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Silver JK, Feld LD, Clark Onwunyi VR. Reframing the gender equity discussion in anaesthesiology: adopting best practices to promote physician retention and belonging. Anaesthesia 2024; 79:675-679. [PMID: 38581231 DOI: 10.1111/anae.16288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Network, Charlestown, MA, USA
| | - Lauren D Feld
- Department of Medicine, University of Massachusetts Chan School of Medicine, Worcester, MA, USA
| | - Varina R Clark Onwunyi
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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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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Wang Y, Xu M, Wei Z, Sun L. Associations between workplace violence and suicidal ideation among Chinese medical staff: a propensity score matching analysis. PSYCHOL HEALTH MED 2024; 29:1020-1034. [PMID: 37656046 DOI: 10.1080/13548506.2023.2254037] [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: 10/02/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023]
Abstract
Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.
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Affiliation(s)
- Yifan Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
- Jinan Center for Disease Control and Prevention, Jinan, China
| | - Meixia Xu
- Department of Current Situation and Policy, Shandong Women's University Jinan Shandong, Jinan, China
| | - Zhen Wei
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
| | - Long Sun
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
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4
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Vergeron L, Morvan Y, Hadouiri N, Haas-Jordache A, Gouy E, Mathieu L, Goulard A, Rolland F, Frajerman A. Use of service and treatment adequacy in medical students and residents suffering from depression in France: A nationwide study. Psychiatry Res 2024; 339:115975. [PMID: 38875916 DOI: 10.1016/j.psychres.2024.115975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
Depression was already a public health issue before the Covid-19 pandemic. Use of service and treatment adequacy in medical students was poorly known. A 2021 French national study found the prevalence of 12-month major depressive disorder (MDD) was 25 % in medical school students and residents (MSSR). The main objective of our study was to measure the prevalence of service use and adequate treatment (therapy and/or recommended pharmacotherapy) and their associated factors. A national online survey was conducted in 2021. The Composite International Diagnostic Interview Short-Form questionnaire was used to assess MDD; 12-months service use and pharmacotherapy were assessed. Univariate and multivariate logistic regressions were performed between students' demographic characteristics, use of services, and treatment adequacy. Among included MSSR who experienced MDD in the last 12 months, only 32 % received adequate treatment, including 20 % with recommended pharmacotherapy. Being more advanced in medical studies and being treated both by a general practitioner and a psychiatrist were associated with receiving recommended pharmacotherapy. To our knowledge, our study is the largest to assess use of service and treatment adequacy in MSSR. Given the low percentage of depressed students receiving recommended treatment, it seems important to develop new interventions to better detect and treat MDD in MSSR.
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Affiliation(s)
- Laure Vergeron
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France
| | - Yannick Morvan
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; Université Paris Nanterre - UFR SPSE - laboratoire CLIPSYD, EA4430, Nanterre, France
| | - Nawale Hadouiri
- Pôle rééducation-réadaptation, CHU de Dijon, 23 rue Gaffarel, 21078 Dijon, France
| | - Adrien Haas-Jordache
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Evan Gouy
- Service de génétique médicale, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - Loona Mathieu
- ANEMF (Association Nationale des Étudiants en Médecine de France), 79 rue Périer, 92120 Montrouge, France
| | - Anne Goulard
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Franck Rolland
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; MGEN Action sanitaire et sociale - groupe VYV, Établissement de Santé Mentale de Rueil-Malmaison, 2 rue du Lac, 92500 Rueil-Malmaison, France
| | - Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France.
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Alnajdawi AM, Alsawalqa RO, Alrawashdeh MN. Suicidal ideation and their relationship with job satisfaction and job strain among Jordanian hospitals' healthcare professionals: a cross-sectional study. Front Public Health 2024; 12:1393867. [PMID: 38827605 PMCID: PMC11140093 DOI: 10.3389/fpubh.2024.1393867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
Suicidal ideation is a major health problem that occurs in response to complex interactions among psychological, sociocultural, and environmental factors. The phenomenon of suicidal ideation among healthcare professionals is still shrouded in mystery in Jordanian society, and there is still a scarcity of studies on its relationship with job strain and job satisfaction has been examined in the Arab world. Therefore, to fill this gap, this study aimed to reveal the prevalence of suicidal ideation among Jordanian hospitals health care professionals, and its relationship to job satisfaction and job strain. Additionally, how some sociodemographic factors were correlated with suicidal ideation levels, including age, sex, monthly income, occupation, years of experience, and sector type. Data were collected through a survey including sociodemographic characteristics, Suicidal ideation Scale (SIS), Job Satisfaction Survey (JSS), and Demand Control Support Questionnaire (DCSQ). The survey was distributed among 910 physicians and nurses of both sexes in public and private Jordanian hospitals. The survey was conducted using an anonymous online platform via Google Forms between October 2022 and December 2023. In light of the strain theory of suicide (STS), our results showed that physicians and nurses reported low levels of suicidal ideation and job satisfaction, with high levels of job strain. Suicidal ideation was positively correlated with job strain and negatively correlated with job satisfaction. Job satisfaction is negatively correlated with job strain. Job satisfaction was a significant mediator between job strain and suicidal ideation. Greater attention should be paid to the work environment in healthcare, particularly to enhance social support, increase job satisfaction levels, reduce job strain, and provide extensive training on effective prevention strategies for suicidal ideation and behaviour in the workplace. Additionally, policies and practices related to the health sector should be modified to create stable, healthy, and safe relationships and work environments.
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Montazeri A, Hantoushzadeh S, Razavi SJ, Dashtkoohi M, Eshraghi N, Ghaemi M. Silent Suffering: The Tragic Suicide Among Medical Residents. ARCHIVES OF IRANIAN MEDICINE 2024; 27:287-288. [PMID: 38690796 PMCID: PMC11097321 DOI: 10.34172/aim.2024.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/11/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Ali Montazeri
- Health Metric Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Sedigheh Hantoushzadeh
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Jafar Razavi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadese Dashtkoohi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Eshraghi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sullivan EE, Etz RS, Gonzalez MM, Deubel J, Reves SR, Stange KC, Hughes LS, Linzer M. You Cannot Function in "Overwhelm": Helping Primary Care Navigate the Slow End of the Pandemic. J Healthc Manag 2024; 69:190-204. [PMID: 38728545 DOI: 10.1097/jhm-d-23-00102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
GOAL This study was developed to explicate underlying organizational factors contributing to the deterioration of primary care clinicians' mental health during the COVID-19 pandemic. METHODS Using data from the Larry A. Green Center for the Advancement of Primary Health Care for the Public Good's national survey of primary care clinicians from March 2020 to March 2022, a multidisciplinary team analyzed more than 11,150 open-ended comments. Phase 1 of the analysis happened in real-time as surveys were returned, using deductive and inductive coding. Phase 2 used grounded theory to identify emergent themes. Qualitative findings were triangulated with the survey's quantitative data. PRINCIPAL FINDINGS The clinicians shifted from feelings of anxiety and uncertainty at the start of the pandemic to isolation, lack of fulfillment, moral injury, and plans to leave the profession. The frequency with which they spoke of depression, burnout, and moral injury was striking. The contributors to this distress included crushing workloads, worsening staff shortages, and insufficient reimbursement. Consequences, both felt and anticipated, included fatigue and demoralization from the inability to manage escalating workloads. Survey findings identified responses that could alleviate the mental health crisis, namely: (1) measuring and customizing workloads based on work capacity; (2) quantifying resources needed to return to sufficient staffing levels; (3) promoting state and federal support for sustainable practice infrastructures with less administrative burden; and (4) creating patient visits of different lengths to rebuild relationships and trust and facilitate more accurate diagnoses. PRACTICAL APPLICATIONS Attention to clinicians' mental health should be rapidly directed to on-demand, confidential mental health support so they can receive the care they need and not worry about any stigma or loss of license for accepting that help. Interventions that address work-life balance, workload, and resources can improve care, support retention of the critically important primary care workforce, and attract more trainees to primary care careers.
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Affiliation(s)
- Erin E Sullivan
- Sawyer School of Business at Suffolk University, Boston, Massachusetts, and the Center for Primary Care, Harvard Medical School, Boston, Massachusetts
| | | | - Martha M Gonzalez
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good and the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | | | - Sarah R Reves
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good and the Department of Family Medicine and Population Health, Virginia Commonwealth University
| | - Kurt C Stange
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good and the Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio
| | - Lauren S Hughes
- Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mark Linzer
- Department of Medicine and Institute for Professional Worklife, Hennepin Healthcare and University of Minnesota, Minneapolis, Minnesota
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8
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Silver JK, Fleming TK, Ellinas EH, Silver EM, Verduzco-Gutierrez M, Bryan KM, Flores LE, Sarno DL. Individual, organizational, and policy strategies to enhance the retention and a sense of belonging for health care professionals in rehabilitation medicine. PM R 2024. [PMID: 38494596 DOI: 10.1002/pmrj.13152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/19/2024]
Abstract
The retention of physicians and other health care professionals in rehabilitation medicine is a critical issue that affects patients' access to care and the quality of the care they receive. In the United States and globally, there are known shortages of clinicians including, but not limited to, physicians, nurses, physical therapists, occupational therapists, and speech-language pathologists. These shortages are predicted to worsen in the future. It is known that attrition occurs in a variety of ways such as a clinician reducing work hours or effort, taking a position at another organization, leaving the field of medicine altogether, stress-related illness, and suicide. Retention efforts should focus on stay factors by creating a positive culture that supports a sense of belonging as well as addressing a myriad of push and pull factors that lead to attrition. In this commentary, we provide a roadmap that includes examples of stay strategies for individuals and organizations to adopt that are aimed at enhancing the retention of rehabilitation medicine professionals.
