Medicine: A Profession With A High Risk Of Suicide
When correctly identifying factors that can increase or decrease the risk level of suicidal cause , it has always been of great interest to pay attention to the close relationship they have with said behavior. It must be taken into account 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 physicians, their profession constitutes a significant added risk to suffer death by suicide. According to the American Foundation for Suicide Prevention (AFSP), an average of 400 doctors of both sexes commit suicide each year in the United States, which is equivalent in absolute numbers to an entire medical school. Similar dynamics also occur among medical students in which, after accidents, suicide is the most common cause of death.
Studies carried out by the AFSP in 2002 confirm that doctors died by suicide more often 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 other professionals, and 250% to 400% higher among female doctors. Unlike other populations, in which 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 physician suicide and concluded that the aggregate suicide rate for male physicians 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; which constitutes a worryingly high rate.
However, The singularities with respect to the rest of professional groups do not end here Several epidemiological studies have found that members of some particular occupations 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 who 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 income, employment status, marital status and gross income are controlled. . But, again, doctors and nurses were the exception, where, in fact, the suicide rate increased.
Furthermore, between people who have received inpatient 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 along with access to lethal means of suicide such as firearms or medicines is also an indicator typical of certain occupational groups. Among all doctors, an even greater risk has been assessed for anesthetists due to 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 very sacrificial profession
After preparing a consensus document among experts to evaluate the state of knowledge of depression and deaths by suicide among doctors, it was concluded that The traditional culture of medicine places the doctor’s mental health as a low priority despite the evidence that they have a high prevalence of mood disorders that are not adequately treated. The barriers for doctors to seek help are usually the fear of social stigma and compromising their professional career, which is why they postpone it until the mental disorder has become chronic and complicated by other pathologies.
The etiopathogenic factors that can explain the increased risk of suicide consist of poor coping, or lack of resources to properly cope, with the psychosocial risks inherent to clinical activity such as the stress inherent to the clinical activity itself, harassment and professional burnout, as well as institutional pressures (cuts, forced schedules and shifts, lack of support, malpractice litigation).
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 themselves when they need it. The doctors are as vulnerable to depression as the general population but they seek help to a lesser extent and rates of completed suicide are higher (Center et al., 2003).
