Psychopathology and Suicide among Quebec Physicians: A Nested Case Control Study

Abstract

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.

Details on suicide among US physicians: data from the National Violent Death Reporting System

“…Several studies have demonstrated higher risk of poisoning/overdose deaths among physicians, presumably due to easier access. [8, 30–32] Physicians in our study had significantly higher rates of antipsychotics, benzodiazepines, and barbiturates found on testing; these are all prescription-medications which could be obtained more easily by a physician, but toxicology testing does not reveal whether their use was intended to be therapeutic or toxic. In the general population, overdose is often considered a less lethal approach than firearms or hanging, but among physicians who are well-educated in the toxic effects and doses for specific medications, overdose may pose a much higher risk.…”

“…[2, 8, 9] Detection of mental illness in physicians is complicated due to the significant stigma experienced by this population and their reluctance to seek treatment. [14, 18, 19] Many physicians voice fears that a depression diagnosis could negatively impact their medical licensing.…”

“…[6, 7] Small studies of suicide and suicide attempts among physicians have noted high levels of psychiatric distress among victims. [8, 9] Most existing sources of information about physician suicides generally lack corroborating or collateral information which would help to verify the overall risk of suicide in the physician population, identify concomitant risk factors for self-harm, or describe mental health variables which might contribute to physician suicide. [2]…”

Stress: Two Sides of a Coin

“…They are sometimes a sign of a long accumulation of small worries and frustrations that can severely affect the quality of life. For some people, prolonged exposure to stress can even lead to depression [22,23]. Stress can lead us to change our lifestyle.…”

Risco de suicídio em dependentes de cocaína com episódio depressivo atual: sentimentos e vivências

“…Psychiatric disorders are closely linked to suicides, with a strong association with depression (19) . Alcohol and crack/cocaine is related to suicide attempts, with an increase of depressive symptoms and impulsivity [20][21] .…”