Medicine: a profession at high risk of suicide

Upon correct identification factors that can increase or decrease the risk level of the suicidal causeIt has always been of great interest to attend to their close relationship with this conduct. It should be noted that this level increases in proportion to the number of manifest factors and that some have a higher specific weight than others. Knowing and studying its relevance can be decisive in understanding the issues surrounding each group.

Unfortunately for hospital patients, their profession poses a significant additional risk suffer death by suicide. According to the American Foundation for Suicide Prevention (AFSP), on average 400 doctors of both sexes commit suicide each year in the United States, which in absolute numbers equates to an entire medical school. Similar dynamics also occur among medical students where, after accidents, suicide is the most common cause of death.

    The relationship between medicine and suicide

    Studies carried out by AFSP in 2002 confirm that doctors kill themselves more frequently than others age, sex of the general population and other occupations. On average, suicide deaths are 70% more common among male physicians than among other professionals and 250% to 400% higher among female physicians. Unlike other populations, where men commit suicide four times more than women, doctors have a very similar suicide rate between men and women.

    Subsequently, in 2004, Schernhammer and Colditz conducted a meta-analysis of 25 high-quality medical suicide studies and concluded that the overall suicide rate of male physicians compared to that of men in the general population is of 1.41: 1, with 95% and a confidence interval of 1.21 to 1.65. For physicians, the ratio was 2.27: 1 (95% CI = 1.90-2.73) compared to women in the general population; which is an extremely high rate.

    however, the peculiarities compared to the rest of the professional groups do not stop there. Several epidemiological studies have shown that members of certain professions in particular have a higher risk of suicide than others and that most of this considerable variation in risk is explained by socio-economic factors, in all cases except those that belonged to the doctors.

    A case-control study with 3,195 suicides and 63,900 matched controls in Denmark (Agerbo et al. 2007) corroborated that the risk of suicide decreases in all occupations if the variables of psychiatric admission, employment status, marital status are monitored. and gross income. But again, doctors and nurses were the exception, in which, in fact, the suicide rate increased.

    Also, enter people who have received psychiatric treatment in hospital there are modest associations between suicide and employment, but not for physicians, who have a much higher risk, up to four times higher.

    Finally, the combination of high stress situations and access to lethal means of suicide such as guns or drugs is also an indicator of certain occupational groups. Among all physicians, an even greater risk was assessed for anesthesiologists to have easy access to anesthetic drugs. These studies are reflected in the results obtained from other high risk groups such as dentists, pharmacists, veterinarians and farmers (Hawton, K. 2009).

    A very sacrificed profession

    After developing a consensus document among experts to assess the state of knowledge on depression and suicide deaths among physicians, it was concluded that the traditional culture of medicine makes the mental health of the physician a low priority despite evidence of a high prevalence of poorly treated mood disorders. The barriers that prevent doctors from seeking help are usually fear of social stigma and compromising their professional career, so they postpone it until the mental disorder becomes chronic and complicated with other conditions.

    The etiopathogenic factors that may explain the increased risk of suicide are poor adaptation, or lack of resources for a good adaptation, psychosocial risks inherent in clinical activity such as stress from the same clinical activity, harassment and burnout, as well as institutional pressures (cuts, schedules and forced changes, lack of support, malpractice litigation).

    It was recommended that professional attitudes and institutional policies be changed to encourage physicians to seek help when they need it and to help their peers recognize and treat themselves when they need it. the doctors they are as vulnerable to depression as the general populationBut seek help to a lesser extent and the rates of suicide consumed are higher (Center et al., 2003).

    Bibliographical references:

    • Medicine and safety at work. Printable version ISSN 0465-546X Med. For sure. treb. vol. 59 n ° 231 Madrid April-June. 2013
    • Suicide and psychiatry. Recommendations for the management of preventive and suicidal behavior. Bobes García J, Giner Ubago J, Saiz Ruiz J, editors. Madrid: Triacastela; 2011

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