Training residents in depression and grief.

Background: About 20 per cent of Americans will experience depression in their lifetimes, and almost all will experience the death of a loved one. Both depression and grief have been associated with adverse health outcomes, including a decline in quality of life and excess mortality. Primary care physicians (PCPs) are the initial health care contact for most patients with depression and grief, yet often perceive that they lack the skills to adequately address these issues. Previous studies have investigated whether educational efforts improve PCP depression and grief knowledge or perceived skills, but few have focused on medical residents. There is the potential that resident education may impact practice over a longer span of time than later career training, simply because it occurs earlier in one's medical career.

Methods: The authors examined whether a brief educational curriculum, delivered in two 2-hour sessions to 40 internal medicine residents, was associated with changes in knowledge, attitudes, comfort level and reported behaviours, with regards to grieving or depressed patients. Self-report surveys were administered before and about 5 months after receipt of the new curriculum.

Results: Residents receiving the curriculum reported increases in knowledge, confidence and self-reported behaviours in working with patients suffering depression and grief. Both depression and grief have been associated with adverse health outcomes DISCUSSION: Although more research is needed to determine whether these findings can be replicated in other settings, the results are promising. Further dissemination of such training may ultimately enhance the detection and treatment of depression and grief in primary care, and decrease the associated emotional and functional burdens in patients.