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Affiliation(s)
- Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Talya K Fleming
- Department of Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute, Rutgers Robert Wood Johnson Medical School and Hackensack Meridian School of Medicine, Edison, New Jersey, USA
| | - Elizabeth H Ellinas
- Center for the Advancement of Women in Science and Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Emily M Silver
- Department of Psychology, University of Chicago, Chicago, Illinois, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Katherine M Bryan
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura E Flores
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Danielle L Sarno
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Boston, Massachusetts, USA
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Nelson BV. Mental Health and the Graduate Medical Education Trainee: Emergent Concerns. MISSOURI MEDICINE 2024; 121:113-115. [PMID: 38694611 PMCID: PMC11057853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Affiliation(s)
- Brook V Nelson
- Assistant Dean of Graduate Medical Education, General Surgery Program Director, and Assistant Professor, Department of Surgery at the University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. She is also Vice-Chair of Surgical Education and President, Missouri American College of Surgeons
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10
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Hunt TL, Hooten WM. Preventing and Responding to Physician Suicide. Mayo Clin Proc 2024; 99:359-361. [PMID: 38432744 DOI: 10.1016/j.mayocp.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/25/2023] [Accepted: 11/27/2023] [Indexed: 03/05/2024]
Affiliation(s)
- Terry L Hunt
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
| | - W Michael Hooten
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
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Chou LB, Kha ST, Shapiro LM. Health Considerations for Female Orthopaedic Surgeons. J Am Acad Orthop Surg 2024; 32:e125-e133. [PMID: 37797264 DOI: 10.5435/jaaos-d-23-00221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
The number of female orthopaedic surgeons is increasing. They face unique health concerns, which include cancer risk, pregnancy and fertility problems, musculoskeletal issues, and mental health disorders. In 2010, a survey study showed a 2.9-fold increased prevalence of breast cancer in female orthopaedic surgeons, compared with women in the general US population. A follow-up study 13 years later showed a 3.97-fold higher prevalence of breast cancer in female orthopaedic surgeons compared with matched women in the US general population. Surveys on fertility have also reported that orthopaedic surgery is one of three surgical subspecialty fields with the highest rates of fertility difficulty. In addition, the rate of pregnancy loss in female surgeons was twice the rate compared with that of the general population. There is an increased risk of preterm delivery in female orthopaedic surgeons. Awareness, education, and preventive measures may help reduce these issues and thereby promote the recruitment, retainment, and success of female surgeons in orthopaedic surgery.
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Affiliation(s)
- Loretta B Chou
- From the Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City (Chou, and Kha), and the Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA (Shapiro)
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Diaz E, Abad-Tortosa D, Ghezal M, Davin J, Lopez-Castroman J. Role of stressful life events and personality traits on the prevalence of wish to die among French physicians. Front Public Health 2024; 12:1244605. [PMID: 38322123 PMCID: PMC10844508 DOI: 10.3389/fpubh.2024.1244605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
Background Suicide rates are higher among physicians than in the general population. We aimed to investigate the role of stressful life events (related or not to work conditions) and personality traits on wish to die, a proxy measure of suicidal ideation. Methods This cross-sectional study took place in France from March 2018 to September 2018. Physicians completed an online questionnaire. A multiple logistic regression model estimated factors associated with wish to die. Moderated moderation models were used to assess the effect of personality traits on the relationship between stressful events and wish to die. Results 1,020 physicians completed the questionnaire. Most (75%) had endorsed a work-related stressful event and one in six (15.9%) endorsed a wish to die the year before. Wish to die was associated with burnout (OR = 2.65, 95%CI = 1.82-3.88) and work-related stressful events (OR = 2.18, 95%CI = 1.24-3.85) including interpersonal conflicts, harassment and work-overload. Emotional stability was the only personality trait associated with wish to die in the logistic regression (OR = 0.69, 95%CI = 0.59-0.82). In moderation models, we observed a significant interaction involving three personality traits-emotional stability, extraversion, and agreeableness-along with gender, influencing the impact of stressful events on the wish to die. Limitations Our study is limited by the impossibility to control for risk factors associated with suicide like psychiatric comorbidities. Conclusion Work-related stressful events significantly contribute to the manifestation of a wish to die among physicians. The impact of stressful events on the wish to die is moderated by factors such as gender and personality traits, including emotional stability and extraversion. These results are overall consistent with prior studies concerning the risk of burnout and suicide among physicians.
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Affiliation(s)
- Emmanuel Diaz
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Diana Abad-Tortosa
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Maha Ghezal
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Josephine Davin
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
- IGF, CNRS-INSERM, University of Montpellier, Montpellier, France
- CIBERSAM, Madrid, Spain
- Department of Signal Theory and Communication, Universidad Carlos III, Madrid, Spain
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13
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Halfmann M, Castioni N, Wetzel L, Koopmann A, König S, Schmieder A. Effects of the COVID-19 pandemic on the mental health of medical students and young physicians in Germany: Gender-specific results of an online survey. Heliyon 2024; 10:e23727. [PMID: 38226267 PMCID: PMC10788433 DOI: 10.1016/j.heliyon.2023.e23727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
Background Healthcare workers and medical students faced new challenges during the COVID-19 pandemic. Processes within many hospitals were completely disrupted. In addition, the face to face teaching of medical students was drastically reduced. Those at risk of developing mental health problems appear to be younger health care workers and women. Objective To investigate potential COVID-19 pandemic-related gender differences in psychological distress among medical students and physicians in their first years of practice. Design and setting An anonymous survey was carried out online between December 1, 2021, and March 31, 2022, at the Mannheim Medical Faculty and the Würzburg Medical Faculty, Germany, after obtaining informed consent. Primary outcome measures were changes in anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS), and changes in participants' current quality of life using the WHO Quality of Life BREF. Results The results show wave-like courses for perceived anxiety and burden overlapping with the course of the COVID-19 incidence. In comparison to men, women showed a significant higher increase in HADS (p = 0.005) and a reduced life quality (p = 0.007) after COVID-19. Both sexes showed different frequencies of the factors influencing quality of life, with the presence of a previous mental illness and mean anxiety having a significant higher negative impact in women. Conclusion Future and young female physicians reported a disproportionate higher burden during COVID-19 compared to their male colleges. These observations suggest an increased need for support and prevention efforts especially in this vulnerable population.
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Affiliation(s)
- Marie Halfmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Mannheim, Germany
- Feuerlein Centre on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Noah Castioni
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Mannheim, Germany
- Feuerlein Centre on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Lea Wetzel
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Mannheim, Germany
- Feuerlein Centre on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Anne Koopmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Mannheim, Germany
- Feuerlein Centre on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Sarah König
- Institute for Medical Teaching and Training Research, University Hospital Wuerzburg, Germany
| | - Astrid Schmieder
- Clinic for Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Germany
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Rometsch C. The Role of Female Physicians in Psychosomatic Medicine: Opportunities and Challenges. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:8-12. [PMID: 38249938 PMCID: PMC10797173 DOI: 10.1089/whr.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/23/2024]
Abstract
Background Female physicians are in some cases preferred by patients due to their sex-related characteristics such as softness and empathy. Psychosomatic medicine presents a compelling working environment due to its holistic approach. Methods This brief review synthesizes the challenges encountered by female physicians in psychosomatic medicine and outlines potential strategies for overcoming these barriers. Results The presence of female role models may constitute a crucial advancement in this process. There exists a pressing demand for specialized clinical and scientific programs in psychosomatic medicine at both national and international levels. Such programs, offered by universities and ministries, as well as comprehensive training initiatives, are indispensable in fostering the next generation of females in psychosomatics. Leading journals can lend their support by publishing special issues dedicated to female physicians. Conclusion Strengthening female physicians throughout all positions in psychosomatic medicine can contribute ultimately to the improvement of patient care.
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Affiliation(s)
- Caroline Rometsch
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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15
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Gostoli S, D’Oronzo A, Malaguti C, Guolo F, Balducci C, Subach R, Lodi V, Petio C, Rafanelli C. Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7153. [PMID: 38131705 PMCID: PMC10742499 DOI: 10.3390/ijerph20247153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
This retrospective observational study on hospital staff requesting an "application visit" (from 2017 to 2022) at the Occupational Medicine department aimed at comparing a "pre-COVID group" (2017-2019) with a "COVID group" (2020-2022) regarding (a) sociodemographic data (i.e., age, sex, occupation, years of employment at the hospital), (b) rate and type of psychiatric diagnoses in both groups and rate of psychiatric diagnoses per subject, and (c) rate of drug/psychotherapeutic prescriptions. Two hundred and five healthcare workers (F = 73.7%; mean age = 50.7 ± 10.33) were visited. Compared with the pre-COVID group, healthcare workers evaluated during COVID-19 were significantly younger and reported fewer years of employment at the hospital. Although rates of primary psychiatric diagnoses were similar in both samples, an increased number of psychopathologies per subject and associated treatment prescriptions in the COVID group was observed. In the COVID group, 61% had one psychiatric diagnosis, and 28% had 2+ psychiatric diagnoses, compared with 83.8% and 6.7% of pre-COVID. Furthermore, 56.2%/1.9% in pre-COVID and 73%/6% in the COVID group were prescribed drugs/psychotherapy, respectively. The findings of the present study highlighted an increase in both younger workers' requests and psychiatric comorbidities during the pandemic, representing a burden on the Italian healthcare system. It is thus relevant to address the mental health challenges of healthcare workers accordingly.
