A systematic review and meta-analysis of interventions to reduce or prevent symptoms of common mental disorders and suicidality in physicians

Abstract

We conducted an updated systematic review and meta-analysis on the effectiveness of interventions for reducing or preventing symptoms of common mental disorder (CMD) and suicidality among physicians. Databases were searched for randomized and non-randomized controlled trials of interventions to reduce or prevent depression, anxiety, general psychological distress or suicidality among physicians. The primary outcome was differences in symptoms of CMD following intervention. Random-effects meta-analyses and subgroup and sensitivity analyses were conducted. Twenty-four studies were included in the qualitative synthesis, of which 21 were included in the meta-analysis. Compared with controls, physician-directed interventions significantly reduced symptoms of CMD among physicians at post-intervention (standardized mean difference 0.45; 95% confidence interval 0.26–0.65; P < 0.001; moderate heterogeneity) and follow-up with a small to moderate effect size. Preliminary findings suggest that group-based, face-to-face and skills-based interventions show promise for reducing symptoms of CMD among physicians. Research regarding organizational-level interventions is urgently required. Systematic review registration: PROSPERO CRD42018091646 . Physicians face high rates of common mental disorders (CMDs) and suicidality, yet effective interventions remain underexplored. This systematic review and meta-analysis synthesizing the latest evidence on interventions finds that a range of physician-directed interventions reduces symptoms of CMD and that these moderate effects are maintained over time.