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Dalum HS, Hem E, Ekeberg Ø, Reneflot A, Stene-Larsen K, Hauge LJ. Suicide rates among health-care professionals in Norway 1980-2021. J Affect Disord 2024; 355:399-405. [PMID: 38537752 DOI: 10.1016/j.jad.2024.03.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/28/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Suicide rates have been high in several health-care professions. Suicide rates were described in physicians, dentists, veterinarians, psychologists, pharmacists, nurses, as well as theologians, other graduates and the general population in Norway. METHODS Data on educational attainment were linked to data on suicide and all-cause mortality from 1980 to 2021. Suicide rates were reported per 100,000 person-years. The total number of person-years included in the study was 66.4 and 67.2 million for males and females, respectively. RESULTS Between 1980 and 2021, male veterinarians (35.9, 95 % CI 19.3-52.4), physicians (25.7, 21.3-30.2) and nurses (22.2, 16.6-27.7) had higher suicide rates compared others with higher education (11.7, 10.7-12.7). For females, this was the case for psychologists (15.0, 8.2-21.7) and nurses (9.3, 8.3-10.3), vs. others with higher education (5.1, 4.2-6.0). Suicide rates declined over the four decades for most groups. For physicians, suicide rates declined and approached the suicide rate of others with higher education. Suicide rates among physicians increased with age, with physicians over 60 years having twice as high suicide rates compared to others with higher education. LIMITATIONS The study included only educational status, not current occupation or employment status. This is a descriptive study, with some known risk factors for suicide not accounted for. CONCLUSIONS Suicide rates for physicians declined over time, but not for nurses. From 2010 to 2021, nurses of both genders was the only group with higher suicide rates compared to other graduates. The increased suicide rates among veterinarians, nurses, female psychologists and elderly physicians are concerning.
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Affiliation(s)
- Helene Seljenes Dalum
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Institute for Studies of the Medical Profession, Oslo, Norway.
| | - Erlend Hem
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Institute for Studies of the Medical Profession, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Khalil MA, Khalifa D, Allam RM, Abdalgeleel SA, Khalaf OO. Suicide and depressive symptoms possible correlates among a sample of Egyptian physicians: observational cross-sectional study (online survey). BMC Psychiatry 2024; 24:408. [PMID: 38816711 PMCID: PMC11137965 DOI: 10.1186/s12888-024-05825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Compared to other occupations, physicians are more susceptible to depression and suicide. Suicide among physicians in some countries reached up to 1.5- to threefold higher than the general population. However, this rate was not homogenous in all countries. Most of the Egyptian studies were related to the stressful pandemic event, but the actual prevalence of depression among physicians is still under research. To the best of the researcher's knowledge, no other study has been conducted to evaluate the risk of suicide among Egyptian physicians. AIM The study aimed to screen for depressive symptoms and suicide among Egyptian physicians and to investigate the correlates associated with suicide ideations. METHODS This cross-sectional survey included Egyptian physicians recruited online by Google Forms. Depressive symptoms were screened using the Beck Depression Scale (BDI-II), while suicidal ideas were assessed using the Suicidal Ideation Attributes Scale (SIDAS). RESULTS Six hundred sixty Egyptian physicians completed the survey following a two-week pilot study between January 10 and July 16, 2023. The average age was 39.1 years, and 71.4% were married. 49.1% were medical specialists. The median daily working hours were eight, and 27.7% of the physicians attended night shifts. 22.3% had a psychiatric illness, and 34.3% had a chronic disease. Younger and single physicians of both sexes were more prone to suicide risk (p-value = 0.019 and 0.021, respectively). Those with psychiatric or chronic medical disorders had a higher suicidal risk (p-values < 0.001 and 0.004, respectively). Physicians with fewer academic degrees and those who work longer hours or night shifts had more depressive symptoms (p-values < 0.001 and 0.009, respectively). The risk of depression and suicide is almost the same in all medical specialties. The SIDAS suicide score and the Beck depression score revealed a statistically significant association (r = 0.288, p-value < 0.001). CONCLUSION Suicide risk is higher among younger, single physicians of both sexes, as well as those with psychiatric or chronic medical disorders. More depressive symptoms are seen in physicians who have more extended hours or night shifts and who have fewer academic degrees. Almost all medical specialties carry the same risk of depression and suicide. Longitudinal research is recommended for regular follow-up of suicidal thoughts and depressive symptoms.
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Affiliation(s)
- Mohamed A Khalil
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Khalifa
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Mahmoud Allam
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
| | - Shaimaa Abdalaleem Abdalgeleel
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
- Department of Public Health, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Ola Osama Khalaf
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Kobo O, Abramov D, Volgman AS, Mieres JH, Wijeysundera HC, Van Spall HGC, Mamas MA. Causes of Death Among Health Care Professionals in the United States. Popul Health Manag 2023; 26:294-302. [PMID: 37643310 DOI: 10.1089/pop.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Specific causes of mortality among various types of health care professionals (HCPs), including those characterized by age, gender, and race, have not been well described. The National Occupational Mortality Surveillance data for deaths in 26 US states in 1999, 2003-2004, and 2007-2014 were queried to address this question. Proportionate mortality ratios (PMRs) were calculated to compare specific causes of mortality among HCPs compared with those among the general population. HCPs were less likely to die from heart disease (PMR 93, 95% confidence intervals [CI] 92-94), alcoholism (PMR 62, 95% CI 57-68), drugs (PMR 80, 95% CI 70-90), and more likely to die from cerebrovascular disease (PMR 105, 95% CI 104-107) and diabetes (PMR 107, 95% CI 105-109). HCPs aged 18-64 years were more likely to die by suicide (PMR 104, 95% CI 101-107), whereas those aged 65-90 years were less likely to die by suicide (PMR 84, 95% CI 77-91), with physicians (PMR 251, 95% CI 229-275) and other HCPs having high PMR for suicide. Among all HCPs, suicide PMR was similarly increased, whereas heart disease PMRs are similarly decreased among Black compared with those among White HCPs and those among male compared with those among female HCPs. HCPs as a group and specific types of HCPs demonstrate causes of mortality that differ in important ways from the general population. Race and gender-based trends in PMRs for key causes of mortality among HCPs suggest that employment in a health care field may not alter race and gender disparities noted among the general population.
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Affiliation(s)
- Ofer Kobo
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
| | - Dmitry Abramov
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, California, USA
| | - Annabelle Santos Volgman
- Division of Cardiology, Department of Internal Medicine, Rush Medical College, Chicago, Illinois, USA
| | - Jennifer H Mieres
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Harindra C Wijeysundera
- Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, California, USA
| | - Harriette G C Van Spall
- Department of Medicine and Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
- Research Institute of St. Joseph's, Hamilton, Ontario, Canada
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
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Mark Anderson D, Diris R, Montizaan R, Rees DI. The effects of becoming a physician on prescription drug use and mental health treatment. JOURNAL OF HEALTH ECONOMICS 2023; 91:102774. [PMID: 37451143 DOI: 10.1016/j.jhealeco.2023.102774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023]
Abstract
There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that determine admission into medical schools, we find that becoming a physician increases the use of antidepressants, anxiolytics, opioids, and sedatives. Increases in the use of antidepressants, anxiolytics, and sedatives are larger among female physicians than among their male counterparts.
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Affiliation(s)
- D Mark Anderson
- Department of Agricultural Economics and Economics, Montana State University, NBER, United States; IZA - Institute of Labor Economics, Bonn, Germany.
| | - Ron Diris
- Department of Economics, Leiden University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Raymond Montizaan
- Research Centre for Education and the Labour Market, Maastricht University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Daniel I Rees
- Department of Economics, Universidad Carlos III de Madrid, Spain
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5
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Petrie K, Zeritis S, Phillips M, Chen N, Shand F, Spittal MJ, Harvey SB. Suicide among health professionals in Australia: A retrospective mortality study of trends over the last two decades. Aust N Z J Psychiatry 2023; 57:983-993. [PMID: 36655674 DOI: 10.1177/00048674221144263] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To examine the relative risk of suicide among healthcare professionals compared to other occupations and examine changes in suicide rates over time. METHODS Suicide cases were identified using the National Coronial Information System and were included if they were recorded as a death by intentional self-harm between 2001 and 2017 and were by an employed adult aged 20-69 with a known occupation at the time of death. Suicide methods were reported descriptively. Workforce data at the population level was extracted from the Australian Bureau of Statistics 2011 Census. Age-standardised suicide rates per 100,000 person-years for each of the four occupational groups were calculated using direct standardisation and using the Australian Bureau of Statistics population-level data from the 2011 Census. Negative binomial regression was used to estimate suicide risk by healthcare employment status and profession, to investigate differences by sex and to examine trends in suicide rates over time, using rate ratios and 95% confidence intervals. RESULTS Healthcare professionals were at increased risk of suicide compared to other occupations (rate ratio = 1.30, 95% confidence interval = [1.19, 1.42], p < 0.001), controlling for age, sex and year of death. Nurses and midwives were identified as being at significantly increased risk of suicide (rate ratio = 1.95, 95% confidence interval = [1.73, 2.19], p < 0.001). Suicide rates among female medical practitioners increased substantially over time (p = 0.01). CONCLUSION Health professionals are at significantly increased risk of suicide, though the relative risk of different groups is changing over time. There has been a substantial increase in the risk of suicide among female medical practitioners with rates of suicide in this group more than doubling over the last two decades. Findings highlight the need for targeted suicide prevention initiatives for healthcare professionals.