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Affiliation(s)
- Sara Gostoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Angelica D’Oronzo
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Carlotta Malaguti
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Francesco Guolo
- Division of Cardiology, Bellaria Hospital, AUSL Bologna, 40139 Bologna, Italy;
| | - Cristian Balducci
- Department of Quality of Life Sciences, University of Bologna, 47921 Rimini, Italy;
| | - Regina Subach
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Vittorio Lodi
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Carmine Petio
- Department of Psychiatry, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
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16
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Hopcraft MS, Stormon N, McGrath R, Parker G. Factors associated with suicidal ideation and suicide attempts by Australian dental practitioners. Community Dent Oral Epidemiol 2023; 51:1159-1168. [PMID: 36812159 DOI: 10.1111/cdoe.12849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION To investigate factors associated with suicidal ideation and suicide attempts amongst Australian dental practitioners. METHODS A self-reported online survey of 1474 registered dental practitioners in Australia was conducted from October to December 2021. Participants reported thoughts of suicide in the preceding 12 months, prior to the preceding 12 months and prior suicide attempts. RESULTS Overall, 17.6% reported thoughts of suicide in the preceding 12 months, 31.4% prior to the preceding 12 months, and 5.6% reported ever having made a suicide attempt. In multivariate models, the odds of suicidal ideation in the preceding 12 months were higher in dental practitioners who were male (OR = 2.01), had a current diagnosis of depression (OR = 1.62), were experiencing moderate (OR = 2.76) or severe psychological distress (OR = 3.58), had self-reported illicit substance use (OR = 2.06) or had previous self-reported suicide attempts (OR = 3.02). Younger dental practitioners had more than twice the odds of recent suicidal ideation than those aged 61+ years, with higher resilience having decreasing odds of suicidal ideation. LIMITATIONS This study did not address help seeking behaviours directly related to suicidal ideation, so it is not clear how many participants were actively seeking mental health support. The response rate was low and results may be subject to responder biases, with practitioners experiencing depression, stress and burnout being more willing to participate. CONCLUSION These finding highlight a high prevalence of suicidal ideation amongst Australian dental practitioners. It is important to continue to monitor their mental health and develop tailored programs to provide essential interventions and supports.
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Affiliation(s)
- Matthew S Hopcraft
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- eviDent Foundation, Melbourne, Victoria, Australia
| | - Nicole Stormon
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Roisin McGrath
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Gordon Parker
- Discipline of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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17
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Ranasinghe PD, Zhou A. Women physicians and the COVID-19 pandemic: gender-based impacts and potential interventions. Ann Med 2023; 55:319-324. [PMID: 36594806 PMCID: PMC9815224 DOI: 10.1080/07853890.2022.2164046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: These are extraordinary times caused by the first global pandemic in our modern era. Physicians and other frontline healthcare providers face unique challenges, for which they have had little formal preparation. This combination of challenge and deficit leads to significant negative impacts, not only on what medical practices and health care systems can deliver to the public, but also on the individual healthcare providers themselves.Methods: In this essay, we specifically address women physicians, and explore the considerable impact they bear from the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy. Because the language we use is important, we think it necessary to clarify that when we refer to 'women physicians,' we are referring to physicians that self-identify as women, and we acknowledge that not all the references we cite may use the same definition.Results: We offer several potential interventions that turn the challenges women physicians are facing into opportunities to address longstanding inequity. These interventions include tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.Conclusion: The COVID-19 pandemic is likely to become a chronic part of our lives; protecting vulnerable populations, such as women physicians, through thoughtful intervention is paramount.KEY MESSAGESWomen physicians experience considerable adversity during the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy.These challenges create opportunities for interventions to improve equity in medicine during the COVID-19 pandemic and in the long-term, including tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.
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Affiliation(s)
| | - Ashley Zhou
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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18
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Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health 2023; 8:e868-e877. [PMID: 37898519 PMCID: PMC10932753 DOI: 10.1016/s2468-2667(23)00207-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Deaths by suicide remain a major public health challenge worldwide. Identifying and targeting risk factors for suicide mortality is a potential approach to prevention. We aimed to summarise current knowledge on the range and magnitude of individual-level risk factors for suicide mortality in the general population and evaluate the quality of the evidence. METHODS In this umbrella review, five bibliographic databases were systematically searched for articles published from database inception to Aug 31, 2022. We included meta-analyses of observational studies on individual-level risk factors for suicide mortality in the general population. Biological, genetic, perinatal, and ecological risk factors were beyond the scope of this study. Effect sizes were synthesised and compared across domains. To test robustness and consistency of the findings, evidence for small-study effects and excess significance bias (ie, the ratio between the overall meta-analysis effect size and that of its largest included study) was examined, and prediction intervals were calculated. Risk of bias was assessed by the Risk of Bias in Systematic Reviews instrument. The protocol was pre-registered with PROSPERO (CRD42021230119). FINDINGS We identified 33 meta-analyses on 38 risk factors for suicide mortality in the general population. 422 (93%) of the 454 primary studies included in the meta-analyses were from high-income countries. A previous suicide attempt and suicidal ideation emerged as strong risk factors (with effect sizes ranging from 6 to 16). Psychiatric disorders were associated with a greatly elevated risk of suicide mortality, with risk ratios in the range of 4-13. Suicide risk for physical illnesses (such as cancer and epilepsy) and sociodemographic factors (including unemployment and low education) were typically increased two-fold. Contact with the criminal justice system, state care in childhood, access to firearms, and parental death by suicide also increased the risk of suicide mortality. Among risk factors for which sex-stratified analyses were available, associations were generally similar for males and females. However, the quality of the evidence was limited by excess significance and high heterogeneity, and prediction intervals suggested poor replicability for almost two-thirds of identified risk factors. INTERPRETATION A wide range of risk factors were identified across various domains, which underscores suicide mortality as a multifactorial phenomenon. Prevention strategies that span individual and population approaches should account for the identified factors and their relative strengths. Despite the large number of risk factors investigated, few associations were supported by robust evidence. Evidence of causal inference will need to be tested in high-quality study designs. FUNDING Wellcome Trust.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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19
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Lee MO, Flores B, Fassiotto M, Hobgood C. Career Advancement Among Women Physicians in Nine Academic Medicine Specialties. J Womens Health (Larchmt) 2023; 32:1073-1079. [PMID: 37192448 DOI: 10.1089/jwh.2022.0464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
Objective: Gender parity lags in academic medicine. We applied the Rank Equity Index (REI) to compare the longitudinal progress of women's academic medicine careers. We hypothesized that women have different rank parity in promotion by specialty based on the proportion of women in the specialty. Materials and Methods: Aggregate data by sex for medical students, residents, assistant professors, associate professors, and professors in nine specialties were obtained from the Association of American Medical Colleges for 2019-2020. Specialties were clustered into terciles based on the proportion of women in the field: upper (obstetrics and gynecology, pediatrics, psychiatry), middle (internal medicine, emergency medicine, anesthesia), and lower (surgery, urology, and orthopedic surgery). We calculated the percentage representation by sex by specialty and rank to calculate REI. Specialty-specific REI comparisons between each rank were performed to assess parity in advancement. Results: Only specialties in the upper tercile recruited proportionally more women medical students to residency training. All specialties advanced women for the resident-to-assistant professor with psychiatry, internal medicine, emergency medicine, anesthesia, urology, and orthopedic surgery that promoted women faculty at rates above parity. No specialty demonstrated parity in advancement based on sex for the assistant professor-to-associate professor or associate professor-to-professor transitions. Conclusion: Gender inequity in advancement is evident in academic medicine starting at the assistant professor-to-associate professor stage, regardless of overall proportion of women in the specialty. This suggests a common set of barriers to career advancement of women faculty in academic medicine that must be addressed starting at the early career stage.
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Affiliation(s)
- Moon O Lee
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Brenda Flores
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Cherri Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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20
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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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21
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Rátiva Hernández NK, Carrero-Barragán TY, Ardila AF, Rodríguez-Salazar JD, Lozada-Martinez ID, Velez-Jaramillo E, Ortega Delgado DA, Fiorillo Moreno O, Navarro Quiroz E. Factors associated with suicide in physicians: a silent stigma and public health problem that has not been studied in depth. Front Psychiatry 2023; 14:1222972. [PMID: 37645639 PMCID: PMC10461439 DOI: 10.3389/fpsyt.2023.1222972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Suicide is a complex and multifaceted public health issue that affects individuals from all walks of life, including healthcare professionals such as physicians. According to research, physicians have a higher risk of suicide compared to the general population, with an estimated suicide rate that is two to three times greater than that of the general population. Suicide in physicians can have devastating consequences, not only for the individual but also for their patients and colleagues. The factors contributing to suicide in physicians are numerous and often interrelated. Physicians are exposed to numerous stressors in their daily lives, including long work hours, high workload, burnout, and exposure to traumatic events. These stressors can lead to mental health problems such as depression, anxiety, and substance use disorders, which in turn can increase the risk of suicide. In addition to work-related stressors, personal factors such as relationship problems, financial stress, and a history of mental health problems can also contribute to suicide risk in physicians. Stigma and shame around seeking help for mental health issues may also prevent physicians from seeking treatment, exacerbating the problem. Understanding the complex factors that contribute to suicide in physicians is crucial for developing effective prevention strategies. For this reason, it is necessary to know the behavior of this phenomenon and the factors associated with a higher risk of suicide in this population. However, taking into account that different regions of the world vary in socioeconomic, cultural, professional, occupational, and health attributes, it is to be expected that the behavior of these risk factors will also be heterogeneous. At present, it is presumed that there is a significant gap in the evidence, due to a predominance of evidence on this topic from high-income countries. Considering the importance of having a comprehensive understanding of the risk factors for suicide in the medical population and possible strategies to mitigate this condition, the aim of this review is to analyze the most recent evidence on these factors, and to assess the quality of the evidence and gaps that need to be studied further.
