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

OBJECTIVE: To study stress, anxiety, and depression in a group of senior health service staff. DESIGN: Postal 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 findings 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 > or = 8 on hospital anxiety and depression scale-D; P = 0.004) with no significant difference between general practitioners and consultants. General practitioners were significantly more likely to show suicidal thinking than were consultants (36 (14%) v 3 (5%); P = 0.04) but not managers (9 (13%)). No significant difference could be found between the three groups on any other measure. CONCLUSIONS: The levels of stress, anxiety, and depression in senior doctors and managers in the NHS seem to be high and perhaps higher than expected.

Assault behaviour in acute psychiatric wards and its relationship to violence in the community: a comparison of two health districts.

Evidence suggests that the level of violence in psychiatric institutions reflects that of society at large. This study investigates this by comparing the psychiatric hospital assault rates and the violent crime rates of two District Health Authorities. The differences between the two districts on each of these parameters were found to be of a very similar order, which would tend to support the hypothesis.