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Affiliation(s)
- Katherine Petrie
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
| | | | | | - Nicola Chen
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Fiona Shand
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Zimmermann C, Strohmaier S, Niederkrotenthaler T, Thau K, Schernhammer E. Suicide mortality among physicians, dentists, veterinarians, and pharmacists as well as other high-skilled occupations in Austria from 1986 through 2020. Psychiatry Res 2023; 323:115170. [PMID: 37001488 DOI: 10.1016/j.psychres.2023.115170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/02/2023] [Accepted: 03/14/2023] [Indexed: 04/17/2023]
Abstract
Some evidence puts health professionals at increased risk of suicide, especially females, whereas other research suggests a lower risk in high-skilled occupations. This study investigated the suicide risk of four health professions (physicians, dentists, veterinarians, pharmacists) and three other high-skilled occupations (notaries, lawyers, tax advisors/public accountants) in Austria compared to the general population, and analyzed suicide methods across occupations. Data was collected from professional associations and Austrian cause-of-death statistics to determine suicide cases. Gender-specific standardized mortality ratios (SMRs), crude and age-adjusted suicide rates and frequencies for suicide methods were calculated for each profession (maximum time span 1986-2020). Among males, only veterinarians had a significantly elevated suicide risk compared to the general population. Physicians and tax advisors/public accountants had a significantly lower suicide risk. Among females, the veterinarians, physicians, and pharmacists had a significantly elevated suicide risk; for dentists, it was also elevated, though non-significantly. Age-adjusted suicide rates showed a smaller gap between men and women in all professions compared to the general population. Poisoning was the predominant suicide method among health professions, except dentists. These findings are consistent with some of the prior literature and call for specific suicide prevention efforts in health professions, focusing on women.
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Affiliation(s)
- Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Kenneth Thau
- Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, United States of America
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7
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Brandenburg JE, Schultz BA, Prideaux CC, Driscoll SW. Physician distress: Where are we and what can be done. J Pediatr Rehabil Med 2023; 16:435-442. [PMID: 37718875 DOI: 10.3233/prm-230032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Depression, suicidal ideation, burnout, and moral injury are on the rise among physicians. Depression and suicidal ideation are mental health disorders that result from multiple interacting factors including biological vulnerabilities and acute stressors. Medical treatment for depression and suicidal ideation is critical to interrupt the potentially deadly progression to suicide that occurs when one's ability to find hope and other solutions is clouded by despair. Yet, stigma and perceived stigma of seeking treatment for mental health disorders still plagues medical providers. Transitions during medical training and practice can be particularly vulnerable time periods, though newer evidence suggests that overall, physicians are not at an increased risk of suicide compared to the general population. While burnout and moral injury are common among rehabilitation physicians, unlike depression, they are not directly associated with suicidal ideation. Opportunities for continued improvement in mental health resources and institutional support exist across the spectrum from medical student to staff physician. With wellness now increasingly supported and promoted by various medical organizations and recognition of the importance of access to effective mental health treatment, regaining hope and positivity while restoring resiliency in physicians, trainees, and medical students is possible.
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Affiliation(s)
- Joline E Brandenburg
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
- Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Billie A Schultz
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Cara C Prideaux
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Sherilyn W Driscoll
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
- Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Sood MM, Rhodes E, Talarico R, Gérin-Lajoie C, Simon C, Spilg E, McFadden T, Kyeeremanteng K, T Myran D, Grubic N, Tanuseputro P. Suicide and Self-Harm Among Physicians in Ontario, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:778-786. [PMID: 35548955 PMCID: PMC9510996 DOI: 10.1177/07067437221099774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies of occupation-associated suicide suggest physicians may be at a higher risk of suicide compared to nonphysicians. We set out to assess the risk of suicide and self-harm among physicians and compare it to nonphysicians. METHODS We conducted a population-based, retrospective cohort study using registration data from the College of Physicians and Surgeons of Ontario from 1990 to 2016 with a follow-up to 2017, linked to Ontario health administrative databases. Using age- and sex-standardized rates and inverse probability-weighted, cause-specific hazards regression models, we compared rates of suicide, self-harm, and a composite of either event among all newly registered physicians to nonphysician controls. RESULTS Among 35,989 physicians and 6,585,197 nonphysicians, unadjusted suicide events (0.07% vs. 0.11%) and rates (9.44 vs. 11.55 per 100,000 person-years) were similar. Weighted analyses found a hazard ratio of 1.05 (95% confidence interval: 0.69 to 1.60). Self-harm requiring health care was lower among physicians (0.22% vs. 0.46%; hazard ratio: 0.65, 95% confidence interval: 0.52 to 0.82), as was the composite of suicide or self-harm (hazard ratio: 0.70, 95% confidence interval: 0.57 to 0.86). The composite of suicide or self-harm was associated with a history of a mood or anxiety disorder (odds ratio: 2.84, 95% confidence interval: 1.17 to 6.87), an outpatient mental health visit in the past year (odds ratio: 3.08, 95% confidence interval: 1.34 to 7.10) and psychiatry visit in the preceding year (odds ratio: 3.87, 95% confidence interval: 1.67 to 8.95). INTERPRETATION Physicians in Ontario are at a similar risk of suicide deaths and a lower risk of self-harm requiring health care relative to nonphysicians. Risk factors associated with suicide or self-harm may help inform prevention programs.
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Affiliation(s)
- Manish M Sood
- Department of Medicine, University of Ottawa, Ottawa, Canada.,Division of Nephrology, Department of Medicine, the Ottawa Hospital, Ottawa, Canada
| | - Emily Rhodes
- 10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Robert Talarico
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Caroline Gérin-Lajoie
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Christopher Simon
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Edward Spilg
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Taylor McFadden
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Kwadwo Kyeeremanteng
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Daniel T Myran
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Nicholas Grubic
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Peter Tanuseputro
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
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Atienza-Carbonell B, Guillén V, Irigoyen-Otiñano M, Balanzá-Martínez V. Screening of substance use and mental health problems among Spanish medical students: A multicenter study. J Affect Disord 2022; 311:391-398. [PMID: 35609765 DOI: 10.1016/j.jad.2022.05.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors. METHODS A multicentre cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA). RESULTS Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days. LIMITATIONS Research-based on self-reported data could favour information bias due to the social desirability effect and memory error. CONCLUSIONS A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.
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Affiliation(s)
- B Atienza-Carbonell
- Department of Medicine, University of Valencia, Valencia, Spain; Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - V Guillén
- Department of Neurosciences, School of Medicine and Nursing. University of the Basque Country, UPV/EHU, Spain.
| | - M Irigoyen-Otiñano
- Department of Psychiatry. Santa Maria University Hospital. Lleida, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
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10
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Akram B, Bibi B, Ashfaq Ahmed M, Kausar N. Work-Family Conflict and Suicidal Ideation Among Physicians of Pakistan: The Moderating Role of Perceived Life Satisfaction. OMEGA-JOURNAL OF DEATH AND DYING 2022; 85:465-482. [DOI: 10.1177/0030222820947246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent studies have shown an increased level of suicidal behavior among physicians, not only in Pakistan but all over the world. In this cross-sectional study, 622 physicians, aged 32–55 years, participated from 50 private and public hospitals located in the seven cities of the Punjab province of Pakistan. Three standardized tools were used to assess suicidal ideation, perceived life satisfaction and work-family conflict of the participants. Results showed work-family conflict as positive whereas life satisfaction was shown to be a negative predictor of suicidal ideation among the physicians. Furthermore, findings suggested that, as a moderator, percieved life satisfaction holds a significant role in decreasing the levels of work-family conflict and suicidal ideation among the physicians. Therefore, it is recommendable to incoroporate a perceived life satisfaction enhancement program into the training of physicians so that suicidal ideation may be prevented and treated effectively.
