What contributes to the high prevalence of physician suicide?

Updated: Jun 11, 2017
  • Author: Louise B Andrew, MD, JD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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In every population, suicide is almost invariably the result of untreated or inadequately treated depression or other mental illness that may or may not include substance or alcohol abuse, coupled with knowledge of and access to lethal means. [2] Depression is at least as common in the medical profession as in the general population, affecting an estimated 12% of males and up to 19.5% of females. [3, 4] Depression is even more common in medical students and residents, with 15-30% of them screening positive for depressive symptoms. [5, 6, 7, 8, 9]  This is not an isolated North American phenomenon. Studies from Finland, Norway, Australia, Singapore, China, Taiwan, Sri Lanka, and others have shown increased prevalence of anxiety, depression, and suicidality among students and practitioners of medicine. [10, 11, 12, 13]

However, because of the stigma associated with depression in almost all cultures, which seems to be greatly magnified among medical practitioners, self reporting likely underestimates the prevalence of the disease in medical populations. Indeed, although physicians seem to have generally heeded their own advice about avoiding smoking and other common risk factors for early mortality, they are decidedly reluctant to address depression, a significant cause of morbidity and mortality that disproportionately affects them. Depression is also a leading risk factor for myocardial infarction in male physicians, and it may play a role in immune suppression thus increasing the risk of many infectious diseases and cancer. [14, 15, 16, 17, 18, 19, 20, 21]

Because of their greater knowledge of and better access to lethal means, physicians have a far higher suicide completion rate than the general public. The most reliable estimates of successful completion of suicide range from 1.4-2.3 times the rate achieved in the general population. Although female physicians attempt suicide far less often than their counterparts in the general population, their completion rate equals that of male physicians and, thus, far exceeds that of the general population (2.5-4 times the rate by some estimates). [3, 4]

A reasonable assumption is that underreporting of suicide as the cause of death by sympathetic colleagues certifying death may well skew these statistics; consequently, the real incidence of physician suicide is probably somewhat higher than the prevailing estimate.

Source Article: Physician Suicide: Overview

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