Association of Violence with Anxiety and Depression among Iraqi Junior Doctors

Background: Doctors are not protected to the occurrence and consequences of mental disorders such as anxiety, depression, and occupational burnout, likely owing to their exposure to high levels of occupational stress. Methods: Written questionnaires were completed by 323 junior resident doctors from 20 teaching Hospitals in Baghdad city. The questionnaire inquired about exposure to any sort of violence, and the presence of any psychological symptoms that may refer to anxiety or depression. The questions were borrowed from the Center for Epidemiologic Studies Depression Scale (CES-D). Findings: More than one half of the doctors (164, 50.8%) reported the presence of anxiety symptoms, and 147 (45.5%) reported depressive symptoms. There was a significant association between exposure to any sort of violence at work (OR= 1.976, p <.005) or outside the work (OR= 1.912, p < .005), and reporting anxiety symptoms. The odds ratio of exposure to arrest, kidnapping or intentional injury was 2.242 (p .006). A significant association was also found between reporting depressive symptoms and exposure to violence at the work (OR=2.547, p =.002) or outside the work (OR=1.841, p =.008), and with history of killing, kidnapping or injury of family members (OR= 1.769, p .012) or colleagues (OR= 1.796, p .031). Exposure to pressure during work was also significantly associated with depressive symptoms (OR=2.455, p .002). Interpretation: The unsafe situation in Iraq has led to a high prevalence of anxiety and depression among junior doctors, Special efforts are needed to insure psychological support, and rehabilitation programs for this “vulnerable” group.