are not well understood. Recent reports of a moderating effect of a genetic polymorphism (5-HTTLPR) in the serotonin transporter protein gene on the likelihood that life stress will precipitate depression may help to understand the development of mood symptoms in medical interns. OBJECTIVES: To identify psychological, demographic, and residency program factors that are associated with depression among interns and to use medical internship as a model to study the moderating effects of this polymorphism. DESIGN: A prospective cohort study. SETTING: Thirteen US hospitals. PARTICIPANTS: Seven hundred forty interns entering participating residency programs. MAIN OUTCOME MEASURES: Subjects were assessed for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9), a series of psychological traits, and the 5-HTTLPR genotype prior to internship and then assessed for depressive symptoms and potential stressors at 3-month intervals during internship. RESULTS: The PHQ-9 depression score increased from 2.4 prior to internship to a mean of 6.4 during internship (P < .001). The proportion of participants who met PHQ-9 criteria for depression increased from 3.9% prior to internship to a mean of 25.7% during internship (P < .001). A series of factors measured prior to internship (female sex, US medical education, difficult early family environment, history of major depression, lower baseline depressive symptom score, and higher neuroticism) and during internship (increased work hours, perceived medical errors, and stressful life events) was associated with a greater increase in depressive symptoms during internship. In addition, subjects with at least 1 copy of a less-transcribed 5-HTTLPR allele reported a greater increase in depressive symptoms under the stress of internship (P = .002). CONCLUSIONS: There is a marked increase in depressive symptoms during medical internship. Specific individual, internship, and genetic factors are associated with the increase in depressive symptoms.
机译：背景:尽管抑郁症的患病率医学实习生大大超过一般人群的具体因素负责任不是很好理解。缓和的报道基因的影响5 - httlpr)多态性(5 -羟色胺转运蛋白基因的可能性生活压力将加速抑郁可能会有所帮助理解情绪症状的发展医学实习生。心理、人口和实习计划与抑郁症相关因素实习生和使用医学实习作为一个模型研究了缓和这种影响多态性。设置:13我们医院。七百四十年实习生进入参加实习项目。措施:受试者评估抑郁使用9-item症状病人的健康调查问卷(phq - 9),一系列的心理5 - httlpr基因型特征,和之前实习,然后评估抑郁症状和潜在的压力在3个月实习期间间隔。抑郁得分从2.4增加之前实习实习期间平均为6.4 (P<措施)。phq - 9标准萧条从3.9%上升在实习期间平均为25.7%实习(P <措施)。测量实习前(美国女性性医学教育、早期家庭困难环境中,抑郁症的历史,更低基线抑郁症状评分,甚至更高神经质)和实习期间(增加工作时间,认为医疗错误,压力性生活事件)有关更大的提高在抑郁症状实习。5 - httlpr基因less-transcribed的副本增加了更多的抑郁症状的压力下实习(P =.002)。抑郁症状在医学实习。特定的个人,实习,和遗传增加相关的因素抑郁症状。

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