Objective: To describe mortality by suicide among physicians in the state of Sã o Paulo, Brazil, between 2000 and2009. Methods: Secondary analysis of government mortality data. The variable of interest was ''underlying cause of death'', specifically deaths classified by the ICD-10 as intentional self-harm (X60 to X84). Results: The analyses examined 2,297 declarations of death, among which suicide accounted for 50 cases, i.e., 1.7% of all causes of death. Women comprised 13.2% of the total sample and represented 24% of the death-by-suicide group, indicating an overrepresentation of women in the latter (p = 0.02). Deaths by suicide occurred on average 20 years earlier than deaths by other causes (46.8614.2 years and 68.1615.8 years, respectively; p = 0.001). There was a significant association between single and/or divorced status and suicide (p o 0.001). The average mortality rate during the study period was 4.2 deaths per 100,000 physicians registered with the Regional Board of Medicine of the State of São Paulo. Conclusion: Deaths by suicide occurred 20 years earlier than deaths by other causes. Medical institutions should develop strategies for the prevention and early detection of mental disorders and occupational stressors that elevate the risk of suicide among physicians.

A pioneering experience in Brazil: the creation of a support network for alcohol and drug dependent physicians. A preliminary report Uma experiência pioneira no Brasil: a criação de uma rede de apoio aos médicos dependentes de álcool e drogas. Um relatório preliminar A b s t r a c t Objective: The objectives of this study are to present the creation and operation of a support network to help physicians in Brazil, describe the socio-demographic profile, and investigate the prevalence of mental disorders and chemical dependence among physicians seeking treatment. Method: Semi-structured interviews using ICD-10 criteria were conducted to obtain data regarding alcohol/drug dependence, and psychiatric comorbidity. Socio-demographic and occupational characteristics were obtained.Results: 247 patients made contact and 192 attended the first evaluation visit. Of those, 158 were male, and most (55%) were married. The mean age was 42.4 ± 11.1 years. The reasons for seeking treatment were: comorbidity between mental disorders and chemical dependence (67.7%); chemical dependence (20.8%); mental disorders (7.8%); and burnout (4.2%). The mean interval between the detection of the problem and seeking treatment was 7.5 years. Factors associated with the severity of the problem included unemployment (21.6%), difficulties of practicing professional activities (63.5%), problems with the Regional Council of Medicine (13%), psychiatric hospital admission (31.2%), and self-medication (71.8%). In our sample, 9.3% of the physicians had changed their area of specialization. Conclusions: A high prevalence of psychiatric disorders was found in this sample as well as psychosocial and professional problems. Treatment networks focusing on the physicians' mental health could catalyze cultural changes in treatment-seeking behavior, thereby improving early detection and treatment.Descriptors: Physicians; Mental health services; Substance-related disorders; Burnout, professional; Mental health disorders Resumo Objetivo: Pretendemos apresentar a criação e o funcionamento de serviço específico para médicos no Brasil, descrever o perfil sociodemográfico, prevalência de transtornos mentais e dependência química entre médicos que buscaram o serviço. Método: Foram realizadas entrevistas clínicas semi-estruturadas baseadas no CID-10 para diagnóstico de dependência de álcool/ drogas e comorbidade psiquiátrica. Um perfil sociodemográfico e ocupacional foi obtido. Resultados: 247 contatos foram feitos e 192 pacientes compareceram ao primeiro atendimento. Destes, 158 eram homens, a maioria casados (55%), idade média de 42,4 ± 11,1 anos. As causas de procura por atendimento foram: comorbidade entre transtorno mental e dependência química (67,7%), dependência química (20,8%), transtornos mentais (7,8%), burnout (4,2%). O intervalo médio entre a identificação do problema e a busca de tratamento foi de 7,5 anos. Desemprego (21,6%), problemas no exercício profissional (63,5%), problemas no Conselho Regional de Medicina (13%), internação psiquiátrica pregressa (...