The Art and Science of Physician Wellbeing by Laura Weiss Roberts & Mickey Trockel

Author:Laura Weiss Roberts & Mickey Trockel
Language: eng
Format: epub
ISBN: 9783319421353
Publisher: Springer International Publishing

Tunajek S (2007) Dealing with Litigation Stress Syndrome. American Association of Nurse Anesthetists News Bulletin

© Springer Nature Switzerland AG 2019

Laura Weiss Roberts and Mickey Trockel (eds.)The Art and Science of Physician Wellbeinghttps://doi.org/10.1007/978-3-319-42135-3_9

9. Mental Illness

Kristin S. Raj1

(1)Stanford School of Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, USA

Kristin S. Raj

Email: [email protected]

Keywords

Physician wellnessMental illnessStigmaDepressionPhysician suicide

When considering impediments to wellness in physicians, untreated mental illness and its consequences must be addressed. Despite the aim of the profession to care for health concerns, physicians often neglect or intentionally ignore their own mental health. While physicians have lower mortality rates of heart disease and cancer than the population, physicians’ rates of suicide are far higher. Whereas level of education is typically a protective factor against suicide, this does not hold true for the healing profession. Each year, the number of physicians who die by suicide is around 400, equivalent to at least one to four full classes of graduating medical students. A psychological autopsy of physician suicide was done with data from over 30,000 suicides between 2003 and 2008, obtained via the state-wide National Violent Death Reporting system from 16 states. Physicians were more likely to be older and married compared to the non-physicians who died by suicide. There was no difference in their mental health diagnosis or depressed mood at the time of death (Gold et al. 2013). Women physicians are particularly at risk; while women physicians attempt suicide less often than non-physician women (who overall attempt more than men by a factor of four, though complete less often than men), women physicians’ rate of dying by suicide equals that of men. Women physicians are thus dying by suicide at a rate far above their non-physician counterparts (Center et al. 2003). Knowledge of the human body and medications is likely playing a role in contributing to these deaths. Indeed, poisoning is the second most common method of suicide for physicians, whereas suicide attempts via poisoning are less likely to result in death in the general population (Gold et al. 2013). Physician knowledge of effective mechanisms of poison and death is likely linked to their higher comparative rates of intentional overdose death. Given that the decision to commit suicide is often impulsive and most people regret the attempt after it occurs, the increased risk of fatality with physicians’ attempts is of grave concern.

Physicians, just like others, suffer from a range of mental health issues. Depression is far more prevalent in medical students and resident physicians than in their age-matched counterparts in the population. The prevalence of depression in residents is 28%, ranging from 20.9% to 43.2% depending on the instrument used to detect this illness. Furthermore, the rates of depression in residents are increasing with each calendar year (Mata et al. 2015). Prevalence of bipolar disorder or treatment-resistant depression in physicians is not known but may be underappreciated, given evidence that physicians who complete suicide are more likely than non-physicians to have antipsychotics in their blood at the time of death (Gold et al.

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