A perspective on stress and depression

This chapter focuses on studies of stress and depression since they are highly related, though the frequent comorbidity between depression and alcohol use will also be discussed where appropriate. Mental health problems in doctors have been the focus of researchers' attention for decades, with good longitudinal studies allowing us to consider their long-term predictors, in particular of general occupational stress, depression and substance abuse. The effects of stress, depression and alcohol use on patient care have been described in a number of reviews. Stress and depression are strongly linked to life events, especially those concerning loss, and these are probably summative in their effects. Alcohol problems may well begin early, both in men and in women, and this too may contribute to the higher than usual levels of suicide, particularly in female doctors. A longitudinal study of doctors in Sweden has found that frequent overtime worked 24 years earlier was associated with heavy alcohol use among women.