More than 28 percent of all resident physicians suffer from depression or depressive symptoms, according to a study published this week by JAMA.

Douglas A. Mata, MD, of Brigham and Women’s Hospital and Harvard Medical School, and colleagues reviewed findings involving more than 17,000 physicians from January 1963 to September 2015. The actual number of resident physicians suffering from depression could range anywhere from 20.9 percent to 43.2 percent, depending on how exactly the number is calculated, the authors wrote.

The data also shows that depression increased among resident physicians with each calendar year.

“Because the development of depression has been linked to a higher risk of future depressive episodes and greater long-term morbidity, these findings may affect the long-term health of resident doctors,” the authors wrote. “Depression among residents may also affect patients, given established associations between physician depression and lower-quality care. These findings highlight an important issue in graduate medical education.”

Mata et al. also added that many of the studies from the past six decades were performed in a less-than-ideal clinical environment.

“The vast majority of participants were assessed through self-report inventories that measured depressive symptoms, rather than gold-standard diagnostic clinical interviews for major depressive disorder,” the authors wrote. “The sensitivity and specificity of these instruments for diagnosing major depressive disorder vary substantially.”

Thomas L. Schwenk, MD, University of Nevada School of Medicine, wrote an editorial for JAMA, describing the study’s findings as “discouraging.”

“The prevalence is unacceptably high, with both personal and professional consequences,” Schwenk wrote. “Studies among medical students and residents have demonstrated that burnout, a different but closely related construct to depression, is associated with higher self-reported rates of cheating on examinations, lying about clinical data, medical errors, and ethical lapses, as well as less altruistic and compassionate care. Relieving the burden of depression among physicians in training is an issue of professional performance in addition to one of human compassion.”

Schwenk went on to name possible solutions to this problem “Provide more and better mental health care to depressed physicians and those in training, limit the trainees’ exposure to the training environment and system that are thought to contribute at least in part to poorer mental health and wellness, and consider the possibility that the medical training system needs more fundamental change.”