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Asia Pac Psychiatry. 2013 Apr;5 Suppl 1:74-81. doi: 10.1111/appy.12048.

Physician, heal thyself: the paradox of anxiety amongst house officers and work in a teaching hospital.

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  • 1Department of Psychiatry, Universiti Kebangsaan Malaysia, Malaysia.



Anxiety among house officers may impair functioning and health care delivery. This study aimed to determine the association between anxiety among house officers at Universiti Kebangsaan Malaysia Medical Center, sociodemographic and work-related factors.


A cross-sectional study using the self-rated and validated Malay Depressive Anxiety and Stress Scale 21, the General Stressor Questionnaire and a sociodemographic questionnaire.


Of the 89 house officers, 60.7% were anxious. Multivariate logistic analysis showed work-related challenges, performance pressure (odds ratio [OR] = 9.000, 95% confidence interval [CI] = 1.812-44.705), poor relationship with supervisors (OR = 5.212, 95% CI = 2.033-3.365), poor relationship with colleagues (OR = 4.642, 95% CI = 1.816-11.866), bureaucratic constraints (OR = 3.810, 95% CI = 1.541-9.415) and poor job prospects (OR = 3.745, 95% CI = 1.505-9.321) strongly associated with anxiety. Family-related stressors were less significant (OR = 1.800, 95% CI = 0.760-4.266) unless they were work related (work-family conflicts [OR = 8.253, 95% CI = 2.652-25.684]).


Almost two-thirds of this cohort reported work-related anxiety symptoms. Administrators need to address these mental health needs early. The subsequent improvement in communication skills, conflict resolution and anxiety reduction will result in short- and long-term benefits towards the young doctors's mental health. The cascading impact on these individuals, thus empowered, will be good work-life balance, improved patient care and safety, a satisfying medical career whilst contributing maximally to the country's health care.


Malaysia; anxiety; internship; medical house officers; stressors

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