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Affiliation(s)
| | | | | | | | - Ivan David Lozada-Martinez
- Epidemiology Program, Department of Graduate Studies in Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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22
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Olfson M, Cosgrove CM, Wall MM, Blanco C. Fatal Drug Overdose Risks of Health Care Workers in the United States : A Population-Based Cohort Study. Ann Intern Med 2023; 176:1081-1088. [PMID: 37549391 DOI: 10.7326/m23-0902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Despite an unprecedented increase in drug overdose deaths in the United States, the risks faced by U.S. health care workers, who often have access to controlled prescription drugs, are not known. OBJECTIVE To estimate risks for drug overdose death among health care workers relative to non-health care workers. DESIGN Prospective cohort study. SETTING United States. PARTICIPANTS Health care workers (n = 176 000) and non-health care workers (n = 1 662 000) aged 26 years or older surveyed in 2008 and followed for cause of death through 2019. MEASUREMENTS Age- and sex-standardized drug overdose deaths were determined for 6 health care worker groups (physicians, registered nurses, other treating or diagnosing health care workers, health technicians, health care support workers, and social or behavioral health workers) and non-health care workers. Adjusted drug overdose death hazards (and 95% CIs) were also evaluated, with adjustment for age, sex, race/ethnicity, marital status, education, income, urban or rural residence, and region. RESULTS Approximately 0.07% of our study sample died of a drug overdose during follow-up. Among health care workers, annual standardized rates of drug overdose death per 100 000 persons ranged from 2.3 (95% CI, 0 to 4.8) for physicians to 15.5 (CI, 9.8 to 21.2) for social or behavioral health workers. Compared with those for non-health care workers, the adjusted hazards of total drug overdose death were significantly increased for social or behavioral health workers (adjusted hazard ratio, 2.55 [CI, 1.74 to 3.73]), registered nurses (adjusted hazard ratio, 2.22 [CI, 1.57 to 3.13]), and health care support workers (adjusted hazard ratio, 1.60 [CI, 1.19 to 2.16]), but not for physicians (adjusted hazard ratio, 0.61 [CI, 0.19 to 1.93]), other treating or diagnosing health care workers (adjusted hazard ratio, 0.93 [CI, 0.44 to 1.95]), or health technicians (adjusted hazard ratio, 1.13 [CI, 0.75 to 1.68]). Results were generally similar for opioid-related overdose deaths and unintentional overdose deaths. LIMITATION Unmeasured confounding, uncertain validity of cause of death, and one-time assessment of occupation. CONCLUSION Registered nurses, social or behavioral health workers, and health care support workers were at increased risk for drug overdose death, suggesting the need to identify and intervene on those at high risk. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute.
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Affiliation(s)
- Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York (M.O.)
| | - Candace M Cosgrove
- United States Census Bureau, Mortality Research Group, Suitland, Maryland (C.M.C.)
| | - Melanie M Wall
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York, New York (M.M.W.)
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Rockville, Maryland (C.B.)
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23
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Kleinhendler-Lustig D, Hamdan S, Mendlovic J, Gvion Y. Burnout, depression, and suicidal ideation among physicians before and during COVID-19 and the contribution of perfectionism to physicians' suicidal risk. Front Psychiatry 2023; 14:1211180. [PMID: 37520224 PMCID: PMC10374214 DOI: 10.3389/fpsyt.2023.1211180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods. Methods A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism. Results More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms. Conclusion Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.
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Affiliation(s)
| | - Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel-Jaffa (MTA), Tel-Jaffa, Israel
| | - Joseph Mendlovic
- Shaare Zedek Medical Center, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
- Ministry of Health, Jerusalem, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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24
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Weinhouse S, Merlo LJ, Bundy CC, Bresnahan LR, Staffa SJ, Fitzsimons MG, Rockoff MA, Vinson AE. Barriers to recovery for medical professionals: Assessing financial support through a survey of Physician Health Programs. Am J Addict 2023; 32:385-392. [PMID: 36883286 DOI: 10.1111/ajad.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is increasing focus on physician burnout, psychiatric problems, and substance use disorders. Costs of recovery for physicians enrolled in Physician Health Programs (PHPs) remain unexamined with little known regarding funding resources. We sought to elucidate perceived costs of recovery from impairing conditions and highlight resources for financial strain. METHODS This survey study was distributed by the Federation of State Physician Health Organizations via e-mail to 50 PHPs in 2021. Questions assessed perceptions of costs and ability to pay for recommended evaluation, treatment, and monitoring. Questions also assessed limitation of engagement due to financial concerns, and availability of financial resources. RESULTS Complete responses were received from 40 of 50 eligible PHPs. The majority (78%) of responding PHPs assessed ability to pay at initial intake evaluation. There is notable financial strain on physicians, particularly those earliest in training, to pay for services. DISCUSSION AND CONCLUSIONS PHPs are vital to physicians, especially physicians-in-training, as "safe haven programs." Methods to financially assist through PHPs included fee deferrals, sliding scale fees, and fee forgiveness. Health insurance, medical schools, and hospitals were able to provide additional assistance. SCIENTIFIC SIGNIFICANCE Because burnout, mental health, and substance use disorders are high stakes amongst physicians, it is critical that access to PHPs is available, destigmatized, and affordable. Our paper focuses specifically on the financial cost of recovery, the financial burden placed on PHP participants, a topic lacking in the literature, and highlights remedies and vulnerable populations.
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Affiliation(s)
- Samuel Weinhouse
- Department of Cardiothoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lisa J Merlo
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA
| | - Chris C Bundy
- Washington Physicians Health Program, Seattle, Washington, USA
- University of Washington School of Medicine, Seattle, Washington, USA
- Washington State University, Elson S Floyd College of Medicine, Seattle, Washington, USA
| | - Linda R Bresnahan
- Federation of State Physician Health Programs, Wilmington, Massachusetts, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Michael G Fitzsimons
- Department of Anesthesia, Critical Care, and Pain Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark A Rockoff
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy E Vinson
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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25
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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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Petrie K, Sanatkar S, Shand F, Harvey SB. Common mental disorder and suicidality among doctors: differences by specialty. Occup Med (Lond) 2023; 73:249-256. [PMID: 37261470 DOI: 10.1093/occmed/kqad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Common mental disorders (CMDs) and suicidal ideation (SI) are prevalent among doctors, yet limited evidence exists investigating the relationship of specialty area to these outcomes. AIMS This study aimed to determine the prevalence of likely CMD and SI among doctors and to investigate whether likelihood of these outcomes varied by area of medical specialty. METHODS A secondary analysis of a representative national survey of 12,252 Australian doctors was conducted. Demographic and work-related variables, SI and CMD (GHQ-28), were assessed among doctors (n = 7037; 57%) working in a range of specialty areas. Logistic regression was used to examine the association between specialty and mental health outcomes in unadjusted and adjusted models. RESULTS Almost one-quarter of doctors (n = 1560; 23%) reported symptom levels indicating likely CMD whilst 9% (n = 667) reported SI in the last year. Doctors in surgery (adjusted odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.54-0.97, P = 0.03) were at significantly lower risk of CMD than General Practitioners (GPs), whilst doctors in anaesthetics (adjusted OR = 1.45; 95% CI 1.09-1.93, P = 0.01) and paediatrics (adjusted OR = 1.88; 95% CI 1.02-3.47, P = 0.04) were at significantly higher risk of experiencing SI compared to GPs after accounting for confounders. CONCLUSIONS Results demonstrated that doctors in Australia working in certain specialties, specifically anaesthetics and paediatrics, were at significantly greater risk of suicidal ideation compared to GPs after accounting for confounders. Interventions to address CMD and SI among doctors in all specialties remain urgently needed.
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Affiliation(s)
- K Petrie
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S Sanatkar
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - F Shand
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
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Padmanathan P, Lamb D, Scott H, Stevelink S, Greenberg N, Hotopf M, Morriss R, Raine R, Rafferty AM, Madan I, Dorrington S, Wessely S, Moran P. Suicidal thoughts and behaviour among healthcare workers in England during the COVID-19 pandemic: A longitudinal study. PLoS One 2023; 18:e0286207. [PMID: 37343030 PMCID: PMC10284388 DOI: 10.1371/journal.pone.0286207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, concern has been raised about suicide risk among healthcare workers (HCWs). We investigated the incidence risk and prevalence of suicidal thoughts and behaviour (STB), and their relationship with occupational risk factors, among National Health Service HCWs in England between April 2020 and August 2021. METHODS In this longitudinal study, we analysed online survey data completed by 22,501 HCWs from 17 NHS Trusts at baseline (Time 1) and six months (Time 2). The primary outcome measures were suicidal ideation, suicide attempts, and non-suicidal self-injury. We used logistic regression to investigate the relationship between these outcomes and demographic characteristics and occupational factors. Results were stratified by occupational role (clinical/non-clinical). RESULTS Time 1 and Time 2 surveys were completed by 12,514 and 7,160 HCWs, respectively. At baseline, 10.8% (95% CI = 10.1%, 11.6%) of participants reported having experienced suicidal thoughts in the previous two months, whilst 2.1% (95% CI = 1.8%, 2.5%) of participants reported having attempted suicide over the same period. Among HCWs who had not experienced suicidal thoughts at baseline (and who completed the Time 2 survey), 11.3% (95%CI = 10.4%, 12.3%) reported such thoughts six months later. Six months after baseline, 3.9% (95% CI = 3.4%, 4.4%) of HCWs reported attempting suicide for the first time. Exposure to potentially morally injurious events, lack of confidence about raising safety concerns and these concerns being addressed, feeling unsupported by managers, and providing a reduced standard of care were all associated with increased suicidal ideation among HCWs during the COVID-19 pandemic. At six months, among clinicians, a lack of confidence about safety concerns being addressed, independently predicted suicidal ideation. CONCLUSION Suicidal thoughts and behaviour among healthcare workers could be reduced by improving managerial support and enhancing the ability of staff to raise safety concerns.