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11
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Mendoza-Saldaña JD, Viton-Rubio JE, Guzman-Carrasco SB, Pacheco-Barrios NV, Lainez-Casal CR. Characteristics and outcomes from COVID-19 among Peruvian physicians: a nationwide register-based study. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:697-701. [PMID: 34872467 DOI: 10.1080/19338244.2021.2011694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The healthcare workforce has played an integral role in fighting COVID-19 and continues to do so despite the continuous adverse outcomes. To address this issue, official public data concerning COVID-19 cases and deaths of Peruvian physicians was used to quantify the risk of death and infection by SARS-CoV-2. 20.9% Peruvian physicians were infected and 0.7% died, with the male general practitioners being the most affected group within the workforce. Notably, the Loreto region was disproportionately affected and had the highest cumulative incidence, mortality and case fatality rate. Ultimately, this identified risk group needs to be supported with sufficient resources/tools such as personal protective equipment, training, access to health care, vaccination, etc.
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Affiliation(s)
- Juan-Diego Mendoza-Saldaña
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- High Altitude Research Institute, Cayetano Heredia Peruvian University, Lima, Peru
- Mental Health Working Group, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
| | - José Enrique Viton-Rubio
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- High Altitude Research Institute, Cayetano Heredia Peruvian University, Lima, Peru
- Mental Health Working Group, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
| | - Susana Brissvany Guzman-Carrasco
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
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12
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Avoidable mortality for causes amenable to medical care and suicide in physicians in Spain. Int Arch Occup Environ Health 2021; 95:1147-1155. [PMID: 34714394 DOI: 10.1007/s00420-021-01813-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare avoidable mortality for causes amenable to medical care and suicide in physicians versus other professionals with similar university studies and socioeconomic position in Spain. METHODS All people aged 25-64 years who were employed on 1 November 2001 (8,697,387 men and 5,282,611 women) were included. Their vital status was followed for 10 years and the cause of death of deceased was recorded. Using a Poisson regression to estimate the mortality rate ratio (MRR), we compared mortality due to causes of death amenable to medical care, all other causes, and suicide in physicians versus other professionals. Mortality in physicians was used as a reference. RESULTS The lowest MRR for causes amenable to medical care was observed in engineers/architects (men: 0.84, 95% confidence interval [CI] 0.72, 0.97; women: 0.93, 95% CI 0.64, 1.35) and healthcare professions other than physicians/pharmacists/nurses (men: 0.86, 95% CI 0.56, 1.34; women: 0.69, 95% CI 0.32, 1.46). Regarding mortality for all other causes of death, professionals from these and other occupations presented lower mortality than physicians. Other healthcare professions, entrepreneurs, and managers/executives completed suicide at a higher rate than physicians. CONCLUSION Although the accessibility to the healthcare system and to the pharmacological drugs could suggest that physicians would present low rates for causes amenable to medical care and high rates of suicide, our results show that this is not the case in Spain.
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Gwiazda S, Dixon E, Cronly M, Kavanagh Y, Cullinane M, Mulligan LM. Propofol misuse in Ireland - Two case reports and a review of the literature. Forensic Sci Int 2021; 326:110909. [PMID: 34311287 DOI: 10.1016/j.forsciint.2021.110909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
Propofol is a rapidly acting sedative drug, which is usually administered intravenously. It is widely used in procedural sedation due to its rapid onset and easy reversibility. It has a good safety profile when used in combination with ventilation and monitoring. However, propofol can bring on feelings of euphoria, sexual disinhibition, tension relief and hallucinations, creating a potential for abuse. At an international level, recreational propofol use among medical staff is a growing, yet under reported problem. In order to highlight this issue in an Irish context, the case reports described are among the first recorded deaths in Ireland due to unmonitored self-administration of propofol. The difficulties facing forensic pathologists in detecting propofol and its metabolites in these cases are outlined. The potential for propofol abuse should influence healthcare facilities to make their staff aware of the risks associated with it. This in turn would promote vigilance and encourage those affected to seek treatment.
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Affiliation(s)
- Sara Gwiazda
- Office of the State Pathologist, Griffith Avenue, Whitehall, Dublin D09RDT8, Ireland
| | - Eleanor Dixon
- Human Toxicology, The State Laboratory, Backweston Campus, Co., Kildare, Ireland
| | - Mark Cronly
- Human Toxicology, The State Laboratory, Backweston Campus, Co., Kildare, Ireland
| | - Yvonne Kavanagh
- Human Toxicology, The State Laboratory, Backweston Campus, Co., Kildare, Ireland
| | - Myra Cullinane
- FRCPI, MFFLM, Barrister-at-Law, Senior Coroner for the Dublin District, Store Street, Dublin 1, Ireland
| | - Linda M Mulligan
- Office of the State Pathologist, Griffith Avenue, Whitehall, Dublin D09RDT8, Ireland.
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Davidson JE, Ye G, Parra MC, Choflet A, Lee K, Barnes A, Harkavy-Friedman J, Zisook S. Job-Related Problems Prior to Nurse Suicide, 2003-2017: A Mixed Methods Analysis Using Natural Language Processing and Thematic Analysis. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(21)00017-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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[Ethics of care and public mental health care: a case study in Barcelona]. Salud Colect 2021; 17:e2966. [PMID: 33822547 DOI: 10.18294/sc.2021.2966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
This article aims to analyze public mental health services in the city of Barcelona from a gender-based perspective. We do so through a case study of mental health services for adults in the context of recent community-oriented and transdisciplinary mental health care reforms. Employing a qualitative methodology, we look at the discourses of mental health professionals regarding the ways in which they approach the therapeutic relationship between professional and user, specifically with reference to vulnerability and proposals for addressing it. Between November 2018 and April 2019 we conducted three discussion groups with professionals and another with a group of female users. Data analysis was guided by a categorical content analysis model. The results show a tendency to understand and address vulnerability from an ethics of care based on a community care model, with differences in the discourses of men and women who participated in the research. We conclude that the community-based model promotes the recovery of users' citizenship, as it is based on a notion of interdependence, in contrast to the hospital-based mental health model.
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Lee WJ, Cha ES, Bang YJ, Hsu CY, Chang SS. Suicide deaths among diagnostic medical radiation workers in South Korea, 1996–2017. Occup Environ Med 2020; 77:675-680. [DOI: 10.1136/oemed-2020-106446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 11/04/2022]
Abstract
ObjectivesSuicide is a leading cause of death in the working-age population. We investigated suicide mortality among diagnostic medical radiation workers in relation to their demographic and occupational factors in South Korea.MethodsThe study population consisted of all diagnostic medical radiation workers enrolled in the National Dosimetry Registry from 1996 to 2011. The registry data were linked with mortality data through the end of 2017. We calculated age-standardised suicide rates, standardised mortality ratios (SMRs) and rate ratios (RRs) by demographic and occupational factors.ResultsA total of 207 suicides were identified among 94 367 medical radiation workers, exhibiting a suicide rate of 14.0 per 100 000 person-years. Compared with the general population, suicide rates were lower for both male and female workers (SMR 0.49, 95% confidence interval (CI) 0.42 to 0.57; SMR 0.54, 95% CI 0.41 to 0.70, respectively). Similarly, decreased SMRs were observed across job titles and other work-related factors. However, a shorter duration of employment was positively associated with RRs for suicide; risks were 2.74 (95% CI 1.56 to 4.81) and 4.66 (95% CI 1.53 to 14.20) times higher in male and female workers with less than 1 year of employment, respectively, than in those with at least 10 years of employment.ConclusionsDiagnostic medical radiation workers in South Korea showed lower suicide rates than in the general population. However, a shorter duration of employment was associated with higher risk of suicide. Suicide prevention efforts could target workers engaged in short-term employment.
