Online CBT Reduces Suicidal Thoughts in New Doctors

For new doctors, the first year of internship is often one of severe stress, very little sleep, and self-doubt which, according to research, can increase thoughts of suicide to nearly four times the normal rate. A new study, however, has found that a free web-based tool designed to support a new doctor’s mental health may significantly reduce the rate of suicidal thoughts.

The study was led by a team led by psychiatrists at the University of Michigan (U-M) and the Medical University of South Carolina (MUSC) who have been studying depression and suicide among medical students and young doctors for years.

Their free online tool, called MoodGYM, is a web-based cognitive behavioral therapy (wCBT) intervention that offers a digital, streamlined form of the “talk therapy” that mental health professionals would provide in office visits.

The positive results have even greater implications in that wCBT could help anyone experiencing high-stress, high-pressure positions. Teaching hospitals and medical schools could use the new results to guide mental health programs for interns, residents, and medical students.

“This is a relatively risk-free intervention to help interns recognize and treat depression,” says Srijan Sen, M.D., Ph.D., senior author of the new study and a U-M Medical School faculty member. “This is the first study to show that wCBT can reduce suicidal ideation, or suicidal thoughts, in training doctors.”

Medical interns are a unique and ideal population to study wCBT’s effects, says Sen, because all of them experience a predictable sharp rise in stress and pressure with the start of their residency. Sen’s past work has shown how this intense pressure makes them particularly prone to depression.

Connie Guille, M.D., of MUSC, first author of the study, adds that this type of intervention is well-suited to this population because “the majority of interns won’t seek traditional mental health treatment, mainly because they lack the time, don’t have convenient access to care, or have concerns about confidentiality.”

The researchers tested the app on 199 interns. All volunteered to take part, and half were randomly assigned to use the wCBT group. The other half got general information on depression and suicide, and contact information for mental health professionals.

The findings show that one in five of the latter group thought about suicide at some point in their internship year, compared to one in eight of those who used the MoodGym. Most of those assigned to use the MoodGym site stuck with it, using it all year.

The researchers are working to build on the success of the wCBT test by developing an app designed specifically for medical trainees. It will focus on specific situations and stresses that new doctors encounter. They’re not affiliated with MoodGym’s developers, from the National Institute for Mental Health Research at the Australian National University.

“Doing this in physicians means we now have a model that shows that this form of wCBT can be remarkably effective as a preventive tool,” says Sen. “There’s a good chance that it would be helpful for all populations undergoing some sort of stress and should be explored and tested in these populations in the future”

The findings are published in the journal JAMA Psychiatry.

Source: University of Michigan Health System

Young doctor using her laptop photo by shutterstock.