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Affiliation(s)
- Prianka Padmanathan
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, United Kingdom
| | - Danielle Lamb
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Hannah Scott
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sharon Stevelink
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Neil Greenberg
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Richard Morriss
- The Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Anne Marie Rafferty
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ira Madan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Dorrington
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Simon Wessely
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Robiner WN, Dorzinski CA. Suicide and homicide deaths of PAs: Analysis of the National Violent Death Reporting System. JAAPA 2023; 36:27-35. [PMID: 37163720 DOI: 10.1097/01.jaa.0000931436.58333.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study describes physician associate/assistant (PA) deaths in the US CDC's National Violent Death Reporting System (NVDRS) from 2003 to 2020. METHODS PAs' violent deaths were analyzed and summarized in terms of decedents' numbers and demographics, methods of death, locations of death, and relationships with assailants. RESULTS The NVDRS identified 93 suicides and 9 homicides in this period. PAs who died by suicide were mostly White (93.5%) and male (67.7%); mean age was 49.7 years. A third of the PAs who died by homicide were Black; most were female (55.6%), and the mean age was 48.7 years. Firearms (41.7%) were most commonly involved in deaths by suicide, and blunt impact (33.3%) was most commonly seen in deaths by homicide. A plurality (46.1%) of suicides and homicides occurred in the South. Homes (72.5%) were the most frequent location. No homicides were reported in medical settings. Known perpetrators were mainly relatives and male; none were patients. CONCLUSIONS Incidence of PA death by suicide or homicide is low relative to the general population. These deaths generally are not related to PAs' work. Delineating the incidence of violent deaths is a step toward informing preventive efforts.
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Affiliation(s)
- William N Robiner
- William N. Robiner is a professor in the departments of medicine and pediatrics, director of health psychology, and director of the psychology internship at the University of Minnesota Medical School in Minneapolis. At the time this article was written, Collin A. Dorzinski was an undergraduate in psychology at the University of Minnesota. The authors have disclosed no potential conflicts of interest, financial or otherwise
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He Z, Lei Q, Hu X, Xiong M, Liu J, Wen J, Shi X, Wang Z. Moral injury and suicidal ideation among health professionals: The role of mental health. J Affect Disord 2023; 333:58-64. [PMID: 37080491 PMCID: PMC10111858 DOI: 10.1016/j.jad.2023.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/23/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND The prolonged COVID-19 pandemic has burdened health professionals mentally and physically. This study aims to explore the relationship between moral injury (MI) and suicidal ideation (SI), and the role of mental health conditions in this relationship. METHODS Three-wave repeated online cross-sectional study with a total of 10,388 health professionals were conducted in different stages (2020-2022) of the COVID-19 pandemic in mainland China. Participants completed the Chinese version of the Moral Injury Symptoms Scale-Health Professional, Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 coupled with a blanket of scales. RESULTS The prevalence of SI and MI among health professionals was 9.8 % and 40.2 %, respectively. The prevalence risk of SI was lower in wave 2 (OR = 0.64, 95 % CI: 0.54-0.77) and wave 3 (OR = 0.71, 95 % CI: 0.60-0.84) when compared with wave 1. MI (OR = 4.66, 95 % CI: 3.99-5.43), medical error (OR = 1.15, 95 % CI: 1.00-1.32), workplace violence (OR = 1.13, 95 % CI: 0.97-1.32), depression (OR = 94.08, 95 % CI: 63.37-139.69), anxiety (OR = 25.54, 95 % CI: 21.22-30.74), PTSD (OR = 24.51, 95 % CI: 19.01-31.60) were associated with a higher risk of SI. The mediation model revealed that depressive, anxiety, and PTSD symptoms explained 90.6 % of the total variance in the relationship between MI and SI. CONCLUSIONS The risk of SI has reduced among health professionals since the first peak of the COVID-19 pandemic in China. MI may contribute to prevalent SI, and mental health conditions, especially depressive symptoms, play a significant role as mediators. LIMITATIONS Cross-sectional design precludes the investigation of casual relationships. The nonrandom sampling method limits the generalization.
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Affiliation(s)
- Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Xue Hu
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Mengyun Xiong
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Jun Liu
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi 56006, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health and Management at Ningxia Medical University, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China.
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China; The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China.
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Garg S, Kharb A, Bansal K. What covariates drive medical students to the brink of suicidal ideation, plan, and attempt? A double-centric cross-sectional study in a resource-constrained rural setting in North India. Indian J Psychiatry 2023; 65:431-442. [PMID: 37325106 PMCID: PMC10263093 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_400_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/07/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023] Open
Abstract
Background Medical students face great stress and put their mental health at risk to become an individual contributing to society, and impulsively attempt suicide. Little is known in the Indian context, so additional knowledge on the magnitude and covariates is required. Aims This study aims to evaluate the magnitude and covariates of suicidal ideation, plan, and attempts among medical students. Methods This was a cross-sectional study conducted in two medical colleges located in rural Northern India and enrolled 940 medical students for a period of two months from February to March 2022. A convenience sampling method was executed to collect the data. The research protocol incorporates a self-administered questionnaire regarding sociodemographic and personal domains, as well as standardized tools to assess psychopathological domains such as depression, anxiety, stress, and stressors. The Suicidal Behavior Questionnaire-Revised (SBQ-R) scale was used to measure the outcomes. Stepwise backward logistic regression (LR) analysis was used to determine the covariates associated with suicidal ideation, plan, and attempts. Results A sample of 787 participants (87.1% response rate) were finally enrolled in the survey, with a mean age of 21.08 (±2.78) years. Around 293 (37.2%) of respondents had suicidal ideation, 86 (10.9%) claimed planning suicide, and 26 (3.3%) mentioned attempting suicide in their lifetime as well as 7.4% of participants assessed the risk of suicidal behavior in the future. The identified covariates poor sleep, family history of psychiatric illness, never seeking psychiatric aid, regret for choosing the field of medicine, bullying, depressive symptoms, high stress, emotion-focused coping, and avoidant coping, were significantly associated with a higher likelihood of lifetime suicidal ideation, plan, and attempt. Conclusion A high frequency of suicidal thoughts and attempts, indicates the need of addressing these concerns promptly. The incorporation of mindfulness techniques, resilience, faculty mentorship programs, and proactive student counseling may help foster the mental health of the students.
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Affiliation(s)
- Sunny Garg
- Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women Khanpur Kalan, Sonipat, Haryana, India
| | - Aakanksha Kharb
- Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women Khanpur Kalan, Sonipat, Haryana, India
| | - Kirti Bansal
- Department of Applied Sciences, Hindu College of Engineering, Sonipat, Haryana, India
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Bhatia G, Sharma P, Pal A, Parmar A. The silent epidemic: Death by suicide among physicians. Asia Pac Psychiatry 2023; 15:e12522. [PMID: 36482514 DOI: 10.1111/appy.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
Suicidal deaths among physicians have been on a steady rise in the past few decades, despite being a part of the healthcare system, training for early identification and easy access to treatment services. While there is no doubt that this warrants concern at individual, institutional, and community levels, physician suicide remains an under-researched topic. We examine the correlates of suicidal deaths among physicians along with risks and protective factors conferred to physicians as a population and emphasize the need for preventive and risk-reduction initiatives that are specifically tailored for physicians and the healthcare provider community.
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Affiliation(s)
- Gayatri Bhatia
- Department of Psychiatry, All India Institute of Medical Sciences, Rajkot, India
| | - Pawan Sharma
- Department of Psychiatry, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Raebareli, India
| | - Arpit Parmar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, India
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32
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Sharma G, Rao SJ, Douglas PS, Rzeszut A, Itchhaporia D, Wood MJ, Nasir K, Blumenthal RS, Poppas A, Kuvin J, Miller AP, Mehran R, Valentine M, Summers RF, Mehta LS. Prevalence and Professional Impact of Mental Health Conditions Among Cardiologists. J Am Coll Cardiol 2023; 81:574-586. [PMID: 36585350 DOI: 10.1016/j.jacc.2022.11.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Mental illness among physicians is an increasingly recognized concern. Global data on mental health conditions (MHCs) among cardiologists are limited. OBJECTIVES The purpose of this study was to investigate the global prevalence of MHCs among cardiologists and its relationships to professional life. METHODS The American College of Cardiology conducted an online survey with 5,931 cardiologists globally in 2019. Data on demographics, practice, MHC, and association with professional activities were analyzed. The P values were calculated using the chi-square, Fischer exact, and Mann-Whitney U tests. Univariate and multivariate logistic regression analysis determined the association of characteristics with MHC. RESULTS Globally, 1 in 4 cardiologists experience any self-reported MHC, including psychological distress, or major or other psychiatric disorder. There is significant geographic variation in MHCs, with highest and lowest prevalences in South America (39.3%) and Asia (20.1%) (P < 0.001). Predictors of MHCs included experiencing emotional harassment (OR: 2.81; 95% CI: 2.46-3.20), discrimination (OR: 1.85; 95% CI: 1.61-2.12), being divorced (OR: 1.85; 95% CI: 1.27-2.36), and age <55 years (OR: 1.43; 95% CI: 1.24-1.66). Women were more likely to consider suicide within the past 12 months (3.8% vs 2.3%), but were also more likely to seek help (42.3% vs 31.1%) as compared with men (all P < 0.001). Nearly one-half of cardiologists reporting MHCs (44%) felt dissatisfied on at least one professional metric including feeling valued, treated fairly, and adequate compensation. CONCLUSIONS More than 1 in 4 cardiologists experience self-reported MHCs globally, and the association with adverse experiences in professional life is substantial. Dedicated efforts toward prevention and treatment are needed to maximize the contributions of affected cardiologists.
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Affiliation(s)
- Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Shiavax J Rao
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
| | - Pamela S Douglas
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Anne Rzeszut
- American College of Cardiology, Washington, DC, USA
| | - Dipti Itchhaporia
- Division of Cardiology, University of California, Irvine, School of Medicine, Irvine, California, USA
| | - Malissa J Wood
- Division of Cardiology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Roger S Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Athena Poppas
- Division of Cardiology, Brown University, Providence, Rhode Island, USA
| | - Jeffrey Kuvin
- Department of Cardiology at Northwell, Zucker School of Medicine, Hempstead, New York, USA
| | | | - Roxana Mehran
- Division of Cardiology, Ichan School of Medicine, Mount Sinai University, New York, New York, USA
| | - Michael Valentine
- Division of Cardiology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Richard F Summers
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laxmi S Mehta
- Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
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Stressed, Lonely, and Overcommitted: Predictors of Lawyer Suicide Risk. Healthcare (Basel) 2023; 11:healthcare11040536. [PMID: 36833071 PMCID: PMC9956925 DOI: 10.3390/healthcare11040536] [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: 01/09/2023] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/15/2023] Open
Abstract
Suicide is a significant public health concern, and lawyers have been shown to have an elevated risk for contemplating it. In this study, we sought to identify predictors of suicidal ideation in a sample consisting of 1962 randomly selected lawyers. Using logistic regression analysis, we found that high levels of work overcommitment, high levels of perceived stress, loneliness as measured by the UCLA loneliness scale, and being male were all significantly associated with an increased risk of suicidal ideation. These results suggest that interventions aimed at reducing work overcommitment, stress, and loneliness, and addressing gender-specific risk factors, may be effective in reducing the risk of suicidal ideation among lawyers. Further research is needed to expand upon these findings and to develop and test interventions specifically tailored to the needs of this population.
