Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers

BMJ 1994; 309 doi: (Published 12 November 1994) Cite this as: BMJ 1994;309:1261
  1. R P Caplan
  1. Department of Psychiatry Lincoln County Hospital, Lincoln LN2 5QY.
  • Accepted 16 September 1994


Objective: To study stress anxiety, and depression in a group of senior health service staff.

Design: Postsal survey.

Subjects: 81 hospital consultants, 322 general practitioners, and 121 senior hospital managers (total 524).

Main outcome measures: Scores on the general health questionnaire and the hospital anxiety and depression scale.

Results: Sixty five (80%) consultants, 257 (80%) general practitioners, and 67 (56%) managers replied. Of all 389 subjects, 183 (47%) scored positively on the general health questionnaire, indicating high levels of stress. From scores on the hospital anxiety and depression scale only 178 (46%) would be regarded as free from anxiety, with 100 (25%) scoring as borderline cases and 111 (29%) likely to be experiencing clinically measurable symptoms. The findigns for depression were also of some concern, especially for general practitioners, with 69 (27%) scoring as borderline or likely to be depressed. General practitioners were more likely to be depressed than managers (69 (27%) v 4 (6%) scored >=8 on hospital anxiety and depression sacle-D; P=0.004) with no sgnificant difference between general practitioners and consultants. General practitioners were significantly more likely to show suicidal thanking than were consultants (36 (14%) v 3 (5%); P=0.04) but not managers (9 (13%)). No significant differnce could be found between the three groups on any other measure.

Conclusions: the levels of stress, anxiety, and depressionin senior doctors and managers in the NHS seem to be high and perhaps higher than expected.


    • Accepted 16 September 1994
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