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Khalil MA, Khalifa D, Allam RM, Abdalgeleel SA, Khalaf OO. Suicide and depressive symptoms possible correlates among a sample of Egyptian physicians: observational cross-sectional study (online survey). BMC Psychiatry 2024; 24:408. [PMID: 38816711 PMCID: PMC11137965 DOI: 10.1186/s12888-024-05825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Compared to other occupations, physicians are more susceptible to depression and suicide. Suicide among physicians in some countries reached up to 1.5- to threefold higher than the general population. However, this rate was not homogenous in all countries. Most of the Egyptian studies were related to the stressful pandemic event, but the actual prevalence of depression among physicians is still under research. To the best of the researcher's knowledge, no other study has been conducted to evaluate the risk of suicide among Egyptian physicians. AIM The study aimed to screen for depressive symptoms and suicide among Egyptian physicians and to investigate the correlates associated with suicide ideations. METHODS This cross-sectional survey included Egyptian physicians recruited online by Google Forms. Depressive symptoms were screened using the Beck Depression Scale (BDI-II), while suicidal ideas were assessed using the Suicidal Ideation Attributes Scale (SIDAS). RESULTS Six hundred sixty Egyptian physicians completed the survey following a two-week pilot study between January 10 and July 16, 2023. The average age was 39.1 years, and 71.4% were married. 49.1% were medical specialists. The median daily working hours were eight, and 27.7% of the physicians attended night shifts. 22.3% had a psychiatric illness, and 34.3% had a chronic disease. Younger and single physicians of both sexes were more prone to suicide risk (p-value = 0.019 and 0.021, respectively). Those with psychiatric or chronic medical disorders had a higher suicidal risk (p-values < 0.001 and 0.004, respectively). Physicians with fewer academic degrees and those who work longer hours or night shifts had more depressive symptoms (p-values < 0.001 and 0.009, respectively). The risk of depression and suicide is almost the same in all medical specialties. The SIDAS suicide score and the Beck depression score revealed a statistically significant association (r = 0.288, p-value < 0.001). CONCLUSION Suicide risk is higher among younger, single physicians of both sexes, as well as those with psychiatric or chronic medical disorders. More depressive symptoms are seen in physicians who have more extended hours or night shifts and who have fewer academic degrees. Almost all medical specialties carry the same risk of depression and suicide. Longitudinal research is recommended for regular follow-up of suicidal thoughts and depressive symptoms.
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Affiliation(s)
- Mohamed A Khalil
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Khalifa
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Mahmoud Allam
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
| | - Shaimaa Abdalaleem Abdalgeleel
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
- Department of Public Health, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Ola Osama Khalaf
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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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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Folk DD, Brown C, Bissell CC, Fowler LA. Depression and associated risk factors among emergency medicine interns: Results from a national longitudinal cohort study. AEM EDUCATION AND TRAINING 2024; 8:e10970. [PMID: 38532738 PMCID: PMC10962121 DOI: 10.1002/aet2.10970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024]
Abstract
Objective Despite depression being common in residents, there are no published studies on the prevalence and risk factors for depression in emergency medicine (EM) interns. Our objectives were to explore the prevalence of depression among EM interns and to identify risk factors for depression including sleep, work hours, rotation type, race, ethnicity, sex, and age. Methods The Intern Health Study is a national longitudinal cohort study on intern mental health in all specialties. Secondary analysis was performed for EM interns only in this study. Data were collected from 2007 to 2021 and study participants completed a pre-intern year baseline survey and quarterly surveys throughout intern year, which included demographics and information on depressive symptoms, work hours, sleep, and rotation specifics. Depression severity was objectified using the Patient Health Questionnaire (PHQ9) with scores of 10 and higher meeting criteria for moderate to severe depression. Results A total of 1123 EM interns completed all surveys. The prevalence of moderate to severe depression among EM interns before starting internship was 4.8%. At Months 3, 6, 9, and 12 of intern year, the prevalence of moderate to severe depression was 17.8%, 20.5%, 20.8%, and 18.8%, respectively. PHQ9 scores were significantly higher at Month 3 of intern year compared to pre-intern year, but there were no differences at subsequent time points during intern year (p < 0.001). Females were more likely to have PHQ9 scores of 10 or above at all time points (p < 0.001). Clinical rotation type had a significant effect on PHQ9 scores, with intensive care unit rotations having a significantly higher PHQ9 score than other rotations (p < 0.001). Pearson's correlation revealed significant weak positive correlations between work hours and PHQ9 at each time point (r = 0.195, 0.200, 0.202, 0.243) and significant weak negative correlations between sleep hours and time off with PHQ9 (-0.162, -0.223, -0.180, -0.178; all p < 0.001). Conclusions Many EM interns experience moderate to severe depression. Female EM interns are more likely to be depressed than male interns. Numerous factors influence depression scores for interns, many of which are modifiable.