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Anderson N, Robinson DG, Verhagen E, Fagher K, Edouard P, Rojas-Valverde D, Ahmed OH, Jederström M, Usacka L, Benoit-Piau J, Foelix CG, Akinyi Okoth C, Tsiouti N, Moholdt T, Pinheiro L, Hendricks S, Hamilton B, Magnani R, Badenhorst M, Belavy DL. Under-representation of women is alive and well in sport and exercise medicine: what it looks like and what we can do about it. BMJ Open Sport Exerc Med 2023; 9:e001606. [PMID: 37200777 PMCID: PMC10186450 DOI: 10.1136/bmjsem-2023-001606] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Nash Anderson
- Tuggeranong Chiropractic Centre, Fadden, Australian Capital Territory, Australia
| | - Diana Gai Robinson
- Sydney Sportsmed Specialists, Sydney, New South Wales, Australia
- School of Medicine, Notre Dame University, Sydney, New South Wales, Australia
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers – Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kristina Fagher
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | - Pascal Edouard
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology (EA 7424), Saint-Etienne, France
| | - Daniel Rojas-Valverde
- Sport Injury Clinic (Rehab&Readapt), Human Movement Sciences and Quality of Life School (CIEMHCAVI), National University of Costa Rica, Heredia, Costa Rica
| | - Osman Hassan Ahmed
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, UK
- The Football Association, Burton-Upon-Trent, Staffordshire, UK
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Moa Jederström
- Athletics Research Center (ARC), Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linkoping, Sweden
| | - Laila Usacka
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Justine Benoit-Piau
- School of Rehabilitation, Faculty of Health Medicine and Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Carole Akinyi Okoth
- National Spinal Injury Referral Hospital, Nairobi, Kenya
- Ministry of Health, Narobi, Kenya
- Medical Commission, Nairobi, Kenya
- National Olympic Committee of Kenya, Nairobi, Kenya
- Kenya Hockey Union, Nairobi, Kenya
| | - Nefeli Tsiouti
- Project Breakalign, Nicosia, Cyprus
- School of Medicine, European University Cyprus, Engomi, Cyprus
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norweigan University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Larissa Pinheiro
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Rehabilitation Sciences Graduate Program. Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sharief Hendricks
- Department of Human Biology, Division of Exercise Science and Sports Medicine, Lifestyle and Sport (HPALS) Research Centre, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University Carnegie School of Sport, Leeds, UK
| | - Blair Hamilton
- Centre for Stress and Age Related Disease, University of Brighton, Brighton, UK
| | - Rina Magnani
- School of Physical Education and Physical Therapy, State University of Goiás, Goiânia, GO, Brazil
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Daniel L Belavy
- Hochschule für Gesundheit, Germany; Department of Applied Health Sciences, Gesundheitscampus 6-8, Bochum, Germany
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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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Sas DJ, Absah I, Phelan SM, Joshi AY, Creo AL, Behl S, Hanson KT, Kumar S. Patient Satisfaction Scores Impact Pediatrician Practice Patterns, Job Satisfaction, and Burnout. Clin Pediatr (Phila) 2022:99228221145270. [PMID: 36550615 DOI: 10.1177/00099228221145270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patient satisfaction (PS) surveying has become a commonly used measure of physician performance, but little is known about the impact on pediatricians. To investigate our hypothesis that PS surveys negatively impact pediatricians, we conducted a survey at an academic children's medical center. Of 155 eligible physicians, 115 responded (response rate 74%). Two-thirds (68%) did not find the PS score report useful and 88% did not feel that PS scores accurately reflect the physician's clinical ability. A third reported ordering tests, medications, or consultations due to pressure for higher PS scores. In addition, one-third agreed that PS surveys contribute to burnout and make it difficult to practice meaningful medicine. Overall, PS score reporting has a negative impact on pediatricians, especially those who are female, BIPOC (Black, Indigenous, and People of color), subspecialists, younger, and attended non-US medical schools. Further investigation into improved methods for providing feedback to pediatric physicians is warranted.
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Affiliation(s)
- David J Sas
- Division of Pediatric Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Imad Absah
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Sean M Phelan
- Division of Health Care Delivery Research & Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Avni Y Joshi
- Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Ana L Creo
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - Supriya Behl
- Children's Research Center, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kristine T Hanson
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
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Saatcioglu F, Cirit B, Koprucu Suzer G. The Promise of Well-Being Interventions to Mitigate Physician Burnout During the COVID-19 Pandemic and Beyond. JCO Oncol Pract 2022; 18:808-814. [PMID: 36162039 DOI: 10.1200/op.22.00108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The high degree of burnout in physicians, including oncologists, is detrimental to physicians themselves, their families, patients, health care organizations, and the health care systems as a whole. This dire situation has significantly worsened during the COVID-19 pandemic. It is well established that both organizational and individual measures are urgently needed to mitigate the negative consequences of physician burnout. Here, we review the research that has begun to indicate potential evidence-based individual approaches to promote physician well-being. We give an overview of these emerging programs and their importance, provide an example from our own experience, and enumerate considerations for future research. We also discuss the need for developing new approaches that are evidence-based and the best ways in which they can be incorporated in the health care setting. When judiciously combined with organizational approaches, preferentially as an integral part of them, individual wellness programs for physicians are poised to contribute significantly toward the much needed relief from physician burnout.
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Affiliation(s)
| | - Burcu Cirit
- University of Health Sciences, Ataturk Chest Diseases Education and Research Hospital, Ankara, Turkey
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Kaggwa MM, Najjuka SM, Favina A, Griffiths MD, Mamun MA. Suicidal behaviors and associated factors among medical students in Africa: A systematic review and meta-analysis. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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McGurgan P, Calvert K, Nathan E, Celenza A, Jorm C. Opinions towards Medical Students' Self-Care and Substance Use Dilemmas-A Future Concern despite a Positive Generational Effect? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13289. [PMID: 36293870 PMCID: PMC9603267 DOI: 10.3390/ijerph192013289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
This study examines demographic factors which may influence opinions concerning medical students' self-care and substance use behaviors as a means of providing insights into how future doctors view these issues compared to Australian doctors and members of the public. We conducted national, multicenter, prospective, on-line cross-sectional surveys using hypothetical scenarios to three cohorts- Australian medical students, medical doctors, and the public. Participants' responses were compared for the different contextual variables within the scenarios and the participants' demographic characteristics. In total 2602 medical students, 809 doctors and 503 members of the public participated. Compared with doctors and the public, medical students were least tolerant of alcohol intoxication, and most tolerant of using stimulants to assist with study, and cannabis for anxiety. Doctor respondents more often aligned with the public's opinions on the acceptability of the medical students' behaviors. Although opinions are not equivalent to behaviour, Australian students' views on the acceptability for cannabis to help manage anxiety, and inappropriate use of prescription-only drugs are concerning; these future doctors will be responsible for prescribing drugs and managing patients with substance abuse problems. However, if current Australian medical student's opinions on alcohol misuse persist, one of the commonest substance addictions amongst doctors may decrease in future.
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Affiliation(s)
- Paul McGurgan
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth 6009, Australia
| | | | - Elizabeth Nathan
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth 6009, Australia
| | - Antonio Celenza
- Division of Emergency Medicine, University of Western Australia, Perth 6009, Australia
| | - Christine Jorm
- Health and Medical Research Office, Australian Government Department of Health, Canberra 2601, Australia
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Nam SH, Nam JH, Kwon CY. Lack of Interventional Studies on Suicide Prevention among Healthcare Workers: Research Gap Revealed in a Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13121. [PMID: 36293696 PMCID: PMC9603174 DOI: 10.3390/ijerph192013121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/29/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Addressing the mental health needs of healthcare workers (HCWs), who are at high risk of suicide, is an important public health issue. Therefore, this systematic review investigated the effect of psychosocial intervention targeting suicidal behavior (i.e., suicidal ideation, attempt, or fulfillment) of HCWs. Five electronic databases were searched for interventional studies reporting HCWs' suicidal behavior outcomes. Only two interventional studies were included in this review, and no consistent conclusion was drawn from the existing literature regarding the psychosocial prevention strategies focusing on the suicide risk of HCWs. The results indicate that compared with numerous observational studies reporting poor mental health and/or severity of suicidal risk among HCWs, intervention studies using psychosocial strategies to reduce the risk of suicide are relatively scarce. Although the insufficient number and heterogeneity of the included studies leave the results inconclusive, our findings emphasize the need to fill the research gap in this field. The causes of the gap are further explored, and suggestions for future research are provided.