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Dutheil F, Aubert C, Pereira B, Dambrun M, Moustafa F, Mermillod M, Baker JS, Trousselard M, Lesage FX, Navel V. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One 2019; 14:e0226361. [PMID: 31830138 PMCID: PMC6907772 DOI: 10.1371/journal.pone.0226361] [Citation(s) in RCA: 224] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/24/2019] [Indexed: 12/14/2022] Open
Abstract
Background Medical-related professions are at high suicide risk. However, data are contradictory and comparisons were not made between gender, occupation and specialties, epochs of times. Thus, we conducted a systematic review and meta-analysis on suicide risk among health-care workers. Method The PubMed, Cochrane Library, Science Direct and Embase databases were searched without language restriction on April 2019, with the following keywords: suicide* AND (« health care worker* » OR physician* OR nurse*). When possible, we stratified results by gender, countries, time, and specialties. Estimates were pooled using random-effect meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Suicides, suicidal attempts, and suicidal ideation were retrieved from national or local specific registers or case records. In addition, suicide attempts and suicidal ideation were also retrieved from questionnaires (paper or internet). Results The overall SMR for suicide in physicians was 1.44 (95CI 1.16, 1.72) with an important heterogeneity (I2 = 93.9%, p<0.001). Female were at higher risk (SMR = 1.9; 95CI 1.49, 2.58; and ES = 0.67; 95CI 0.19, 1.14; p<0.001 compared to male). US physicians were at higher risk (ES = 1.34; 95CI 1.28, 1.55; p <0.001 vs Rest of the world). Suicide decreased over time, especially in Europe (ES = -0.18; 95CI -0.37, -0.01; p = 0.044). Some specialties might be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general surgeons. There were 1.0% (95CI 1.0, 2.0; p<0.001) of suicide attempts and 17% (95CI 12, 21; p<0.001) of suicidal ideation in physicians. Insufficient data precluded meta-analysis on other health-care workers. Conclusion Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits for preventive strategies at the workplace. Finally, the lack of data on other health-care workers suggest to implement studies investigating those occupations.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Occupational and Preventive Medicine, WittyFit, Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- * E-mail:
| | - Claire Aubert
- Université de Versailles Saint-Quentin-en-Yvelines, Faculty of Health Science Simone Veil, Versailles, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Biostatistics Unit, the Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Michael Dambrun
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency, Clermont-Ferrand, France
| | - Martial Mermillod
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Marion Trousselard
- French Armed Forces Biomedical Research Institute-IRBA, Neurophysiology of Stress, Neuroscience and Operational Constraint Department, Brétigny-sur-Orge, France
| | - François-Xavier Lesage
- University of Montpellier, Laboratory Epsylon EA, Dynamic of Human Abilities & Health Behaviors, CHU Montpellier, University Hospital of Montpellier, Occupational and Preventive Medicine, Montpellier, France
| | - Valentin Navel
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Clermont-Ferrand, France
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Ko DT, Chu A, Austin PC, Johnston S, Nallamothu BK, Roifman I, Tusevljak N, Udell JA, Frank E. Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada. JAMA Netw Open 2019; 2:e1915983. [PMID: 31755946 PMCID: PMC6902820 DOI: 10.1001/jamanetworkopen.2019.15983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Although cardiovascular disease is the leading cause of death in most developed countries, little is known about current physicians' cardiovascular health and outcomes. OBJECTIVE To compare cardiac risk factor burden, health services use, and major cardiovascular event incidence between physicians and the general population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from practicing physicians and nonphysicians without cardiovascular disease aged 40 to 75 years in Ontario, Canada. Cohorts were assembled beginning January 1, 2008, and were followed up to December 31, 2015. Data analysis was performed between November 2017 and September 2019. EXPOSURE Being a practicing physician. MAIN OUTCOMES AND MEASURES The primary outcome was 8-year incidence of a major cardiovascular event (ie, cardiovascular death or hospitalization for myocardial infarction, stroke, heart failure, or coronary revascularization). Secondary outcomes included health services used, such as physician assessments and guideline-recommended tests. RESULTS The cohort comprised 17 071 physicians (mean [SD] age, 53.3 [8.8] years; 11 963 [70.1%] men) and 5 306 038 nonphysicians (mean [SD] age, 53.7 [9.5] years; 2 556 044 [48.2%] men). Physicians had significantly lower baseline rates of hypertension (16.9% vs 29.6%), diabetes (5.0% vs 11.3%), and smoking (13.1% vs 21.6%), while having better cholesterol profiles (total cholesterol levels >240 mg/dL, 13.3% vs 16.5%; low-density lipoprotein cholesterol >130 mg/dL, 33.2% vs 36.8%); age- and sex-adjusted differences were even larger. Physicians also had lower rates of periodic health examinations (58.9% [95% CI, 57.5%-60.4%] vs 67.9% [95% CI, 67.8%-67.9%]), hyperlipidemia screening (76.3% [95% CI, 74.7%-78.0%] vs 83.8% [95% CI, 83.7%-83.9%]), and diabetes screening (79.0% [95% CI, 77.3%-80.8%] vs 85.3% [95% CI, 85.2%-85.4%]), but higher rates of cardiologist consultations (25.2% [95% CI, 24.2%-26.3%] vs 19.5% [95% CI, 19.4%-19.5%]). The 8-year age- and sex-standardized primary outcome incidence was 4.4 major cardiovascular events per 1000 person-years for physicians and 7.1 major cardiovascular events per 1000 person-years for the general population. After adjusting for age, sex, socioeconomic status, and cardiac risks and comorbidities, physicians had a 22% lower hazard (hazard ratio, 0.78; 95% CI, 0.72-0.85) of experiencing the primary outcome compared with the general population. CONCLUSIONS AND RELEVANCE Practicing physicians in Ontario had fewer cardiovascular risk factors, underwent less preventive testing, and were less likely to experience major adverse cardiovascular outcomes than the general population.
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Affiliation(s)
- Dennis T Ko
- ICES, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Sharon Johnston
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Departmentof Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Brahmajee K Nallamothu
- Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Idan Roifman
- ICES, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Jacob A Udell
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Erica Frank
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Rukundo GZ, Byakwaga H, Kinengyere A, Bapolisi AM, Betancourt M, Akena D. Prevalence and factors associated with suicide among medical professionals in low/middle-income countries: a systematic review protocol. BMJ Open 2019; 9:e028884. [PMID: 31427329 PMCID: PMC6701610 DOI: 10.1136/bmjopen-2018-028884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION A number of studies in low/middle-income countries (LMICs) have reported varying prevalence of suicide among medical professionals with low rates. This may be because of the methods used in suicide assessment and the stigma associated with it. For this study, the prevalence of suicidal ideation, attempt and completed suicide, as well as the factors associated with suicidality and methods used during suicidal acts, will be documented. METHODS AND ANALYSIS Studies published in peer-reviewed journals in which the prevalence and factors associated with suicidal ideation, attempt and completion among medical professionals in LMICs will be included. The Cochrane Library (CENTRAL), PsychINFO, PubMed and Embase will be systematically searched. We will search for all the papers available in the databases up to March 31 2019. Methodological quality of the articles will be assessed using the quality in prognostic studies tool. The risk of bias of the articles will be assessed using Cochrane risk of bias assessment tool for non-randomised studies. In the event of no statistical heterogeneity, a meta-analysis of the findings will be conducted. ETHICS AND DISSEMINATION Ethical permission will not be required since this work does not involve the use of participant data that can be used to identify individuals. Findings from this study will be available for clinicians and other medical professionals, scientists and policy makers. On request, a data set of the study can be provided. TRIAL REGISTRATION NUMBER CRD42018095990.
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Affiliation(s)
- Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbaarara University, Mbarara, Uganda
| | - Helen Byakwaga
- Department of Community Health, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
| | - Alison Kinengyere
- Albert Cook Library, Makerere College of Health Sciences, Kampala, Uganda
| | - Achille Mwira Bapolisi
- Department of Psychiatry, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
| | - Miriela Betancourt
- Department of Physiology, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere University, Kampala, Uganda
- Africa Centre for Systematic Reviews, Kampala, Uganda
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Solenova LG, Nekrasova LA. Healthcare workers: occupational carcinogenic factors and cancer risk. ADVANCES IN MOLECULAR ONCOLOGY 2018. [DOI: 10.17650/2313-805x-2018-5-3-25-39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The number of healthcare workers is over two million in Russia. Many of them are exposed to hazardous physical, chemical and biological occupational factors acting along with psychological strain. The results of large epidemiological studies carried out in various countries revealed greater cancer risk in physicians and nurses: cancer of the breast, skin, brain and other sites. Higher cancer risk of lung, breast, uterine, ovary, brain is considered to be associated with ionizing radiation. The female healthcare workers who handle antineoplastic drugs showed a greater risk of birth defects in offspring, spontaneous abortions and breast cancer. In Russia, the growing number of accidents among healthcare workers following transmission of infection by carcinogenic biological factors such as HBV and HIV is observed. Higher risk of reproductive impairments, hyperplasia of the breast and uterine tissues, breast cancer are revealed in nurses working the night shift. In Russia, there is lack of epidemiological studies of cancer risk among healthcare workers, the number of medical personal exposed to occupational carcinogens is unknown. That all does not show the actual situation in our country and does not allow setting priorities in cancer prevention among medical workers.
