Rates of Depression and Anxiety in Physical Therapy and Occupational Therapy Students: A Cross-Profession Comparison Study
Purpose: Rates of internalizing disorders (i.e., anxiety and depression) have been steadily increasing in college students. Internalizing disorders in medical and nursing students have been associated with greater propensity to make medical errors4 and a higher likelihood of student departure,5 indicating that mental health impacts both education and practice. To date, however, comparatively few investigations have focused on the mental health of Physical Therapy (PT) or Occupational Therapy (OT) students.6,7 Questions arise, therefore, as to whether PT/OT students exhibit similar rates and correlates of anxiety/depression as other health-related and non-health-related fields. The present study aimed to answer these questions using data from a large, nationally-distributed survey of college student mental health.Methods/Description: College students’ responses from the 2016-2017 National Healthy Minds Study (HMS) were used by permission as archival data. PT/OT students’ responses (N = 327) were compared to students of nursing (N = 3578), medicine (N = 639), and seven non-health-related fields (e.g., law, business). All participants completed the HMS online and provided self-report responses for validated measures of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) symptom severity, as well as an HMS-developed item assessing the academic impact of mental health.8,9 Multigroup structural equation modeling (MSEM) was used to examine between-group differences while controlling for the confounding effects of measurement error. MSEM identified if (a) anxiety and depression scores could be confidently compared across each profession, (b) PT/OT students evidenced significantly higher rates of anxiety/depression compared to other professions, and (c) the associations between anxiety/depression and academic impact were moderated by profession.Results/Outcomes: Results indicated that the latent anxiety and depression variables were assessing the same construct in each profession, meaning each could be compared across groups with confidence. PT/OT evidenced the lowest anxiety severity compared to nursing and most non-health-related fields, but there were no differences compared to medical students, and PT/OT generally reported the same levels of depression as all comparison groups. Approximately 20% of PT/OT students screened positive for clinical levels of depression or anxiety, and profession did not moderate the associations between depression/anxiety and a measure of academic impact. Depression/anxiety symptom severity explained 40% of the variation in academic impact.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Findings suggest that PT/OT students appear to be equally as likely of experiencing depression as their medical and non-medical student peers, and that the negative academic effects of anxiety and depression are prevalent for all college students, including those in PT/OT programs. More attention is needed toward PT mental health and well-being.References: 1. Gallagher RP. National Survey of College Counseling Centers 2014. The International Association of Counseling Services (IACS); 2015. 2. Prince JP. University student counseling and mental health in the United States: Trends and challenges. Mental Health & Prevention. 2015;3(1):5-10. 3. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis. JAMA. 2016;316(21):2214-2236. 4. Melnyk BM, Orsolini L, Tan A, et al. A national study links nurses’ physical and mental health to medical errors and perceived worksite wellness. J Occup Environ Med. 2018;60(2):126-131. 5. Hartley MT. Increasing resilience: Strategies for reducing dropout rates for college students with psychiatric disabilities. American Journal of Psychiatric Rehabilitation. 2010;13(4):295-315. 6. Macauley K, Plummer L. Prevalence and predictors of anxiety in doctor of physical therapy students. J Allied Health. 2017;46(2):39E-41E. 7. Frank LM, Cassady SL. Health and wellness in entry-level physical therapy students: Are measures of stress, anxiety, and academic performance related? Cardiopulm Phys Ther J. 2005;16(4):5-13. 8. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. 9. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092-1097.