Physicians Suffering from Depression are More Likely to Make Medical Errors

Physicians suffering from symptoms of depression are more likely to make medical errors, according to the findings of a recent study published in JAMA Network Open.

Depression is highly prevalent among physicians and has been associated with increased risk of medical errors. However, questions regarding the magnitude and temporal direction of these associations remain open in recent literature,” the research authors wrote in their abstract.

To conduct this study, the researchers combed Embase, ERIC, PubMed, PsycINFO, Scopus, and Web of Science from database inception to December 2018.  Their search focused on peer-reviewed empirical studies that reported on physician depressive symptoms associated with perceived or observed medical errors. Overall, they included 11 studies comprising 21,517 physicians in the study analysis. The primary endpoint was defined as the relative risk estimates for the associations between physician depressive symptoms and medical errors.

Depression Takes a Toll

According to the results of the study, overall RR for medical errors among physicians with a positive screening for depression was 1.95 (95% CI, 1.63 to 2.33), with high diversity observed across the studies (χ2 = 49.91; P < .001; I2 = 82%; τ2 = 0.06). They researchers noted that among the variables assessed, the study design explained the most heterogeneity across studies, with lower RR estimates associated with medical errors in longitudinal studies (RR, 1.62; 95% CI, 1.43 to 1.84; χ2 = 5.77; P = .33; I2 = 13%; τ2 < 0.01) and higher RR estimates in cross-sectional studies (RR, 2.51; 95% CI, 2.20 to 2.83; χ2 = 5.44; P = .14; I2 = 45%; τ2 < 0.01).

Overall, the results revealed that similar to the meta-analysis of physician depressive symptoms associated with subsequent medical errors, the meta-analysis of four longitudinal studies showed that medical errors associated with subsequent depressive symptoms had a pooled RR of 1.67 (95% CI, 1.48-1.87; χ2 = 1.85; P = .60; I2 = 0%; τ2 = 0), suggesting a two-way link between physician depressive symptoms and medical errors.

“By combining data from multiple studies, this systematic review and meta-analysis found that physician depressive symptoms were associated with increased risk for perceived medical errors and that the association between depressive symptoms and perceived errors was bidirectional,” the authors wrote in their conclusion.

They added that: “Future research is needed to evaluate the associations of physician depressive symptoms with objective measures of medical errors, such as active surveillance. Studies that include physicians from different countries could answer whether cultural and socioeconomic aspects play a role in the associations between depressive symptoms and errors. Future research is also needed into the degree to which interventions for reducing physician depressive symptoms could mitigate medical errors and improve physician well-being and patient care.”