Depressed residents make more drug errors

Researchers say these findings show residency programs need to focus on physicians' mental health and work conditions.

By Myrle Croasdale, AMNews staff. March 10, 2008.

Depressed medical residents make six times more medication errors than residents who are not depressed, according to a U.S. study published online Feb. 7 in the British Medical Journal.

"Depression is a significant problem for residents as well as for their patients," said lead study author Amy Fahrenkopf, MD, MPH. "The fact that it's a problem for both needs to be addressed."

The study looked at 123 pediatric residents at Children's Hospital Boston, Lucile Packard Children's Hospital in Palo Alto, Calif., and Children's National Medical Center in Washington, D.C. A medication error was defined as any error in the ordering, transcription or administration of a medication.

Participants wrote a total of 6,078 orders, and 45 medication errors were found. Depressed residents made 6.2 times more errors per month than residents who were not depressed. The study found that 20% of residents were depressed, while 74% were burned out.

Dr. Fahrenkopf said it made sense that depressed residents would make more errors, because depression causes problems with attention and reaction time. Half of the depressed residents were unaware of their mental illness, she said.

"Most people expect to be miserable during residency, and they often miss when they cross the line into illness," said Dr. Fahrenkopf, a pediatric hospitalist at Children's Hospital Boston.

Christopher Landrigan, MD, MPH, the study's principal investigator, said that while the researchers were not the first to find a high incidence of depression among residents, the study is important because it clearly links depression with medical errors.