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SDL Project Assignment #3

By Eric Medrano

Section I: Search Criteria& Overview


This bibliography is compiled from multiple articles through a search for a study of the contributing
factors to the higher suicide rates that medical physicians face. Most of these studies are meta-
analysis studies of a combination of studies that look into the factors that contribute the higher
suicide rates of physician’s vs non physicians. These factors include access to mental health, stigma,
burnout, and societal expectations. I’m hoping to use these studies in order to present a strong
picture on the risks that many of IUSM’s students and current physicians might face.

Section II: Selected Articles (5 minimum)

Article #1:
Schernhammer, Eva S., and Graham A. Colditz. "Suicide rates among physicians: a quantitative and
gender assessment (meta-analysis)." American Journal of Psychiatry 161.12 (2004): 2295-2302.

Link - https://www.ncbi.nlm.nih.gov/pubmed/15569903

This is a meta-analysis study of the suicide rates among physicians. One of the main things from
this meta-analysis is there is substantial evidence to support the claim that physicians have a higher rate
of suicide than the general population. Another key point from this publication is the significant increase
in female physician suicide rates. The point of this study is to establish the main claim that physicians do
have a higher rate of suicide compared to the non-physician population.

Article #2:

Center, C., Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., & Michels, R. (2003).
Confronting depression and suicide in physicians: a consensus statement. Jama, 289(23), 3161-
3166.

Link - https://scholar.google.com/scholar?q=Confronting+depression+
+suicin+in+physcians+&btnG=&hl=en&as_sdt=0%2C15

This is a consensus statement from 15 experts in the field of physician suicide. They discuss the certain
risk factor that might contribute to the higher suicide rate in physicians. They state they there is a lower
priority to physician mental health which increases the rate of their suicide. This includes discrimination
in medical licensing, hospital privileges, and opportunities for professional advancement. The article
argues that there needs to be a transformation in changing the policies to encourage physicians to
acquire the help they need.
Article #3:

Eva Schernhammer MD, DrPH. "Taking their own lives-the high rate of physician suicide." The
New England journal of medicine 352.24 (2005): 2473.

Link - http://www.nejm.org/doi/full/10.1056/NEJMp058014

This is a meta-analysis study that looks into the contributing factors of suicide rates among
physicians. It notes that there is a higher rate of physician suicide compared to non-physicians. One
important claim of this study is women physicians also have a much greater percentage of
successful suicide attempts than non- female physicians. The authors make note that female
physicians have other factors that are not as common while male physicians. For example, risks of
sexual harassment, competing in a male dominated profession, and the societal pressure of having a
family life (i.e. children/married) and their career.

Article #4:

Gold, Katherine J., Ananda Sen, and Thomas L. Schwenk. "Details on suicide among US
physicians: data from the National Violent Death Reporting System." General hospital
psychiatry 35.1 (2013): 45-49.

Link - http://www.sciencedirect.com/science/article/pii/S016383431200268X

This study looked at the details on suicide among US physicians. They gathered a data set from
31,636 physicians who committed suicide. The results of this study showed that physician suicide is
substantially different than non-physician suicide victims. 2 main factors were noted. The first factor
was noted that suicide has a higher preference of a “job problem” factor. Issues with work crises
such as patient demands, role conflicts, and lack of control over working conditions. It’s important
to note however that there is no difference noted when dealing with a recent loss due to work. The
authors believe this may be due to the idea that physicians have an easier way to tolerate death in
their field, however tend to have an inability to cope with problems related to their identity as
physicians.

Another important factor is the increased in mental illness but the lower rate of medication
treatment in physicians. The authors believe this may be due to the stigma that many physicians
face when dealing with mental illness (i.e. threat of losing their medical licenses). Issues with
confidentiality and mental illness stigma may be contributing factors to why mentally ill physicians
are not getting the treatment and aid they need.

A limitation that is noted from the authors is that the variables from their data sets is dependent by
the interpretation of the coders who are taking and abstracting the data from the police/toxicology
reports. They believe that this might under estimate the true incidence of mental illness and other
factors because the victim cannot be interviewed about these factors.

Article #5:
Hawton, K., et al. "Doctors who kill themselves: a study of the methods used for suicide." Qjm
93.6 (2000): 351-357.
Link - https://academic.oup.com/qjmed/article/93/6/351/1536833/Doctors-who-kill-
themselves-a-study-of-the-methods

This is a study sought to gather information about physician suicide methods from Office
for National statistics with death entries of deaths in England and Wales between 1879 and
1995. It was concluded from their analysis that the methods of suicide differ from physicians
and non – physicians. Physicians have been shown to have a greater successful risk of
committing suicide through poisoning/overdose especially with barbiturates. Although
overdosing tends to be unsuccessful among the common population. Overdosing is extremely
successful among physicians. This may be due to their improved knowledge in physiology and
toxicology that allows their attempts to be successful. It should also be noted that doctors have
greater access to these drugs which might be a contributing factors to the increased rate of this
specific method of suicide..