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We thank Williams et al.1 for their article describing the rates of depressive symptoms among pharmacy residents. Their work adds to the literature and critical discussion of depression rates among healthcare providers. The researchers found the overall rate of depressive symptoms in pharmacy residents, as measured by the Patient Health Questionnaire (PHQ-9) score, was higher than reported depression rates among medical residents and the general U.S. population. Even though the article showed an increase in depression symptoms in pharmacy residents, data were not presented regarding the change in severity over time. Additionally, this article examined depressive symptoms specifically in September, December, and March during a residency year and did not identify mental health resources within each program, limiting prevalence conclusions and resultant recommendations.

While a focus has been on the prevalence of depression among residents, it is important to consider symptom severity and change over time. Medical residents have been reported to have severe depression rates of 11.3% (defined by a Centers for Epidemiologic Studies Depression score of >21),2 and in comparison, Williams et al.1 reported a rate of severe depression (defined as PHQ-9 score 15–19) of 10.3% in pharmacy residents. While mild depression is burdensome, severe depression poses more risks to the resident and patient safety through poor job performance. In the report of Williams et al., it is unclear how the pharmacy residents’ depression levels changed during the study. How residency program directors monitor and offer support to residents would be different if changes in depressive symptoms were minor (from not depressed to mildly depressed) versus a more drastic change (from not depressed to severely depressed).

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