818 Prevalence of and Risk Factors for Depression, Anxiety, and Burnout in U.S. Neurosurgical Residents

INTRODUCTION: Rates of mental illness are disproportionately higher among medical residents. Neurosurgical trainees are no exception and may be more likely to suffer from depression, anxiety, and/or burnout than other residents. An assessment of the prevalence of mental illness in U.S. neurosurgical residents in the post-COVID-19 era is lacking in the literature and understanding the risk factors is vital to combating these mental health disorders. METHODS: Cross-sectional study analyzing responses to a 28-question survey from March-May 2023 distributed to U.S. neurosurgery residents. The survey included demographic and program-specific information, as well as Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) screening questions. PHQ-9 and GAD-7 scores >5 represent at least mild depression and anxiety, respectively. RESULTS: Forty-eight responses were included in the analysis, which consisted of 35 males (74%), 36 married respondents (77%), and 27 junior residents (56%, PGY-1 to 4). Twenty-four residents (50%) screened positive for depression, 19 residents (40%) screened positive for anxiety, and 26 residents (54%) reported feeling burned out. Depressed residents were highly more likely to also suffer from anxiety (70%, p < 0.0001) and burnout (79%, p = 0.001). Further, junior residents (63%, p = 0.042), female residents (83%, p = 0.008), and residents on a neurosurgical rotation (60%, p = 0.036) were more likely to screen positive for depression. However, being married (p = 0.318), practicing in one’s home state (p = 0.724), having a 24-hour call system (0.188), having formal didactic time (p = 0.125), and having program-led wellness initiatives (p = 0.069) were not protective. CONCLUSIONS: Half of U.S. neurosurgery residents who responded screened positive for depression, 40% screened positive for anxiety, and 54% felt burned out. Depression was strongly correlated with both anxiety and burnout. Neurosurgery residents who were female, in their junior years, and on-service were at particularly high risk for depression.