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In most areas of study, nurses and physicians demonstrated comparable results; however, a series of statistically significant differences suggest that these groups may have unique clinical needs. The policy implications of these findings are discussed.

The assessment and treatment of physicians with substance use disorders has been of considerable interest over the past twenty years. This study compares two cohorts of addicted physicians treated at a single program. Data from 101 physicians treated during 1985 to 1987 were compared with 73 physicians treated from 1995 to 1997. Although the cohorts were similar on demographic, physician specialty, and drug of choice variables, psychiatric comorbidity was significantly more prevalent in the later sample.

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The co-morbidity of personality disorders (PDs) and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.

Physician health and impairment have been of considerable interest in recent years. This study contributes detailed clinical data to the existing body of knowledge, by drawing from a sample of physicians assessed at a behavioral health center over a two year time frame. Demographic, referral, and clinical data were gathered using a systematic medical record review procedure, based on 108 physicians who were evaluated within an intensive multidisciplinary assessment program. The majority suffered from active substance use disorders (52.8%), with other psychiatric disorders (29.6%), and substance use disorders in remission (17.6%) the other largest categories. Of those with an active substance use disorder, primary drugs of choice were alcohol and prescription opiates. Over half had comorbid psychiatric disorders (Axis I, II, or both). Significant relationship, employment, and emotional problems were found in all three groups. The significant increase in presentation and/or detection of psychiatric and behavioral problems, both comorbid with and not substance use related, confirms the need for a revision and expansion of views about physicians' behavioral health concerns.

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This article discusses a multi-faceted treatment paradigm used to service professionals with addictive disorders. Individualized treatment plans are developed based on a multitude of factors including administration of the TCI-R (Temperament Character Inventory), MCMI-III (Millon Clinical Multiaxial Inventory) and the WASI (Wechsler Abbreviated Scale of Intelligence). Treatment goals include specific therapeutic interventions and patient and therapist-directed tasks related to enhanced development of the character dimensions of Self-Directedness, Cooperativeness and Self-Transcendence, as measured on Cloninger's TCI-R inventory.