Physician Suicide Linked to Work Stress

A new study reveals that suicide among US physicians appears to follow a different profile than in the general population, with a greater role played by job stress and mental health problems.

Researchers at the University of Michigan (Ann Arbor, USA) examined data from the United States National Violent Death Reporting System to evaluate the demographics, mental health variables, recent stressors, and suicide methods among physician versus nonphysician suicide victims in 17 US states. The data set included 31,636 suicide victims, of whom 203 were identified as physicians. Medical students and physician assistants were excluded from the analysis, although retired physicians were not.

The results showed that occupational problems contributed to a suicide rate that was 3.12 times more likely among physicians. Although physicians were not significantly more likely to have a current mental health disorder or to have current depressed mood at the time of death than those in other occupations, the difference became significant on multivariate analysis: Having a known mental illness was modestly associated with physician status, with an odds ratio of 1.34 after adjustment for gender, race, age, and marital status. Known alcohol or substance abuses were also less common, though, among physicians, as were antidepressants.

The substances that were more common among physicians than other suicide victims were antipsychotics, benzodiazepines, and barbiturates. Firearms were the most common method used for suicide by both physicians and nonphysicians, at roughly half in both groups. Poisoning came in next most common among physician suicides, with a slightly higher proportion than among nonphysicians (24% versus 18%). The study was published in the November 2012 issue of General Hospital Psychiatry.

“I think stigma about mental health is a huge part of the story. There is a belief that physicians should be able to avoid depression or just 'get over it' by themselves,” said lead author Katherine Gold, MD, MSW, of the department of family medicine. “Fear that a depression diagnosis could hurt their medical licensing is common, and many physicians appear to avoid treatment completely in order to protect confidentiality about their mental health problems.”

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