Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review

Evidence suggests physicians have higher rates of mental distress than other professionals. Although multiple studies have been conducted among Saudi medical trainees to address this issue, no reviews assessed multiple psychological problems simultaneously. We aimed to examine the prevalence and trends of depression, anxiety, burnout and stress among Saudi medical trainees. A systematic review was conducted searching PubMed/Medline, OVID, Scopus, PsychInfo, EBSCOhost and the Directory of Open Access Journals (DOAJ) for studies addressing depression, burnout, stress and anxiety among Saudi medical trainees, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Joanna Briggs Critical Appraisal Checklist was used to evaluate quality. The main findings were summarised in tables. We identified 57 records from 2001 to 2020. Overall (mild, moderate or severe) depression ranged from 28% to 70.6%, while stress ranged from 30.5% to 90.7%. Burnout was primarily assessed among residents with an overall prevalence reaching 85.5%. Overall anxiety ranged from 52.7% to 67%, and was only assessed among undergraduates. Higher levels of all four mental conditions were reported among females. This review suggests high prevalence of depression, stress, burnout and anxiety among medical trainees, with higher estimates for females compared to males.

已有研究证据表明，与其他行业从业者相比，医师群体的心理困扰检出率更高。尽管此前已有多项针对沙特医学受训人员的相关研究，但尚无系统综述同时对多种心理问题进行评估。本研究旨在探讨沙特医学受训人员抑郁（depression）、焦虑（anxiety）、职业倦怠（burnout）与心理压力（stress）的流行现状及变化趋势。本研究按照《系统综述与元分析首选报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-analyses, PRISMA）的规范，通过PubMed/Medline、OVID、Scopus、PsycINFO、EBSCOhost及开放获取期刊目录（Directory of Open Access Journals, DOAJ）数据库，检索针对沙特医学受训人员抑郁、职业倦怠、心理压力与焦虑的相关研究，开展系统综述。研究采用乔安娜·布里格斯批判性评价清单（Joanna Briggs Critical Appraisal Checklist）对纳入文献的质量进行评估，主要研究结果以表格形式汇总呈现。本次综述共纳入2001年至2020年的57项研究。整体（轻度、中度或重度）抑郁检出率范围为28%~70.6%，心理压力检出率范围为30.5%~90.7%。职业倦怠的评估对象主要为住院医师，整体检出率高达85.5%。焦虑的整体检出率范围为52.7%~67%，且仅针对医学本科生开展了相关评估。研究显示，女性医学受训人员的四种心理问题检出水平均高于男性。本系统综述结果表明，沙特医学受训人员的抑郁、心理压力、职业倦怠与焦虑检出率均处于较高水平，且女性群体的检出率显著高于男性。