Association Observed Linking Anxiety, Depression to Burnout Among Dermatologists

There is an association between depression/anxiety and burnout among dermatologists, according to recent findings, with a greater depression/anxiety risk for female dermatologists and a greater risk of alcohol use disorder among male dermatologists and resident physicians.¹

These findings resulted from a new study conducted to assess burnout syndrome and its connection with chronic occupational stress among dermatologists, with the investigators looking at the condition’s prevalence and connection with other disorders among clinicians.

This research was led by Alberto Soto-Moreno, from the department of dermatology at the Hospital Universitario Virgen de Las Nieves in Granada, Spain. Soto-Moreno and colleagues sought to use a larger sample sizes to evaluate this association among dermatologists, though they did acknowledge that burnout risk factors in this group have at least begun to be looked into by researchers.²

“Based on this background, a cross-sectional study was designed to analyze the prevalence of burnout, anxiety, depression, and AUD in dermatologists and the relationship between these disorders and associated factors,” Soto-Moreno and colleagues wrote.

Background and Methods

The investigators recruited subjects from December 2022 - June 2023 and evaluated dermatologists who were either physicians or residents, having participants use a self-administered questionnaire utilizing online instant messaging. Recruitment of these subjects was done through the communications channel of the Spanish Academy of Dermatology and Venereology.

The research team’s main goal was to look at the prevalence of anxiety, depression, burnout, and alcohol use disorder among the dermatologists they had recruited for their research. The relationship between such conditions and physician burnout as well as any sociodemographic risk factors linked to development of these conditions.

Subjects of the team’s research were required to be physicians or dermatology residents actively working in Spain at the time of the study period, and they would be excluded if they refused to participate or provided an incomplete or duplicate questionnaire.

The investigators implemented the Maslach Burnout Inventory Human Services Survey version (MBI-HSS) to evaluate participants’ burnout. The survey’s inventory was made up of 22 items that were rated using a 7-point Likert scale, with higher scores on the survey suggesting greater impairment.
The research team looked at mental health conditions through the use of the Hospital Anxiety and Depression Scale (HADS), involving 17 Likert-type inquiries that assessed intensity of participant symptoms that were placed on a scale from 0 - 3. Clinical relevance was determined on a 0–7 scale, with rankings determining mild, moderate, and severe anxiety/depression.

The team looked at risk profiles for alcohol consumption by implementing the Alcohol Use Disorders Identification Test (AUDIT), a test that involves 10 inquiries with scores from 0 - 4 points. This test, developed by the WHO and validated for Spain, uses categories for consumption of alcohol, with low (0–7 points), medium (8–15 points), and high risk (16–19 points) individuals as well as probable alcohol use disorder labels being 20 points or more.

Findings

The investigators’ research ended up involving 420 clinicians that had been recruited in Spain, with the subjects having an average age of 44.5 years and 62% reported to be women. A notable finding the team identified in the study’s conclusion was that 11% of the participants had a moderate risk of burnout, with over half reporting at least a single symptom of burnout.

The research team also reported that 47% showed some level of anxiety and 20.3% showed signs of depression. They also noted that less than 1% were found to have had a high risk of alcohol use disorder.

The investigators also identified gender distinctions, given that females showed an increased risk of depression/anxiety and males and residents showed greater likelihood to develop alcohol use disorder. The team also reported that there was a substantial link between physician burnout and its components with depression and anxiety, though they could find no such link with abuse of alcohol.

“This cross-sectional study's results suggest a higher risk of anxiety and depression in female dermatologists, whereas being male or a resident physician is associated with a higher probability of presenting AUD,” they wrote. “Dermatology, as a medical specialty, is also exposed to psychiatric morbidity.”

References

1. ^{Soto-Moreno, A., Martínez-López, A., Sánchez-Díaz, M., Martínez-García, E., Buendía-Eisman, A. and Arias-Santiago, S. (2024), Anxiety, depression, and alcohol use disorder in dermatologists: relationship with burnout and associated risk factors. Int J Dermatol. https://doi.org/10.1111/ijd.17116.}
2. ^{Colon A, Gillihan R, Motaparthi K. Factors contributing to burnout in dermatologists. Clin Dermatol. 2020; 38(3): 321–327.}