ABSTRACT
Major depressive disorder (MDD) is among the most prevalent disorders in the US that often goes underdiagnosed and untreated. The burden of disability among those untreated is heaviest among untreated minority populations. Recent studies show that among African Americans, those with socioeconomic stress are less likely to report psychological symptoms or remain compliant with initiated treatment. While minority populations are less likely to suffer from acute episodes of MDD than Caucasians, they are more likely to suffer from prolonged, chronic, and severely debilitating depression with heavy consequences on their level of daily functioning. Part of the problem of underdiagnoses lies with the provider. Many providers today are unable to notice subtleties in presentation or recognize uncommon presentation of disease. This paper focuses on discrepancies in the presentation of depression among minorities when compared to Caucasians as well as factors that serve as boundaries for successful treatment.
ABSTRACT
OBJECTIVE: Psychiatry residents face challenges daily that test their capacity to be empathic and attuned to their own self-care. This can have a deleterious impact not only on the residents but also on patient-care. Training to manage the challenges of the work and cultivate stronger patient relationships is needed but often missing in medical education. This study aimed to pilot an empathy training course based in relational mindfulness and assess the impact on burnout and empathy. METHODS: Seven first-year psychiatry residents (PGY-1) at an academic medical center in a mid-size city in the southeast participated in an eight-week pilot program created by the authors that integrated relational mindfulness and empathy training. Data were gathered from the seven PGY-1s on measures of burnout and empathy and on their experience of the training. RESULTS: The PGY-1s demonstrated a downward trend in means on all three burnout subscales and significant improvement on the measure of empathy (f = 8.98; p = .02). Overall, the PGY-1s reported an increased awareness of their cognitive and emotional experiences and stated that the skills learned in the program increased their ability to care for themselves, their patients, and their families. CONCLUSIONS: Training in intrapersonal and interpersonal attunement is often overlooked in medical training, leading to resident burnout and negative patient outcomes. An empathy course based in relational mindfulness may be a viable strategy for programs looking to attend to their residents' emotional health and bridge the empathy training gap.