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Affiliation(s)
- Soo-Hyun Nam
- Department of Nursing, Hallym Polytechnic University, Chuncheon-si 24210, Korea
| | - Jeong-Hyun Nam
- Department of Korean Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, 52-57 Yangjeong-ro, Busanjin-gu, Busan 47227, Korea
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Kim K, Ye GY, Haddad AM, Kos N, Zisook S, Davidson JE. Thematic analysis and natural language processing of job-related problems prior to physician suicide in 2003-2018. Suicide Life Threat Behav 2022; 52:1002-1011. [PMID: 35766392 DOI: 10.1111/sltb.12896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Although previous studies have consistently demonstrated that physicians are more likely than non-physicians to experience work-related stressors prior to suicide, the specific nature of these stressors remains unknown. The current study aimed to better characterize job-related problems prior to physician suicide. METHODS The study utilized a mixed methods approach combining thematic analysis and natural language processing to develop themes representing death investigation narratives of 200 physician suicides with implicated job problems in the National Violent Death Reporting System database between 2003 and 2018. RESULTS Through thematic analysis, six overarching themes were identified: incapacity to work due to deterioration of physical health, substance use jeopardizing employment, interaction between mental health and work-related issues, relationship conflict affecting work, legal problems leading to work-related stress, and increased financial stress. Natural language processing analysis confirmed five of these themes and elucidated important subthemes. CONCLUSIONS This is the first known study that integrated thematic analysis and natural language processing to characterize work-related stressors preceding physician suicide. The findings highlight the importance of bolstering systemic support for physicians experiencing job problems associated with their physical and mental health, substance use, relationships, legal matters, and finances in suicide prevention efforts.
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Affiliation(s)
- Kristen Kim
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Gordon Y Ye
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | | | - Nicholas Kos
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Sidney Zisook
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Judy E Davidson
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,University of California San Diego Health, La Jolla, California, USA
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Zisook S, Doran N, Mortali M, Hoffman L, Downs N, Davidson J, Fergerson B, Rubanovich CK, Shapiro D, Tai-Seale M, Iglewicz A, Nestsiarovich A, Moutier CY. Relationship between burnout and Major Depressive Disorder in health professionals: A HEAR report. J Affect Disord 2022; 312:259-267. [PMID: 35760197 DOI: 10.1016/j.jad.2022.06.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/19/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Burnout is a "normal" albeit concerning response to workplace stress, whereas Major Depressive Disorder (MDD) is a serious illness associated with impairment and suicide risk. Because of symptomatic overlap between the two conditions and MDD-associated stigma, individuals reporting work-related stress and depression often are "diagnosed" with burnout at the expense of recognizing and treating MDD. Our study aimed to leverage organizational implementation of the American Foundation of Suicide Prevention's Interactive Screening Program to elucidate relationships among burnout, depression, and other suicide risk factors. METHODS 2281 of about 30,000 (~7.6 %) medical trainees, staff, and faculty responded to an anonymous online stress and depression questionnaire. Respondents were grouped into four cohorts: screened positive for burnout alone (n = 439, 19 %), depression alone (n = 268, 12 %), both conditions (n = 759, 33 %), or neither condition (n = 817, 36 %), and compared on multiple measures of distress and other suicide risk factors. RESULTS Burnout alone and depression alone each predicted greater distress and suicide risk compared with neither condition. Depression was a stronger predictor than burnout and demonstrated a consistent association with other suicide risk factors regardless of whether burnout was present. In contrast, burnout was not consistently associated with other suicide risk factors when depression was present. LIMITATIONS The sample was limited to one state-supported academic medical center; to individuals who elected to take the online survey; and relied on a single item, non-validated measure of burnout. CONCLUSION When emotional distress is reported by healthcare workers, attention should not stop at "burnout," as burnout frequently comingles with clinical depression, a serious and treatable mental health condition.
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Affiliation(s)
- Sidney Zisook
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America.
| | - Neal Doran
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America
| | - Maggie Mortali
- American Foundation for Suicide Prevention, New York, NY, United States of America
| | - Laura Hoffman
- American Foundation for Suicide Prevention, New York, NY, United States of America
| | - Nancy Downs
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America
| | - Judy Davidson
- University of California San Diego Health and Research Scientist, Department of Psychiatry, University of California San Diego, United States of America
| | - Byron Fergerson
- UC San Diego Department of Anesthesiology and Veterans Affairs, San Diego Healthcare System, La Jolla, CA, United States of America
| | - Caryn Kseniya Rubanovich
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States of America
| | - Desiree Shapiro
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America
| | - Ming Tai-Seale
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America
| | - Alana Iglewicz
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America; Veterans Affairs, San Diego Healthcare System, La Jolla, CA, United States of America
| | - Anastasiya Nestsiarovich
- University of California San Diego, Department of Psychiatry, La Jolla, CA, United States of America
| | - Christine Yu Moutier
- American Foundation for Suicide Prevention, New York, NY, United States of America
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Matilla Santander N, Blazevska B, Carli V, Hadlaczky G, Linnersjö A, Bodin T, Johansson G. Relation between occupation, gender dominance in the occupation and workplace and suicide in Sweden: a longitudinal study. BMJ Open 2022; 12:e060096. [PMID: 35738642 PMCID: PMC9226951 DOI: 10.1136/bmjopen-2021-060096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe the association between occupations and suicide, and to explore the effect of gender dominance in the occupation and in the workplace on the risk of suicide. DESIGN Register-based cohort study. PARTICIPANTS 3 318 050 workers in Sweden in 2005 and followed up until 2010. Exclusion criteria for the study were: missing information in the occupational codes, yearly income of <100 Swedish krona, missing information of the employer, death or migration, and registered occupational code reported from more than 5 years ago. OUTCOME Suicides occurring during 2006-2010 identified in the cause of death register by the International Classification of Diagnoses-10 codes X60-84 and Y10-34. RESULTS Occupations with increased suicide were life science and health professionals (OR: 2.8, 95% CI: 1.50 to 5.26) among women. In men, these were metal, machinery and related workers (OR: 1.5, 95% CI: 1.09 to 2.05) and personal and protective service workers (OR: 1.59, 95% CI: 1.14 to 2.22). In terms of gender dominance in the occupation, borderline associations with increased suicide risk were found for men in both male-dominated (OR: 1.32, 95% CI: 0.98 to 1.79) and female-dominated (OR: 1.37, 95% CI: 0.99 to 1.91) occupations. For women, borderline increased risk of suicide was found in female-dominated occupations (OR: 1.51, 95% CI: 0.95 to 2.40). Finally, men showed a borderline increased risk of suicide in female-dominated workplaces (OR: 1.31, 95% CI: 0.94 to 1.81). CONCLUSIONS This study found that women in the 'life science and health professionals' group and men in the 'metal, machinery and related workers' as well as 'personal and protective service workers' groups have increased incidence of suicide also when adjusting for sociodemographic characteristics, precariousness of the employment relationship, spells of unemployment, previous mental disorders and suicide attempts. Moreover, gender dominance at workplace and occupation seems to be associated with the risk of suicide among men. The results of our study are novel and are worth exploring in future qualitative studies.
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Affiliation(s)
- Nuria Matilla Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - Bianca Blazevska
- National Centre for Suicide Research and Prevention, Centre for Health Economics, Informatics and Health Services Research, Stockholm Health Care Services, Stockholm, Sweden
- National Centre for Suicide Research and Prevention, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention, Centre for Health Economics, Informatics and Health Services Research, Stockholm Health Care Services, Stockholm, Sweden
- National Centre for Suicide Research and Prevention, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention, Centre for Health Economics, Informatics and Health Services Research, Stockholm Health Care Services, Stockholm, Sweden
- National Centre for Suicide Research and Prevention, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Anette Linnersjö
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
| | - Gun Johansson
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
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Chahal S, Nadda A, Govil N, Gupta N, Nadda D, Goel K, Behra P. Suicide deaths among medical students, residents and physicians in India spanning a decade (2010-2019): An exploratory study using on line news portals and Google database. Int J Soc Psychiatry 2022; 68:718-728. [PMID: 33904322 DOI: 10.1177/00207640211011365] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite having one of the world's largest medical education consortium, India lacks a comprehensive and nationally representative data on suicide deaths among medical students and physicians unlike the one found in most of the developed nations of the world. AIM We aimed to explore the different characteristics of suicide deaths among medical students, residents and physicians in India over a decade (2010-2019). METHODS Content analysis of all suicide death reports among medical students, residents and physicians available from online news portals and other publicly available sites was done. Search was done retrospectively using pertinent search words individually or in combination with language restricted to Hindi and English and timed from January 2010 to December 2019. Reports on completed suicide by allopathic medical students, residents and physicians from India were included. Socio-demographic and suicidological variables were analysed using R software. RESULTS A total of 358 suicide deaths among medical students (125), residents (105) and physicians (128) were reported between 2010 and 2019. Around 7 out of 10 suicides happened before the age of 30 and had mean age 29.9 (±12.2) years. Female residents and physicians were younger than their male counterparts at the time of suicide. Overall maximum suicide deaths were concentrated in South India except the state of Kerala. The specialty of anesthesiology (22.4%) followed by obstetrics-gynaecology (16.0%) had the highest suicide deaths. Violent suicide methods were more commonly used by all, with hanging being the most common mean of suicide. Academic stress among medical students (45.2%) and residents (23.1%), and marital discord among physicians (26.7%) were the most noticeable reasons for suicide. Mental health problems were the next most common reason in medical students (24%) and physicians (20%) while harassment (20.5%) was in residents. Twenty six percent had exhibited suicide warning signs and only 13% had ever sought psychiatric help before ending their lives. A total of nine reports of suicide pact were found with the average deaths per pact being 2.4 and predominantly driven by financial reasons. CONCLUSION Academic stress among medical students and residents, and marital discord in physicians emerged as the key reasons for suicide. However, this preventable domain should be further explored through focused research. This is the first of its kind study from India which attempted to explore this vital yet neglected public health issue using the most feasible and practical method of online news content-based analysis.