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Affiliation(s)
- L. G. Solenova
- Research Institute of Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
| | - L. A. Nekrasova
- Research Institute of Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
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Abstract
OBJECTIVE The aim of this study was to test a strategy for quantifying incidence of nurse suicide using San Diego County data as a pilot for national investigation. BACKGROUND Worldwide, 1 person dies by suicide every 40 seconds; more than 1 000 000 suicides occur yearly. Suicide rates for nurses in the United States have not been evaluated. This methodological article tested a strategy to identify incidence of nurse suicide compared with those of physicians and the general public. METHOD Deidentified San Diego County Medical Examiner data from 2005 to 2015 were analyzed with a descriptive epidemiologic approach. RESULTS Overall RN (18.51) and physician (40.72) incidences of suicide per 100 000 person-years were higher than the San Diego general population, excluding nurses (15.81) normalized to 100 000 person-years. CONCLUSIONS Establishing incidence of nurse suicide is confounded by variation in reporting mechanisms plus incomplete availability of nurse gender data. Relatively small outcome numbers compared with the general population may underestimate results. Research using a larger sample is indicated. Nurse executives may decrease risk by proactively addressing workplace stressors.
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Zivanovic R, McMillan J, Lovato C, Roston C. Death by Suicide among Canadian Medical Students: A National Survey-Based Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63. [PMID: 29513629 PMCID: PMC5846966 DOI: 10.1177/0706743717746663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate a rate of death by suicide in the Canadian medical student population and examine the prevalence of institutional response policies for suicide. METHODS A survey was sent to all 17 Canadian medical undergraduate programs (MDUPs) to collect information on deaths by suicide over the past 10 years. In the case of a reported suicide, basic demographic data was collected. Respondents were asked to indicate whether internal statistics or response policies for suicide existed at their MDUP. RESULTS Responses were obtained from 16 of 17 (94%) MDUPs. Six suicides (50% female) were reported over the ten-year period from 2006 to 2016. The estimated cause-specific mortality rate was 5.9-8.7/100,000 medical students/year. There were seven (44%) MDUPs that kept statistics on student deaths including suicides and 10 (63%) reported having policies or guidelines regarding what to do in the event of a suicide. CONCLUSIONS Our estimated suicide rate falls within previously reported rates in medical students. While this may be lower than the national rate for Canadians between the ages of 20-30 years old, any suicide in the medical student community must be an impetus for national dialogue and further study. A strategy is needed to better define the prevalence, risk factors for and impact of medical student suicide in Canada.
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Affiliation(s)
- Rebecca Zivanovic
- 1 Resident, Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janette McMillan
- 2 Student Affairs, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Lovato
- 3 School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christina Roston
- 2 Student Affairs, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Pan CC, Huang HL, Chen MC, Kung CY, Kung PT, Chou WY, Tsai WC. Lower risk of end stage renal disease in diabetic nurse. Biomedicine (Taipei) 2017; 7:25. [PMID: 29130450 PMCID: PMC5682979 DOI: 10.1051/bmdcn/2017070425] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 08/03/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives: As professional medical caregivers, nurses have extensive medical knowledge and information than general population. However, they may use their professional knowledge and networks to seek prompt health services. In this study, we aimed to determine susceptibility of nurses with diabetes to developing end-stage renal disease requiring dialysis compared to diabetes patients in the general population. Methods: This retrospective longitudinal study extracted data of nurses with newly diagnosed diabetes and general patients with diabetes from the National Health Insurance Database between 1998 and 2006 and follow-up to December 2009, satisfied the participant inclusion criteria was 518,058. Nurses and general population were matched with propensity score method in a 1:10 ratio. Basic characteristics and health status were similar between groups. Cox proportional hazards model was used to compare relative risks and dialysis factors between groups. Results: Nurses were younger than general population with diabetes (42.01 years vs. 59.29 years) and had lower risk of dialysis (adjusted hazard ratio = 0.36, 95% confidence interval 0.16-0.81). Nurses with Diabetes Complications Severity Index (DCSI)≧3 had dialysis risk up to 83.53 times higher than that of the reference group (DCSI < 3). DCSI was the only variable determined to be a related factor affecting dialysis risk in nurses with diabetes. Conclusions: Nurses with diabetes have lower risk of dialysis. This suggests that nurses may have more knowledge regarding chronic disease control and change their lifestyles than general diabetes patients. Results of this study may serve as a reference for developing health education.
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Affiliation(s)
- Cheng-Chin Pan
- Department of Urology, Hengchun Tourism Hospital, Ministry of Health and Welfare, Pingtung 946, Taiwan
| | - Hsiu-Ling Huang
- Department of Aged Welfare & Social Work, Toko University, Chiayi 613, Taiwan - Department of Health Services Administration, China Medical University, Taichung 404, Taiwan
| | - Ming-Chih Chen
- Department of Orthopedics, Hengchun Tourism Hospital, Ministry of Health and Welfare, Pingtung 946, Taiwan
| | - Chuan-Yu Kung
- Department of Nursing, Hengchun Tourism Hospital, Ministry of Health and Welfare, Pingtung 946, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung 413, Taiwan
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, Taichung 404, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung 404, Taiwan
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Ohtonen P, Alahuhta S. Mortality rates for Finnish anaesthesiologists and paediatricians are lower than those for the general population. Acta Anaesthesiol Scand 2017; 61:880-884. [PMID: 28782108 DOI: 10.1111/aas.12936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 06/12/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies on mortality among anaesthesiologists in the Nordic countries have reported inconsistent results. In an effort to examine mortality patterns among Finnish anaesthesiologists, we compared anaesthesiologists and paediatricians with the general population. METHODS The year of birth and mortality data for anaesthesiologists and paediatricians deceased during the period 1996-2014 were assembled from the membership files maintained by the Finnish Medical Association. Data for the general population and causes of death were obtained from the database of Statistics Finland. Standardized mortality ratios (SMR) for anaesthesiologists and paediatricians were calculated using the general population as a reference. RESULTS During the follow-up period, there were 62 deaths among anaesthesiologists and and 95 among peadiatricians. Anaesthesiologists had a lower mean age at death (66.9 years) than did peadiatricians (76.2 years). Standardized mortality ratios for both the groups were well below 1.0. The rate of suicides for anaesthesiologists was more than three times higher than that for paediatricians and more than five times higher for that of the general population. DISCUSSION We found no evidence of increased mortality for anaesthesiologists or paediatricians. The number of suicides among anaesthesiologists was higher than among paediatricians and the general population.
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Affiliation(s)
- P Ohtonen
- Department of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - S Alahuhta
- Department of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Aasland OG. Are anaesthesiologists different? Acta Anaesthesiol Scand 2017; 61:874-875. [PMID: 28782110 DOI: 10.1111/aas.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- O G Aasland
- Institute for Studies of the Medical Profession, Oslo, Norway
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Pilgrim JL, Dorward R, Drummer OH. Drug-caused deaths in Australian medical practitioners and health-care professionals. Addiction 2017; 112:486-493. [PMID: 27866392 DOI: 10.1111/add.13619] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/01/2016] [Accepted: 09/21/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS There are numerous factors putting health-care professionals (HCP) at a higher risk of substance abuse and premature death, including high-stress jobs, access to controlled substances, long hours of practice and constant contact with the critically ill. This study aimed to examine fatal drug toxicity in this high-risk cohort, in order to: (1) estimate the rate of drug-caused deaths of Australian HCPs; (2) describe the key characteristics of the cohort; and (3) examine the relationship between HCP occupation and drug type, or intent. DESIGN Retrospective cohort study. SETTING The National Coronial Information System (NCIS), a database of cases reported to an Australian coroner. PARTICIPANTS A total of 404 drug-caused deaths reported to an Australian coroner between 2003 and 2013 involving HCPs (including medical practitioners, paramedics, nurses, dentists, psychologists, pharmacists and veterinarians). MEASURES χ2 tests and descriptive statistics were used to examine relationships. The primary outcome measures were drug type and intent. Covariates included occupation type, mental illness and self-harm. FINDINGS Females comprised nearly two-thirds of the cohort. The highest number of cases involved nurses (62.87%) and medical practitioners (18.07%). The mortality rate was highest among the veterinary group [confidence interval (CI) = 42.21-58.79]. Most were intentional self-harm deaths (50.25%), followed by unintentional deaths (37.62%) (CI = 92.15-109.85). Mental illness was common, diagnosed in almost half of cases (46.04%), with the majority involving depression (CI = 33.48-44.12). Specific drugs were associated significantly with certain professions, such as intravenous barbiturates among veterinarians (χ2(7) = 237.391). A number of cases reported additional stressors, such as relationship, work-place or financial issues, and drugs were diverted from the work-place in nearly a fifth of cases. CONCLUSIONS Between 2003 and 2013, Australian health-care professionals averaged 37 deaths per year attributed to drug toxicity, with a mortality rate of nearly five deaths per 1000 employed HCPs. Drug-caused deaths among HCPs in Australia commonly involve females in their mid-40s, with a diagnosis of mental illness, personal and professional stress and the intent to self-harm.
