The effect of long working hours on mental health among Chinese medical residents: A multi-center cross-sectional study (Preprint)

BACKGROUND Long working hours are common among medical residents and may increase the risk of mental disorders. OBJECTIVE We aimed to investigate this risk among Chinese medical residents. METHODS This multi-center, cross-sectional study was conducted in February 2020; 1,343 residents from eight hospitals in Northeastern China were included in the final analysis. The data were collected from participants via self-reported questionnaires. Depression and anxiety were measured by the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale, respectively. Adjusted odds ratios and 95% confidence intervals were determined after adjusting for potential confounders by binary unconditional logistic regression. RESULTS The effective response rate was 87.61%. Among the 1,343 participants, 12.88% (173), 9.90% (133), and 9.68% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. We found that longer weekly worktime increased the risk of major depression, particularly in those who worked for more than 60 hours per week (≥ 61 hours vs. ≤ 40 hours, OR=1.87, P for trend = 0.003). However, this trend was not observed for either major anxiety or suicidal ideation (P for trend > 0.05 for both). CONCLUSIONS This study revealed that there was a considerable incidence of poor mental health among medical residents; furthermore, the longer weekly worktime was associated with a higher risk of major depression, especial for those who worked more than 60 hours per week, but this association was not observed in either major anxiety or suicidal ideation. This may help policymakers to develop targeted interventions.