Medicine: a profession with a high risk of suicide
When identifying correctly the factors that can increase or decrease the level of risk of the suicidal cause It has always been of great interest to attend to the close relationship they have with this behavior. Keep in mind that this level increases proportionally to the number of manifest factors and that some have a greater specific weight than others. Knowing them and studying their relevance can be decisive when it comes to understanding the problems that surround each group.
Unfortunately for internal doctors, their profession constitutes an important added risk to suffer a death by suicide. Every year an average of 400 doctors of both sexes commit suicide in the United States, which is equivalent in absolute numbers to an entire medical school. There are also similar dynamics among medical students in which, after accidents, suicide is the most common cause of death.
- Related article: "What must be done to reduce the suicide rate?"
The relationship between medicine and suicide
The studies carried out by the AFSP in 2002 confirm that Doctors died by suicide more frequently than other people of the same age, gender of the general population and other professions. On average, death by suicide is 70% more common among male doctors than in other professionals, and 250% to 400% higher among female doctors. Unlike other populations, where men commit suicide four times more often than women, doctors have a suicide rate that is very similar between men and women.
Subsequently, in 2004, Schernhammer and Colditz conducted a meta-analysis of 25 quality studies on medical suicide and concluded that the aggregate suicide rate for male doctors compared to that of men in the general population is 1.41: 1, with 95% and a confidence interval of 1.21 to 1.65. For female physicians, the ratio was 2.27: 1 (95% CI = 1.90-2.73) compared to women in the general population; what constitutes a worryingly high rate.
But nevertheless, the singularities with respect to the rest of professional groups do not end here . Several epidemiological studies have found that members of some occupations in particular have a higher risk of suicide than others and that most of this considerable variation in risk is explained by socioeconomic 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 and gross income are controlled. . But, again, doctors and nurses were the exception, in which, in fact, the suicide rate increased.
Also, between people who have received hospital psychiatric treatment there are modest associations between suicide and occupation, but not for doctors, who have a much more marked risk, up to four times greater.
Finally, the combination of situations with high stress and access to lethal means of suicide such as firearms or medicines is also an indicator of certain occupational groups. Among all the doctors, an even greater risk for anesthetists has been evaluated for having easy access to anesthetic drugs. These studies are reflected with the results obtained from other high-risk groups such as dentists, pharmacists, veterinarians and farmers (Hawton, K. 2009).
A profession very sacrificed
After elaborating a consensus document among experts to assess the state of knowledge of depression and suicide deaths among physicians, it was concluded that the traditional culture of medicine places the mental health of the doctor as a low priority despite the evidence that they have a high prevalence of mood disorders not adequately treated. The barriers to doctors seeking help are usually the fear of social stigma and compromising their career, so they postpone it until the mental disorder has become chronic and complicated with other pathologies.
The etiopathogenic factors that may explain the increased risk of suicide consist of poor coping, or lack of resources for due coping, of the psychosocial risks inherent to clinical activity such as the stress inherent in the same clinical activity, harassment and burnout, as well as institutional pressures (cuts, schedules and forced shifts, lack of support, litigation for malpractice).
It has been recommended to change professional attitudes and change institutional policies to encourage doctors to ask for help when they need it and to help their colleagues recognize and treat them when they need it. The doctors they are as vulnerable to depression as the general population , but they seek help to a lesser extent and the rates of completed suicide are higher (Center et al., 2003).
Bibliographic references:
- Medicine and Work Safety. Print version ISSN 0465-546X Med. Segur. trab. vol.59 no.231 Madrid abr.-jun. 2013
- Suicide and Psychiatry. Preventive recommendations and management of suicidal behavior. Bobes García J, Giner Ubago J, Saiz Ruiz J, editors. Madrid: Triacastela; 2011
- //afsp.org/
- //www.doctorswithdepression.org/