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Affiliation(s)
- Jennifer L Pilgrim
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
| | - Rhyse Dorward
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
| | - Olaf H Drummer
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia.,Victorian Institute of Forensic Medicine, Southbank, VIC, Australia
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Damasceno KS, de Sousa Barbosa É, Pimentel JVC, Júnior AGT, de Meneses ACP, Júnior JG, de Sousa DF, da Costa Lima PS, Sales IB, Gouveia AS, Biruel EP, Neto MLR, do Nascimento VB. Suicide among Physicians and Methodological Similarities of MEDLINE/PubMED and BVS/BIREME Open Access Bibliographic Databases: A Systematic Review with Metanalysis. Health (London) 2017. [DOI: 10.4236/health.2017.92025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hertler S. The Biologically-Based Bias of Personality Disorder Diagnosis. Front Psychol 2016; 7:1293. [PMID: 27617001 PMCID: PMC4999440 DOI: 10.3389/fpsyg.2016.01293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/12/2016] [Indexed: 11/13/2022] Open
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Kim HL, Park HJ, Sim YH, Choi EY, Shim KW, Lee SW, Lee HS, Chun H. Cancer Prevalence among Physicians in Korea: A Single Center Study. Korean J Fam Med 2016; 37:91-6. [PMID: 27073607 PMCID: PMC4826997 DOI: 10.4082/kjfm.2016.37.2.91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 08/16/2015] [Accepted: 09/27/2015] [Indexed: 12/02/2022] Open
Abstract
Background There is little research regarding whether working as a physician affects cancer risk. Moreover, there is no research on cancer prevalence among physicians in Korea. This study utilized the Korea National Cancer Incidence Database to determine whether the prevalence of cancer among physicians differs from the prevalence of cancer within the general population. Methods We analyzed the medical records of a representative sample of 382 doctors who underwent a health examination between 2010 and 2013 at a health examination center in a Ewha Womans University Medical Center.Cancer incidence was measured as cases that were eventually diagnosed as cancer according to a biopsy. Results We collected medical records from 382 physicians (mean age, 51.9±8.1 years) and calculated the standardized prevalence ratios compared to the general population. Thirty physicians (9 male and 21 female) were identified as having cancer. Physicians had a significantly higher prevalence of cancer compared to the general population.Cancer prevalence in male physicians was found to be 2.47 times higher than the prevalence expected within the general population (P=0.006). Among female physicians, cancer prevalence was 3.94 times higher than that in the general population (P<0.001). Conclusion This study revealed that physicians had a higher prevalence of cancer compared to the general population in Korea, which suggests that there may be a problem present in the health care of physicians. Changes to the working environment of physicians will be needed to reduce the high prevalence of cancer among physicians.
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Affiliation(s)
- Hye Lin Kim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hae Jin Park
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Yun Hye Sim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Eun Young Choi
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Kyung Won Shim
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sang Wha Lee
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hong Soo Lee
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyejin Chun
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
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Abstract
OBJECTIVES This paper is a guide to the general psychiatric assessment of the late career medical practitioner (LCP) from a clinical viewpoint. CONCLUSIONS Late career is a specific developmental stage in medical practitioners, a time of transition towards retirement. The treating psychiatrist should be mindful of the welfare of the practitioner, the public and the profession during the assessment, which is conducted from a complex therapeutic and regulatory viewpoint. It is important to assess the physical, psychological and cognitive health of the LCP. Although rates of burnout, depression and suicidal ideation are lowest in Australian doctors over 60, only a small minority of LCPs over 75 are likely to perform at a cognitive level similar to that of younger colleagues. There are a number of therapeutic challenges, including the practitioner's acceptance of their own ageing.
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Affiliation(s)
- Chanaka Wijeratne
- Senior Staff Specialist, Prince of Wales Hospital, Randwick, NSW, and; School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Braquehais MD, Eiroa-Orosa FJ, Holmes KM, Lusilla P, Bravo M, Mozo X, Mezzatesta M, Casanovas M, Pujol T, Sher L. Differences in Physicians' and Nurses' Recent Suicide Attempts: An Exploratory Study. Arch Suicide Res 2016; 20:273-9. [PMID: 25517040 DOI: 10.1080/13811118.2014.996693] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to examine the characteristics of physicians' and nurses' suicide attempts (SA). A retrospective review of 493 medical records of physicians and nurses admitted to an inpatient unit for health professionals; 36 patients had a recent SA. Depression, cluster B and C personality disorders, and a history of previous SA were more prevalent in patients with a recent SA compared to those without it. Both professional groups preferred drug overdose as a suicide method. Physicians made more lethal attempts and had a history of more previous stressors than nurses. Depression, cluster B and C personality disorders, and previous SA should be appropriately screened and treated in order to prevent SA amongst physicians and nurses.
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Brown SG, Shirachi S, Zandbergen D. HEALTH SELECTION THEORY: AN EXPLANATION FOR THE PARADOX BETWEEN PERCEIVED MALE WELL-BEING AND MORTALITY. QUARTERLY REVIEW OF BIOLOGY 2015; 90:3-21. [PMID: 26434163 DOI: 10.1086/679761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Paradoxically, men report better health and quality of life than women, but men experience higher mortality rates than women at most ages. One conclusion from these findings is that men have been selected to disregard signs of ill health, or even to deceive themselves about their health, to their detriment because presenting themselves as healthy has fitness benefits. We hypothesize that men have been sexually selected to present themselves to women as healthy but that the cost of not attending to their minor health problems results in earlier mortality than women. We present a review of the human and primate literature that supports health selection theory, the hypothesis that females have preferentially selected males who present themselves as healthy.
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Gignon M, Havet E, Ammirati C, Traullé S, Manaouil C, Balcaen T, Loas G, Dubois G, Ganry O. Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey. Workplace Health Saf 2015; 63:54-63. [PMID: 25881656 DOI: 10.1177/2165079915570917] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated addictive substance use by French medical students. A cross-sectional survey was distributed to 255 participants randomly selected from 1,021 second- to sixth-year medical students. Questionnaires were self-administered and included questions on sociodemographic characteristics, mental health, and alcohol (The Alcohol Use Disorders Identification Test [AUDIT test]), tobacco (Fagerstrom test), and illegal substance consumption (Cannabis Abuse Screening Test [CAST test]). The AUDIT scores indicated that 11% of the study participants were at risk for addiction and 21% were high-risk users. Tobacco dependence was strong or very strong for 12% of the participants. The CAST score showed that 5% of cannabis users needed health care services. Cannabis users were also more likely than non-users to fail their medical school examinations (89% vs. 39%, p<.01). One quarter of medical student participants (n=41) had used other illegal drugs, and 10% of study participants had considered committing suicide during the previous 12 months. Psychoactive substance consumption by French medical students requires preventive measures, screening, and health care services.