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Affiliation(s)
- Destiny D. Folk
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Cortlyn Brown
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Carrie C. Bissell
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Lauren A. Fowler
- Department of Physiology and PharmacologyWake Forest School of MedicineCharlotteNorth CarolinaUSA
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Jelin A, Nijagal M, Wu A, Flaherty M, Perrone EE. Physician Suicide: A Personal Story and Call to Action. J Pediatr Surg 2023; 58:1607-1608. [PMID: 37270325 DOI: 10.1016/j.jpedsurg.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/07/2023] [Indexed: 06/05/2023]
Affiliation(s)
- Angie Jelin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Malini Nijagal
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Albert Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Marissa Flaherty
- Department of Psychiatry, Office of Student Affairs, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Erin E Perrone
- Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
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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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Zimmermann C, Strohmaier S, Niederkrotenthaler T, Thau K, Schernhammer E. Suicide mortality among physicians, dentists, veterinarians, and pharmacists as well as other high-skilled occupations in Austria from 1986 through 2020. Psychiatry Res 2023; 323:115170. [PMID: 37001488 DOI: 10.1016/j.psychres.2023.115170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/02/2023] [Accepted: 03/14/2023] [Indexed: 04/17/2023]
Abstract
Some evidence puts health professionals at increased risk of suicide, especially females, whereas other research suggests a lower risk in high-skilled occupations. This study investigated the suicide risk of four health professions (physicians, dentists, veterinarians, pharmacists) and three other high-skilled occupations (notaries, lawyers, tax advisors/public accountants) in Austria compared to the general population, and analyzed suicide methods across occupations. Data was collected from professional associations and Austrian cause-of-death statistics to determine suicide cases. Gender-specific standardized mortality ratios (SMRs), crude and age-adjusted suicide rates and frequencies for suicide methods were calculated for each profession (maximum time span 1986-2020). Among males, only veterinarians had a significantly elevated suicide risk compared to the general population. Physicians and tax advisors/public accountants had a significantly lower suicide risk. Among females, the veterinarians, physicians, and pharmacists had a significantly elevated suicide risk; for dentists, it was also elevated, though non-significantly. Age-adjusted suicide rates showed a smaller gap between men and women in all professions compared to the general population. Poisoning was the predominant suicide method among health professions, except dentists. These findings are consistent with some of the prior literature and call for specific suicide prevention efforts in health professions, focusing on women.
