Abstract
To explore the prevalence of depression among emergency medicine (EM) interns before and during the COVID-19 pandemic. The Intern Health Study is a national longitudinal cohort study examining mental health among interns across various specialties. In this secondary analysis, we focused specifically on EM interns from 2008 to 2022. Participants completed a baseline survey before their intern year and quarterly surveys throughout their intern year. Depression severity was assessed using the Patient Health Questionnaire (PHQ9), with scores of 10 or higher indicating moderate-to-severe depression. In total, 1956 EM interns from 160 programs completed all PHQ9 surveys. PHQ9 scores at baseline (start of the intern year) were significantly lower prior to the COVID-19 pandemic compared to during it (p < 0.001). PHQ9 scores at month 9 were significantly higher during the COVID-19 pandemic (p < 0.05) compared to pre-COVID-19 pandemic interns at month 9. One-way ANOVA comparing pre-COVID-19 and during COVID-19 differences in PHQ9 from baseline to the end of intern year revealed a significant difference, with during COVID-19 differences being significantly less than pre-COVID-19. There was no significant difference in the proportion of interns with PHQ9 scores greater than 10 during the COVID-19 pandemic. The COVID-19 pandemic had a significant effect on the mental health of EM interns, with higher baseline depression scores observed during the pandemic. However, the smaller change in depression severity over the intern year during the pandemic suggests a complex interplay of factors that warrants further investigation. Our study is the first to examine depression among EM interns during the COVID-19 pandemic using a large, multi-year sample, providing a unique and comprehensive analysis of how the pandemic impacted mental health in this high-risk group. Unlike previous studies with smaller sample sizes, our research offers robust, generalizable insights into the trends and severity of depression in EM interns, highlighting the critical need for ongoing mental health support in medical training.