【摘要】 目的 探讨精神科规范化培训医生（规培生）焦虑、抑郁的情况，分析职业倦怠在工作负荷和焦虑、抑郁之间的中介作用。方法 于2021年2月至2022年2月选取北京回龙观医院、北京大学第六医院、首都医科大学附属北京安定医院的1 174名精神科规培生为研究对象。采用Maslach职业倦怠问卷（MBI-GS）、9项患者健康问卷（PHQ-9）、7项广泛性焦虑障碍量表（GAD-7）以及自制的工作负荷调查量表调查规培生的职业倦怠感、焦虑情绪、抑郁情绪以及工作负荷。采用SPSS 26.0软件Process V3.4插件中的模型4分析精神科规培生职业倦怠在工作负荷和焦虑、抑郁情绪之间的中介效应。结果 本研究共发放问卷1 174份，回收有效问卷1 129份，问卷有效回收率为96.17%。不同规培年限、身份类型、个人月收入规培生的抑郁情况比较，差异有统计学意义（P<0.05）；不同规培年限、身份类型、个人月收入、文化程度规培生的焦虑情况比较，差异有统计学意义（P<0.05）。精神科规培生工作负荷量表得分为7.00(5.00,8.00)分，GAD-7得分为5.00(2.00,9.00)分，PHQ-9得分为5.00(2.00,9.00)分，MBI-GS得分为35.00(24.00,44.00)分。规培生职业倦怠、工作负荷、焦虑情绪以及抑郁情绪两两之间呈正相关（r=0.421～0.838;P<0.001）。规培生工作负荷对焦虑情绪与抑郁情绪的直接预测作用显著（β=0.693、0.465;P<0.001），工作负荷正向预测职业倦怠（β=4.728,P<0.001），职业倦怠正向预测焦虑情绪与抑郁情绪（β=0.189、0.237;P<0.001）。规培生职业倦怠在工作负荷与焦虑情绪之间起部分中介作用，中介效应值为0.868(95%CI:0.742～0.998)，占总效应的55.82%；职业倦怠在工作负荷与抑郁之间起到部分中介作用，中介效应值为1.092(95%CI:0.930～1.254)，占总效应的69.87%。结论 工作负荷不仅直接影响精神科规培生焦虑与抑郁情绪，还通过职业倦怠间接影响焦虑与抑郁情绪。更多还原

【Abstract】 Objective To explore the anxiety and depression among psychiatric standardized training students, and analyze the mediating role of job burnout between workload and anxiety and depression.Methods From February 2021 to February 2022, 1 174 psychiatric standardized training students from Beijing Huilongguan Hospital, Peking University Sixth Hospital, Beijing Anding Hospital of Capital Medical University were selected as the research subject. The Maslach Burnout Inventory-General Survey(MBIGS), Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder 7-Item(GAD-7), and selfmade workload questionnaire were used to investigate the job burnout, anxiety, depression, and workload of standardized training students. Model 4 in the Process V3.4 plugin of SPSS 26.0 software was used to analyze the mediating effect of job burnout between workload and anxiety and depression. Results A total of 1 174questionnaires were distributed, and 1 129 valid questionnaires were collected, with an effective response rate of 96.17%. There were statistically significant differences in depression among standardized training students with different training years, identity types, personal income, and educational levels(P < 0.05). There were statistically significant differences in anxiety among standardized training students with different identity types, personal income, and educational levels(P<0.05). The workload questionnaire, GAD-7, PHQ-9, and MBIGS scores of psychiatric standardized training students were 7.00(5.00,8.00), 5.00(2.00,9.00), 5.00(2.00,9.00), and 35.00(24.00,44.00), respectively. There were positive correlations between job burnout, workload, anxiety, and depression among standardized training students, and the difference was statistically significant(r=0.421-0.838; P < 0.001). The direct predictive effect of the workload of standardized training students on anxiety and depression was significant(β=0.693, 0.465; P<0.001), workload positively predicted job burnout(β=4.728, P<0.001), job burnout positively predicted anxiety and depression(β=0.189, 0.237; P<0.001), the above differences were statistically significant. Job burnout had a partial mediating effect between workload and anxiety, with a mediating effect value of 0.868 [95%CI(0.742, 0.998)], accounting for 55.82% of the total effect. Job burnout partially mediated the relationship between workload and depression, with a mediating effect value of 1.092 [95%CI(0.930, 1.254)], accounting for 69.87% of the total effect. Conclusions Workload not only directly affects the anxiety and depression of psychiatric standardized training students, but also indirectly affects anxiety and depression through job burnout.更多还原