BACKGROUND: Previous studies have highlighted risks for depression and suicide in medical cohorts, but evidence regarding psychiatric residents is missing. This study aimed to determine rates of depression, suicide ideation and suicide attempt among psychiatric residents and to identify associated individual, educational and work-related risk factors. METHODS: A total of 1980 residents from 22 countries completed the online survey which collected data on depression (PHQ-9), suicidality (SIBQ), socio-demographic profiles, training, and education. Generalized linear modeling and logistic regression analysis were used to predict depression and suicide ideation, respectively. RESULTS: The vast majority of residents did not report depression, suicide ideation or attempting suicide during psychiatric training. Approximately 15% (n = 280) of residents met criteria for depression, 12.3% (n = 225) reported active suicide ideation, and 0.7% (n = 12) attempted suicide during the training. Long working hours and no clinical supervision were associated with depression, while more completed years of training and lack of other postgraduate education (e.g. PhD or psychotherapy training) were associated with increased risk for suicide ideation during psychiatric training. Being single and female was associated with worse mental health during training. LIMITATIONS: Due to the cross-sectional nature of the study, results should be confirmed by longitudinal studies. Response rate was variable but the outcome variables did not statistically significantly differ between countries with response rates of more or less than 50%. CONCLUSION: Depression rates among psychiatric residents in this study were lower than previously reported data, while suicide ideation rates were similar to previous reports. Poor working and training conditions were associated with worse outcomes. Training programmes should include effective help for residents experiencing mental health problems so that they could progress through their career to the benefit of their patients and wider society.

1st Psychiatric Department Eginition Hospital Medical School National and Kapodistrian University of Athens Greece

Children's University Hospital Temple St Dublin and School of Medicine and Medical Sciences University College Dublin Ireland

Department for Affective Disorders Aarhus University Hospital Denmark

Department of child psychiatry University Children's Hospital Bohoričeva 20 1525 Ljubljana Slovenia

Department of Psychiatry and Psychoterapy Semmelweis University Budapest Hungary

Department of Psychiatry University of Campania Luigi Vanvitelli Naples Italy

Department of Psychiatry University of Medicine and Pharmacy of Tîrgu Mureş Tîrgu Mureş Romania

Department of Psychology University of Ljubljana Aškerčeva 2 SI 1000 Ljubljana Slovenia

Heiligenfeld Klinik Waldmünchen Krankenhausstrasse 3 93449 Waldmünchen Germany

Hellesdon Hospital and Norwich Medical School University of East Anglia Norwich UK

Hospital Júlio de Matos do Centro Hospitalar Psiquiátrico de Lisboa e Clínica Universitária de Psiquiatria e Psicologia Médica da Faculdade de Medicina da Universidade de Lisboa Lisboa Portugal

InnerHour Mumbai India

Institute of Neuropsychiatric Care Prague and Department of Psychiatry 1st Faculty of Medicine Charles University Prague Czech Republic

PHI Health Center Prijedor Community Mental Health Center Kralja Aleksandra 23 79000 Prijedor Bosnia and Herzegovina

Private practice 122A New Henry House 10 Ice House Street Central Hong Kong

Private Practice 140 Avenue Victor Hugo 75116 Paris France

Psychiatric Clinic of Minsk City Minsk Belarus

Psychiatric Clinic Tartu University Hospital Tartu Estonia

Regional Ressource Center of Old Age Psychiatry Corentin Celton Hospital Issy les Moulineaux and Academic Hospital of West Paris APHP Descartes University Paris 5 France

Riga Stradins University Riga Latvia

Siberian State Medical University Moskovsky tract 2 Tomsk 634050 Russia

Tokiwa Child Development Center Tokiwa Hospital and Department of Neuropsychiatry School of Medicine Sapporo Medical University Japan

Unit for Social and Community Psychiatry WHO Collaborating Centre for Mental Health Service Development Blizard Institute Queen Mary University of London NCfMH Glen Road London E13 8SP UK

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