Psychiatric epidemiology in Turkey: main advances in recent studies and future directions.
BACKGROUND Major work has been carried out on the psychological well-being of emergency room doctors in the US, Canada and in other developed countries, but little has been published regarding the same in the countries in economic transition. OBJECTIVE To determine the level of, and the factors related to, depression and anxiety among doctors working in emergency units in Denizli, Turkey. METHODS This cross-sectional study was conducted in May 2004, using a sample of 192 doctors employed in emergency units in Pamukkale University Hospital, the City Hospital, the Social Security Hospital, private hospitals, citywide primary healthcare centres and 112 emergency services in Denizli, Turkey. Data were obtained using a self-administered questionnaire, including questions on sociodemographic characteristics and two instruments determining the level of depressive symptoms and anxiety. Logistic regression was the method chosen for multivariate statistical analysis. RESULTS The mean (standard deviation (SD)) depression score was 10.6 (6.5) and the frequency (%) of depression was 29 (15.1). Not having any hobby and having high anxiety scores were salient factors among doctors experiencing depressive symptomatology in bivariate comparisons. Logistic regression analysis showed that not having any hobby (p = 0.07) and having increased anxiety scores (p<0.001) were positive contributors to depression scores. The mean (SD) anxiety score was 8.7 (8.2) and the frequency (%) of anxiety was 28 (14.6). Being a woman, having a low monthly income and having high depression scores contributed considerably to the anxiety of doctors in bivariate comparisons. Low monthly income (<1000 v 1000-2000 YTL) (p = 0.03), the number of years spent in emergency units (p = 0.03) and having high depression scores (p<0.001) were the factors that contributed significantly to the anxiety of doctors in the multivariate regression analysis. CONCLUSION The considerable amount of depression and anxiety found among doctors in this study should trigger further work. Studies using more powerful designs would help to illuminate the factors leading to depression and anxiety, which result in attrition among doctors from emergency units.