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Affiliation(s)
- Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Kenneth Thau
- Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, United States of America
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de la Vega Sánchez D, Irigoyen-Otiñano M, Carballo JJ, Guija JA, Giner L. Suicidal thoughts and burnout among physicians during the first wave of the COVID-19 pandemic in Spain. Psychiatry Res 2023; 321:115057. [PMID: 36791592 PMCID: PMC9867840 DOI: 10.1016/j.psychres.2023.115057] [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: 05/14/2022] [Revised: 01/07/2023] [Accepted: 01/13/2023] [Indexed: 01/23/2023]
Abstract
BACKGROUND The exact mechanisms through which the impact of the SARS-CoV-2 pandemic could influence the prevalence of suicidal thoughts are not yet known, both in the general population and in health workers. The objectives of the present study are to determine the prevalence of suicidal thoughts in the physician population and to detect sociodemographic and clinical variables associated with presenting suicidal thoughts during the first wave of COVID-19. METHODS Cross-sectional observational study via an online survey distributed in Spain in June 2020 via 52 Official Medical Associations. The sample is made up of all practicing and registered physicians in Spain (3,140 of the 270,235 registered physicians in Spain). An online questionnaire which included sociodemographic, professional and work variables, variables related to the pandemic, work data in relation to COVID-19 and clinical variables (medical-psychiatric history and previous suicidal behaviour) was distributed. RESULTS In our sample, the prevalence of serious suicidal thoughts was 6.31% and up to 17.32% of the subjects reported thoughts about killing themselves during the pandemic. Being female (Exp (B)= 1.989, p=0.001), presence of previous suicide attempts (Exp(B)= 6.127, p=<0.001), taking a psychotropic drug (Exp(B)= 2.470, p=<0.001) and working in a different area during the pandemic (Exp(B)= 1.751, p= 0.037) were associated with a higher risk of suicidal ideation. Cohabiting was a protective factor in the development of suicidal ideation although not in all our measures (Exp(B)=0.940, p=0.850 Vs Exp (B)= 0.620, p=0.018). LIMITATIONS The main limitation of this study is its cross-sectional nature, which prevents establishing a causal relationship. As a strength, it stands out that it is a large sample of the population studied and in a particularly complex context of the pandemic. CONCLUSIONS Suicidal thoughts among the Spanish registered physician population during the pandemic is high and mainly associated with socio-demographic factors, clinical mental health variables, and aspects of job satisfaction.
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Affiliation(s)
- Diego de la Vega Sánchez
- Department of Psychiatry, Universidad de Sevilla, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | | | - Juan José Carballo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IISGM, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM Madrid, Spain
| | - Julio A Guija
- Service of Forensic Psychiatry, Instituto de Medicina Legal de Sevilla, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
| | - Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain.
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Atienza-Carbonell B, Guillén V, Irigoyen-Otiñano M, Balanzá-Martínez V. Screening of substance use and mental health problems among Spanish medical students: A multicenter study. J Affect Disord 2022; 311:391-398. [PMID: 35609765 DOI: 10.1016/j.jad.2022.05.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors. METHODS A multicentre cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA). RESULTS Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days. LIMITATIONS Research-based on self-reported data could favour information bias due to the social desirability effect and memory error. CONCLUSIONS A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.
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Affiliation(s)
- B Atienza-Carbonell
- Department of Medicine, University of Valencia, Valencia, Spain; Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - V Guillén
- Department of Neurosciences, School of Medicine and Nursing. University of the Basque Country, UPV/EHU, Spain.
| | - M Irigoyen-Otiñano
- Department of Psychiatry. Santa Maria University Hospital. Lleida, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
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Okawara M, Ishimaru T, Yoshikawa T, Kido M, Nakashima Y, Nakayasu A, Kimori K, Imamura S, Matsumoto K. Working hours, side work, and depressive symptoms in physicians: A nationwide cross‐sectional study in Japan. J Occup Health 2022; 64:e12377. [DOI: 10.1002/1348-9585.12377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Makoto Okawara
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences University of Occupational and Environmental Health, Japan Kitakyushu Japan
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences University of Occupational and Environmental Health, Japan Kitakyushu Japan
| | - Toru Yoshikawa
- Research Center for the Overwork‐Related Disorders National Institute of Occupational Safety and Health, Japan Kawasaki Japan
| | - Michiko Kido
- Department of Obstetrics & Gynecology Japanese Red Cross Medical Center Tokyo Japan
| | | | - Anna Nakayasu
- Department of Obstetrics & Gynecology Japanese Red Cross Medical Center Tokyo Japan
| | - Kokuto Kimori
- Executive Boards Japan Medical Association Tokyo Japan
| | - Satoshi Imamura
- Executive Boards Japan Medical Association Tokyo Japan
- Imamura Clinic Tokyo Japan
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