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Affiliation(s)
- M Gignon
- University Paris 13 Jules Verne University of Picardy Amiens University Hospital
| | - E Havet
- Jules Verne University of Picardy
| | - C Ammirati
- University Paris 13 Jules Verne University of Picardy
| | | | | | - T Balcaen
- Jules Verne University of Picardy Amiens University Hospital
| | - G Loas
- Jules Verne University of Picardy
| | - G Dubois
- Jules Verne University of Picardy Amiens University Hospital
| | - O Ganry
- Jules Verne University of Picardy Amiens University Hospital
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Moore LJ, Wilson MR, Waine E, McGrath JS, Masters RSW, Vine SJ. Robotically assisted laparoscopy benefits surgical performance under stress. J Robot Surg 2015; 9:277-84. [DOI: 10.1007/s11701-015-0527-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/17/2015] [Indexed: 01/08/2023]
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Aasland OG. O.G. Aasland svarer:. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.15.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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[Suicide Ideation Among Medical Students: Prevalence and Associated Factors]. ACTA ACUST UNITED AC 2014; 43 Suppl 1:47-55. [PMID: 26574113 DOI: 10.1016/j.rcp.2013.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 11/28/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION It is well documented that physicians have higher rates of suicide than the general population. This risk tends to increase even from the beginning of undergraduate training in medicine. There are few studies evaluating the frequency of suicidal behaviors in undergraduate medical students, particularly in Latin America. OBJECTIVE To determine the lifetime prevalence and the variables associated with suicidal ideation and suicide attempts in a sample of medical students from the city of Bucaramanga, Colombia. MATERIALS AND METHODS An analytical cross-sectional observational study was conducted to determine the lifetime prevalence of suicidal ideation and suicide attempts in a non-random sample of medical students enrolled in three medical schools in Bucaramanga. A self-administered questionnaire was voluntarily and anonymously answered by the participants. Validated versions of the CES-D and CAGE scales were used to assess the presence of depressive symptoms and problematic alcohol use, respectively. A multivariate logistic regression model was generated in order to adjust the estimates of variables associated with the outcome «suicidal ideation in life». RESULTS The study sample consisted of 963 medical students, of which 57% (n=549) of the participants were women. The average age was 20.3 years (SD=2.3 years). Having had at least one episode of serious suicidal ideation in their lifetime was reported by 15.7% (n=149) of the students, with 5% (n=47) of the students reported having made at least one suicide attempt. Having taken antidepressants during their medical training was reported by 13.9% (n=131) of the students. The variables associated with the presence of suicidal ideation in the logistic regression model were: clinically significant depressive symptoms (OR: 6.9, 95% CI; 4.54-10.4), history of illicit psychoactive substance use (OR 2.8, 95% CI; 1.6-4.8), and perception of poor academic performance over the past year (OR: 2.2, 95% CI; 1.4-3.6). The logistic regression model correctly classified 85% of the subjects with a history of suicidal ideation. CONCLUSION Suicidal ideation is a frequently occurring phenomenon in medical students. Medical schools need to establish screening procedures for early detection and intervention of students with emotional distress and suicide risk.
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Eneroth M, Gustafsson Sendén M, Løvseth LT, Schenck-Gustafsson K, Fridner A. A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine. BMC Public Health 2014; 14:271. [PMID: 24655908 PMCID: PMC3994345 DOI: 10.1186/1471-2458-14-271] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/20/2014] [Indexed: 12/03/2022] Open
Abstract
Background Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n = 234) and specialists (n = 813) working at a university hospital were examined using cross-sectional data. Results Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR = 0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR = 0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR = 2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.
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Affiliation(s)
| | | | | | | | - Ann Fridner
- Department of Psychology, Stockholm University, Stockholm, Sweden.
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Rezaeian M. Self-immolation Among Medical Practitioners and Medical Students: More Evidence is Needed from Developing Countries. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2014; 8:105-6. [PMID: 25053965 PMCID: PMC4105612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 05/31/2014] [Accepted: 06/18/2014] [Indexed: 10/30/2022]
Affiliation(s)
- Mohsen Rezaeian
- Department of Social Medicine, Occupational Environmental Research Center AND Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,Corresponding author: Mohsen Rezaeian PhD, Department of Social Medicine, Occupational Environmental Research Center AND Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Address: Department of Social Medicine, Occupational Environmental Research Center AND Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Postal code: 7719617996, Rafsanjan, Iran. Tele: +98 3915234003, Fax:+98 3915225209,
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Rosta J, Aasland OG. Changes in the lifetime prevalence of suicidal feelings and thoughts among Norwegian doctors from 2000 to 2010: a longitudinal study based on national samples. BMC Psychiatry 2013; 13:322. [PMID: 24286517 PMCID: PMC4219507 DOI: 10.1186/1471-244x-13-322] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 11/22/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Thinking about suicide is an indicator of suicide risk. Suicide rates are higher among doctors than in the population. The main aims of this study are to describe the changes in the lifetime prevalence of suicidal feelings from 2000 to 2010 and the possible predictors of serious suicidal thoughts in 2010 among Norwegian doctors. Differences in lifetime prevalence of suicidal feelings between Norwegian doctors in 2010 and German doctors in 2006 will be also described. METHODS Longitudinal and cross-sectional study based on questionnaire data from 2000 and 2010, including approximately 1,600 Norwegian doctors. In Germany, cross-sectional study based on questionnaire data from 2006 among a sample of 3,295 doctors. The main outcome measures were the lifetime prevalence of suicidal feelings (felt life was not worth living, wished own death, had thoughts of taking own life). RESULTS The prevalences in 2000 and 2010 of ever had feelings of life not worth living were 48 (44 to 52) % and 45 (41 to 49) %, of ever wished own death 27 (23 to 30) % and 23 (20 to 26) %, and of ever had thoughts of taking own life 29 (16 to 33) % and 24 (21 to 27) %. Paired t-tests among those who responded both in 2000 and 2010 show significant reductions for felt life not worth living (t = -3.4; p = 0.001), wished own death (t = -3.1; p = 0.002) and had thoughts of taking own life (t = -3.5; p < 0.0001). In 2010, significant predictors of serious suicidal thoughts in a multivariate model were low subjective well-being (OR 0.68; 95% CI 0.52-0.90), poor or average self-rated health (2.36; 1.25-4.45) and high psychosocial work stress (1.92; 1.06-3.46), controlled for age, gender, speciality and job satisfaction. Norwegian doctors in 2010 compared with their German counterparts in 2006 reported quite similar prevalences of suicidal feelings. CONCLUSIONS Suicidal feelings among Norwegian doctors decreased from 2000 to 2010. Individual and work-related factors may to certain explain these findings. Compared with other professionals in Norway and doctors in Germany, Norwegian doctors showed no higher risk of suicidal thoughts.
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Affiliation(s)
- Judith Rosta
- Institute for Studies of Medical Profession (LEFO), Oslo, Norway.
| | - Olaf G Aasland
- Institute for Studies of Medical Profession (LEFO), Oslo, Norway,Institute of Health and Society, Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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Gramstad TO, Gjestad R, Haver B. Personality traits predict job stress, depression and anxiety among junior physicians. BMC MEDICAL EDUCATION 2013; 13:150. [PMID: 24207064 PMCID: PMC3842670 DOI: 10.1186/1472-6920-13-150] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/06/2013] [Indexed: 05/22/2023]
Abstract
BACKGROUND High levels of stress and deteriorating mental health among medical students are commonly reported. In Bergen, Norway, we explored the impact of personality traits measured early in their curriculum on stress reactions and levels of depression and anxiety symptoms as junior physicians following graduation. METHODS Medical students (n = 201) from two classes participated in a study on personality traits and mental health early in the curriculum. A questionnaire measuring personality traits (Basic Character Inventory (BCI)) was used during their third undergraduate year. BCI assesses four personality traits: neuroticism, extroversion, conscientiousness and reality weakness. Questionnaires measuring mental health (Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist 25 (SCL-25)), and stress (Perceived Medical School Stress (PMSS)) were used during their third and sixth undergraduate year. During postgraduate internship, Cooper's Job Stress Questionnaire (CJSQ) was used to measure perceived job stress, while mental health and stress reactions were reassessed using HADS and SCL-25. RESULTS Extroversion had the highest mean value (5.11) among the total group of participants, while reality weakness had the lowest (1.51). Neuroticism and reality weakness were related to high levels of perceived job stress (neuroticism r = .19, reality weakness r = .17) as well as higher levels of anxiety symptoms (neuroticism r = .23, reality weakness r = .33) and symptoms of depression (neuroticism r = .21, reality weakness r = .36) during internship. Neuroticism indirectly predicted stress reactions and levels of depression and anxiety symptoms. These relations were mediated by perceived job stress, while reality weakness predicted these mental health measures directly. Extroversion, on the other hand, protected against symptoms of depression (r = -.20). Furthermore, females reported higher levels of job stress than males (difference = 7.52). CONCLUSIONS Certain personality traits measured early in the course of medical school relates to mental health status as junior physicians during postgraduate internship training. This relation is mediated by high levels of perceived job stress.
