Objective. To describe a psychiatric profile and characteristics of physicians who killed themselves in Quebec between 1992 and 2009. Method. The cases of 36 physicians (7 females and 29 males) and 36 nonphysicians who committed suicide were matched for age and gender and examined in a nested case control design. All subjects were judged as definite suicide by the Quebec Coroner Head Office. Consensus regarding DSM-IV diagnoses was established by two forensic psychiatrists. Results. Rates of all Axis I diagnoses were 83% for physicians and 91% for nonphysicians at the time of suicide. Major depressive disorders were the most frequently observed pathology in both groups (61% and 56%, resp.). Conclusions. Physicians and nonphysicians who committed suicide in Quebec suffered from the same type of psychiatric disorder at the time of killing themselves. The findings advocate strongly for more efficient suicide prevention measures including early detection and treatment of mood disorders for the physicians.
Introduction:A First Manic Episode (FME) can evolve differently and some patients remain chronically ill (Poor Outcome Manic Syndrome = POMS). Even, the majority of subsequent episodes reoccur over the time; few studies have looked at the long-term course of a FME. The aim is therefore to look at the longitudinal clinical characteristics of FME in a hospital setting.Method:The subjects, developing POMS, were patients admitted to hospital with at least 2 hospitalizations for mania and having received continuing psychiatric care for ≥ 5 years. The control group subjects were FME patients with only one admission. The data was gathered from hospital discharge summaries for all 472 subjects with FME (age 14–64) admitted to a Quebec regional psychiatric hospital for the first time during a 30 year period (1980-2011).Results:Amongst all first admitted FME patients, 27% ended up with POMS. A logistic regression analysis indicates the subsequent development of POMS was correlated with younger age, male gender and alcohol misuse at the time of the initial admission to hospital. The historical data available (median=11 years) shows that the diagnosis evolved towards bipolar disorder (76%), schizoaffective disorder (17%) and schizophrenia (6%).Conclusion:The results indicate that development of POMS is an inevitable clinical reality. The influence of alcoholism on the evolution of FME is clearly adverse. It is particularly associated with more manic episodes. The results underline the necessity for concomitant intervention for alcoholism in the presence of FME.
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