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- R P Caplan.
- Department of Psychiatry, Lincoln County Hospital.
- BMJ. 1994 Nov 12;309(6964):1261-3.
ObjectiveTo study stress, anxiety, and depression in a group of senior health service staff.DesignPostal survey.Subjects81 hospital consultants, 322 general practitioners, and 121 senior hospital managers (total 524).Main Outcome MeasuresScores on the general health questionnaire and the hospital anxiety and depression scale.ResultsSixty five (80%) consultants, 257 (80%) general practitioners, and 67 (56%) managers replied. Of all 389 subjects, 183 (47%) scored positively on the general health questionnaire, indicating high levels of stress. From scores on the hospital anxiety and depression scale only 178 (46%) would be regarded as free from anxiety, with 100 (25%) scoring as borderline cases and 111 (29%) likely to be experiencing clinically measurable symptoms. The findings for depression were also of some concern, especially for general practitioners, with 69 (27%) scoring as borderline or likely to be depressed. General practitioners were more likely to be depressed than managers (69 (27%) v 4 (6%) scored > or = 8 on hospital anxiety and depression scale-D; P = 0.004) with no significant difference between general practitioners and consultants. General practitioners were significantly more likely to show suicidal thinking than were consultants (36 (14%) v 3 (5%); P = 0.04) but not managers (9 (13%)). No significant difference could be found between the three groups on any other measure.ConclusionsThe levels of stress, anxiety, and depression in senior doctors and managers in the NHS seem to be high and perhaps higher than expected.
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