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Affiliation(s)
| | - Rolf Gjestad
- Research department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Brit Haver
- Department of Clinical Medicine, Division of Psychiatry, University of Bergen, Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
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Sanchez ZM, Alves HNP, Nogueira-Martins LA, Prado MCO. Estudo da mortalidade dos médicos no Estado de São Paulo, Brasil, no período 2000-2009. CAD SAUDE PUBLICA 2013; 29:1461-6. [DOI: 10.1590/s0102-311x2013000700019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 04/24/2013] [Indexed: 11/21/2022] Open
Abstract
O presente estudo apresenta a distribuição das causas de morte de médicos do Estado de São Paulo, Brasil, cujos óbitos ocorreram entre os anos de 2000 e 2009. Utilizou-se o banco de dados do Sistema de Informações sobre Mortalidade, do Ministério da Saúde, limitando-se às declarações de óbito cujo campo de ocupação estava preenchido como "médico". As causas básicas de morte foram classificadas de acordo com os capítulos da CID-10. O estudo revela que doenças do aparelho circulatório foram a principal causa de morte entre os médicos na última década, seguidas das neoplasias e doenças do aparelho respiratório. As causas externas constituíram as principais causas de morte abaixo de 40 anos. Câncer da mama foi responsável pela maior parte dos óbitos por neoplasias entre mulheres, enquanto entre os homens a neoplasia de pulmão ocupou a primeira posição. Sugere-se a necessidade de se estimular hábitos adequados de saúde e prevenção de doenças entre os médicos, buscando informar e sensibilizar este grupo de profissionais.
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Iliceto P, Pompili M, Spencer-Thomas S, Ferracuti S, Erbuto D, Lester D, Candilera G, Girardi P. Occupational stress and psychopathology in health professionals: an explorative study with the multiple indicators multiple causes (MIMIC) model approach. Stress 2013; 16:143-52. [PMID: 22632290 DOI: 10.3109/10253890.2012.689896] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Occupational stress is a multivariate process involving sources of pressure, psycho-physiological distress, locus of control, work dissatisfaction, depression, anxiety, mental health disorders, hopelessness, and suicide ideation. Healthcare professionals are known for higher rates of occupational-related distress (burnout and compassion fatigue) and higher rates of suicide. The purpose of this study was to explain the relationships between occupational stress and some psychopathological dimensions in a sample of health professionals. We investigated 156 nurses and physicians, 62 males and 94 females, who were administered self-report questionnaires to assess occupational stress [occupational stress inventory (OSI)], temperament (temperament evaluation of Memphis, Pisa, Paris, and San Diego autoquestionnaire), and hopelessness (Beck hopelessness scale). The best Multiple Indicators Multiple Causes model with five OSI predictors yielded the following results: χ2(9) = 14.47 (p = 0.11); χ2/df = 1.60; comparative fit index = 0.99; root mean square error of approximation = 0.05. This model provided a good fit to the empirical data, showing a strong direct influence of casual variables such as work dissatisfaction, absence of type A behavior, and especially external locus of control, psychological and physiological distress on latent variable psychopathology. Occupational stress is in a complex relationship with temperament and hopelessness and also common among healthcare professionals.
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Affiliation(s)
- Paolo Iliceto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Al-Shafaee M, Al-Kaabi Y, Al-Farsi Y, White G, Al-Maniri A, Al-Sinawi H, Al-Adawi S. Pilot study on the prevalence of abuse and mistreatment during clinical internship: a cross-sectional study among first year residents in Oman. BMJ Open 2013; 3:bmjopen-2012-002076. [PMID: 23396558 PMCID: PMC3585976 DOI: 10.1136/bmjopen-2012-002076] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate perceptions of being mistreated during internship among first year Oman Medical Specialty Board residents. DESIGN A cross-sectional study. SETTING Training centres for Oman Medical Specialty Board. PARTICIPANTS First year medical residents following completion of internship during the study period 2009-2010. METHOD A cross-sectional survey of first year medical residents. RESULTS Of 58 residents (response rate 84%), 96.6% perceived that mistreatment exists. Among different types of mistreatment reported, verbal and academic abuses were the most common (87.9%), followed by sexual harassment (24.1%), then physical abuse (22.4%). Forty-four (75.9%) residents had advised at least one of their relatives not to join medical school. CONCLUSIONS Mistreatment of medical interns is an ethical issue challenging the quality of clinical training. Further research is needed to understand factors influencing mistreatment and to draw guidelines to limit such problems.
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Affiliation(s)
- Mohammed Al-Shafaee
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yousuf Al-Kaabi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yousuf Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Gillian White
- Directorate of Education and Training, Ministry of Health, Muscat, Oman
| | - Abdullah Al-Maniri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Hamed Al-Sinawi
- Directorate of Education and Training, Ministry of Health, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Rosta J, Aasland OG. Changes in alcohol drinking patterns and their consequences among Norwegian doctors from 2000 to 2010: a longitudinal study based on national samples. Alcohol Alcohol 2013; 48:99-106. [PMID: 22940613 DOI: 10.1093/alcalc/ags084] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To describe changes in the patterns and consequences of alcohol use among Norwegian doctors from 2000 to 2010. METHODS Longitudinal study based on data from nation-wide postal surveys in 2000 and 2010 among a representative sample of 682 doctors in Norway. The Alcohol Use Disorder Identification Test (AUDIT) was used to measure the changes in drinking patterns (frequency of drinking, frequency of heavy drinking and quantity of drinking), symptoms of alcohol dependence and adverse consequences of drinking. A score above 8 was defined as hazardous drinking. RESULTS From 2000 to 2010, the proportion of doctors who used alcohol twice a week or more significantly increased from 31.4 (27.9-34.9) % to 48.7 (44.9-48.7) %, and the proportion of those who drank to intoxication weekly or more decreased significantly from 6.6 (4.7-8.6) % to 2.5 (1.3-1.7) %. The proportion who scored above 8 on the AUDIT decreased from 10.7 (8.4-13.0) % in 2000 to 8.2 (6.2-10.3) % in 2010. There was a significant increase in the partial AUDIT-score for drinking patterns (t = 2.4; P = 0.016), and a significant decrease in the partial AUDIT-score for adverse consequences of drinking (t = -3.6; P < 0.001). The partial AUDIT-score for symptoms of alcohol dependence did not change significantly (t = -1.6; P = 0.112). There were gender differences in drinking patterns. Females had less frequent alcohol consumption and fewer episodes of heavy and hazardous drinking in 2000 and 2010. CONCLUSION The drinking pattern of Norwegian doctors has changed over the past decade towards more moderate alcohol consumption and less negative alcohol-related consequences. Changes in the attitude towards alcohol consumption may to a certain extent explain these findings.
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Affiliation(s)
- Judith Rosta
- Research Institute of the Norwegian Medical Association, Sentrum, 0107 Oslo, Norway.
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Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry 2013; 35:45-9. [PMID: 23123101 PMCID: PMC3549025 DOI: 10.1016/j.genhosppsych.2012.08.005] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/18/2012] [Accepted: 08/21/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide. We sought to evaluate these factors among physicians versus non-physician suicide victims. METHODS We used data from the United States National Violent Death Reporting System to evaluate demographics, mental health variables, recent stressors and suicide methods among physician versus non-physician suicide victims in 17 states. RESULTS The data set included 31,636 suicide victims of whom 203 were identified as physicians. Multivariable logistic regression found that having a known mental health disorder or a job problem which contributed to the suicide significantly predicted being a physician. Physicians were significantly more likely than non-physicians to have antipsychotics, benzodiazepines and barbiturates present on toxicology testing but not antidepressants. CONCLUSIONS Mental illness is an important comorbidity for physicians who complete a suicide but postmortem toxicology data shows low rates of medication treatment. Inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians.
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Austin AE, van den Heuvel C, Byard RW. Physician suicide. J Forensic Sci 2012; 58 Suppl 1:S91-3. [PMID: 22900898 DOI: 10.1111/j.1556-4029.2012.02260.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/07/2011] [Accepted: 10/29/2011] [Indexed: 11/26/2022]
Abstract
Pathology files at Forensic Science South Australia were examined over a 14-year period, from January 1997 to March 2011 for cases of physician suicide. Nine cases were identified (ages, 30-69 years; median = 41 years; M:F = 3:1). Three cases (33.3%) had a history of prescription drug abuse, and eight cases (88.9%) died from lethal drug self-administration. Intravenous administration of drugs was the favored method in seven cases. In only one case was an alternative method used, involving jumping from a high building. A history of depression and/or suicidal ideation was noted in six cases (66.7%). The methods of self-destruction contrasted with the general population where hanging, carbon monoxide poisoning, and gunshot wounds are more common. Availability and knowledge of lethal effects have been shown to be important determinants in the choice of methods of suicide. Access to drugs should therefore be carefully monitored in physicians with histories of depression and/or substance abuse.
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Affiliation(s)
- Amy E Austin
- Discipline of Anatomy and Pathology, The University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
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