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Suicide Among Physicians and Health-Care Workers: A Systematic Review and Meta-Analysis
44 Pages Posted: 7 Jun 2019
More...Abstract
Background: Medical-related professions are at high suicide risk. However, data are contradictory and comparisons were not made between gender, occupation and specialties, epochs of times.
Methods: To conduct a systematic review and meta-analysis on suicide risk among health-care workers, were searched in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on April 2019. We stratified results by gender, countries, time, and specialties. Estimates were pooled using random-effect meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Information on suicides, suicidal attempts, and suicidal ideation, and related-characteristics were retrieved from national or local specific registers or case records. In addition, suicide attempts and suicidal ideation were also retrieved from questionnaires (paper or internet).
Findings: The overall SMR for suicide in physicians was 1.44 (95CI 1.16, 1.72) with an important heterogeneity (I2=93.9%, p<0.001). Female were at higher risk (SMR=1.9; 95CI 1.49, 2.58; and ES=0.67; 95CI 0.19, 1.14; p<0.006 compared to male). US physicians were at higher risk (ES=1.34; 95CI 1.28, 1.55; p <0.001 vs Rest of the world). Suicide decreased over time, especially in Europe (ES=0.18; 95CI 0.00, 0.37; p=0.044). Some specialties might be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general surgeons. There were 1.0% (95CI 1.0, 2.0; p<0.001) of suicide attempts and 17% (95CI 12, 21; p<0.001) of suicidal ideation in physicians. Insufficient data precluded meta-analysis on other health-care workers.
Interpretation: Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits for preventive strategies at the workplace. Finally, the lack of data on other health-care workers suggest to implement studies investigating those occupations.
Funding Statement: The authors declare: "None."
Declaration of Interests: The authors of this work ascertain that there are no conflicts of interests.
Ethics Approval Statement: PRISMA checklist was utilized.
Keywords: physicians, health-care workers, suicide, suicide attempts, suicidal ideation, prevention
Suggested Citation: Suggested Citation