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Affiliation(s)
- Savita Chahal
- Department of Psychiatry, Kalpana Chawla Government Medical College, Karnal, Haryana, India
| | - Anuradha Nadda
- Department of Community Medicine & School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nikhil Govil
- Department of General Medicine, Kalpana Chawla Government Medical College, Karnal, Haryana, India
| | - Nishu Gupta
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research Satellite Centre, Sangrur, Punjab, Chandigarh, India
| | - Diviyanshu Nadda
- Department of Ophthalmology Command Hospital Chandimandir, Panchkula, Haryana, India
| | - Kapil Goel
- Department of Community Medicine & School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Priyamadhaba Behra
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Pouquet M, Niare D, Guerrisi C, Blanchon T, Hanslik T, Younes N. [Suicide prevention: How to act?]. Rev Med Interne 2022; 43:375-380. [PMID: 35606205 DOI: 10.1016/j.revmed.2022.03.342] [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: 08/03/2021] [Revised: 03/04/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
Abstract
Although being complex, suicide is a phenomenon considered as preventable, and its prevention has been made as a public health priority. Some interventions to prevent suicide have been evaluated, such as the education of the healthcare workers, especially in the suicidal assessment (suicidal risk and suicidal emergency/dangerousness), the diagnosis and management of common mental disorders, the care provided after a suicide attempt, the restriction access to common means of suicide, the use of websites to educate the public, or the appropriate reports of suicide in media. Other interventions, even not rigorously evaluated, are implemented in France as in many parts of the world. It is the case of interventions among identified high-risk groups. To be efficient, prevention programs should simultaneously include different strategies targeting several known risk factors for suicide. Clinicians play a crucial role in the suicide prevention strategies.
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Affiliation(s)
- M Pouquet
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France.
| | - D Niare
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - C Guerrisi
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - T Blanchon
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France
| | - T Hanslik
- Sorbonne université, Inserm, institut Pierre-Louis d'épidémiologie et de santé publique, (IPLESP), 75012 Paris, France; Service de médecine interne, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, AP-HP, 92100 Boulogne-Billancourt, France; UFR des sciences de la santé Simone-Veil, université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France
| | - N Younes
- UFR des sciences de la santé Simone-Veil, université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France; Université Versailles-Saint-Quentin, université Paris Saclay, CESP, Team DevPsy, 94807 Villejuif, France; Centre hospitalier Versailles, service hospitalo-universitaire de psychiatrie de l'adulte et d'addictologie, 78157 Le Chesnay, France; Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Spottswood M, Lim CT, Davydow D, Huang H. Improving Suicide Prevention in Primary Care for Differing Levels of Behavioral Health Integration: A Review. Front Med (Lausanne) 2022; 9:892205. [PMID: 35712115 PMCID: PMC9196265 DOI: 10.3389/fmed.2022.892205] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
Importance Suicide prevention implementation in primary care is needed due to the increasing rate of suicide in the past few decades, particularly for young and marginalized people. Primary care is the most likely point of contact for suicidal patients in the healthcare system. Attention to the level of medical integration with behavioral health is vital to suicide prevention and is applied throughout this review. Methods A narrative review was performed. Observations Many interventions help improve suicide prevention care. PCP education, screening, safety planning/lethal means reduction, care transitions, psychotherapy, and medication management are all evidence-based strategies. Additionally, the pragmatic topics of financing suicide prevention, supporting providers, enacting suicide postvention, and preparing for future directions in the field at each level of primary care/behavioral health integration are discussed. Conclusions and Relevance The findings are clinically relevant for practices interested in implementing evidence-based suicide prevention strategies by attending to the behavioral health/medical interface. Leveraging the patient/provider relationship to allow for optimal suicide prevention care requires clinics to structure provider time to allow for emotionally present care. Defining clear roles for staff and giving attention to provider well being are also critical factors to supporting primary care-based suicide prevention efforts.
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Affiliation(s)
- Margaret Spottswood
- Department of Psychiatry, University of Vermont Medical Center, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Community Health Centers of Burlington, Burlington, VT, United States
| | - Christopher T. Lim
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Dimitry Davydow
- Executive Leadership, Comprehensive Life Resources, Tacoma, WA, United States
| | - Hsiang Huang
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
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Knipe D, Padmanathan P, Newton-Howes G, Chan LF, Kapur N. Suicide and self-harm. Lancet 2022; 399:1903-1916. [PMID: 35512727 DOI: 10.1016/s0140-6736(22)00173-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022]
Abstract
Suicide and self-harm are major health and societal issues worldwide, but the greatest burden of both behaviours occurs in low-income and middle-income countries. Although rates of suicide are higher in male than in female individuals, self-harm is more common in female individuals. Rather than having a single cause, suicide and self-harm are the result of a complex interplay of several factors that occur throughout the life course, and vary by gender, age, ethnicity, and geography. Several clinical and public health interventions show promise, although our understanding of their effectiveness has largely originated from high-income countries. Attempting to predict suicide is unlikely to be helpful. Intervention and prevention must include both a clinical and community focus, and every health professional has a crucial part to play.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
| | - Prianka Padmanathan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nav Kapur
- Centre for Mental Health and Safety, University of Manchester, Academic Health Science Centre, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, UK
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Irigoyen-Otiñano M, Castro-Herranz S, Romero-Agüit S, Mingote-Adán JC, Garrote-Díaz JM, Matas-Aguilera V, López-Ordoño GJ, Puigdevall-Ruestes M, Alberich S, González-Pinto A. Suicide among physicians: Major risk for women physicians. Psychiatry Res 2022; 310:114441. [PMID: 35183987 DOI: 10.1016/j.psychres.2022.114441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The risk of suicide is related to professional activity. Preliminary data suggest that being in the medical profession increases the risk of suicide in women. The objective of this nationwide study is to compare the death rate of physicians due to suicide with that of the general population and to assess the differences based on gender. MATERIALS AND METHODS All physicians and the general population who died by suicide in Spain between 2005 and 2014, both inclusive, were studied. Between these years, the Spanish population grew from 43,662,613 to 46,455,123 persons and from 199,123 to 238,240 number of doctors. The data relating to the deaths of physicians were extracted from the databases of the General Council of Official Medical Associations (CGCOM) and data related to the general population were obtained from the National Institute of Statistics (INE). The variables included in the analyses are gender, age, specialty, place of residence and death, and causes of death according to the ICD-10. RESULTS The annual mean of physician deaths was 918, with an annual crude rate of 4.8 per 1,000 registered physicians. It is confirmed that physicians have a significantly higher suicide rate (average of 1.3%) than the general population (average of 0.8%) (p = 0.003). The comparison of suicide between men and women doctors is significantly higher in women (X2= 53.068, p<0.001). In addition, if we separate by gender, female physicians have a suicide rate 7.5% higher than women from the general population, although the difference is not significant (X2 = 2.614, p = 0.107). CONCLUSIONS . Suicide is higher among physicians than the general population and affects female physicians significantly more.
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Affiliation(s)
- M Irigoyen-Otiñano
- Psychiatrist, former Secretary General of the Medical Association Lérida. University Hospital Santa Maria, Lérida. Spain.
| | - S Castro-Herranz
- Forensic Doctor, national representative of physicians in Public Administrations at CGCOM. Spain
| | - S Romero-Agüit
- Family Doctor, former President General Council of Medical Associations of Spain (CGCOM). Spain
| | | | - J M Garrote-Díaz
- Family Doctor, former Secretary General of the General Council of Medical Associations of Spain (CGCOM). Spain
| | - V Matas-Aguilera
- Family Doctor, national representative of Urban Primary Health Care at CGCOM. Spain
| | - G J López-Ordoño
- General Surgeon, National representative of Hospitals at CGCOM. Spain
| | | | - S Alberich
- Mathematician, Araba Univesity Hospital-Santiago. Bioaraba. CIBERSAM. UNED. Spain
| | - A González-Pinto
- Psychiatrist. Professor of Psychiatry University of the Basque Country. President of the Spanish Foundation of Mental Health. CIBERSAM. Spain
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Hogan WB, Daniels AH. Orthopaedic Surgeon Burnout and Suicide: Social Isolation as a Driver of Self-Harm. J Bone Joint Surg Am 2022; 104:e22. [PMID: 34648475 DOI: 10.2106/jbjs.21.00657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- William B Hogan
- Department of Orthopedics, Warren Alpert Medical School, Brown University, East Providence, Rhode Island
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50
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Renner A, Kaiser J, Kersting A. [Traumatization in the Medical Profession: Initiating Events, Roles and Process Factors]. Psychother Psychosom Med Psychol 2022; 72:378-381. [PMID: 35226961 DOI: 10.1055/a-1749-6325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physicians show an increased prevalence of post-traumatic stress disorder (PTSD). Potentially traumatic events in the medical profession include confrontation with suffering, death, violent experiences, and medical errors. The aim of the present analysis is to record traumatic events (TE) in physicians seeking help and to qualitatively analyze the roles and process factors involved. METHOD Using an online questionnaire, physicians who had experienced a traumatic event (TE) were surveyed regarding posttraumatic stress (PCL-5), depression (PHQ-9), alcohol abuse (CAGE test), and suicidality (BSIS). Reports of TEs were qualitatively analyzed using structured content analysis. RESULTS N=41 physicians described at least one TE. K=54 descriptions of TEs were qualitatively analyzed. In some cases, the physicians were victims of e. g., accidents or violence; in other cases, they were involved as witnesses or helpers. The following themes could be identified: Accompaniment of and confrontation with suffering and dying, negative courses of treatment (especially complications and medical errors), and lack of support (especially lack of error management). 53,7% of physicians had PTSD, and 36,6% showed symptoms of posttraumatic stress. Harmful alcohol use was observed in 24,4% of the sample. Psychotropic medication was taken by 31,7% of the respondents. DISCUSSION The results show a high burden of TE in the medical profession. In this context, physicians are affected by traumatization in their role as victims, witnesses, or treatment providers and confronted with the death or dying process of others. Residency presumably represents a particularly vulnerable phase. CONCLUSION Easily accessible forms of therapy (e. g., online therapy), structural changes (e. g., adequate support for residents), and programs for functional error management in hospitals could have a positive effect on the mental health of physicians.
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Affiliation(s)
- Anna Renner
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Julia Kaiser
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Anette Kersting
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
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