US Women Physicians Have Higher Risk of Suicide Compared With General Population
(Clinical Pain Advisor, Ron Goldberg) – Women physicians in the United States vs women who are not physicians have a higher rate of suicide, according to study findings published in JAMA Psychiatry.
Since 2007, there have been inconclusive reports of comparative suicide incidence among US physicians vs nonphysicians regardless of sex. In the current study, researchers aimed to estimate this difference and analyze associated factors.
The researchers used data from the National Violent Death Reporting System to conduct a retrospective cohort study in the US from January 2017 through December 2021. Data used was from 30 US states and Washington, DC.
Across the study period, suicides were identified among 448 physicians (mean [SD] age, 60 [16] years; 21% women, 79% men). Comparatively, 97,467 general population suicides were identified (51 [17], years; 21% women, 79% men). Physician decedents vs nonphysicians were more likely married or in a domestic partnership (53% vs 34% [data from all US jurisdictions]).
“Comprehensive and multimodal suicide prevention strategies remain warranted for physicians, with proactive consideration for those experiencing mental health issues, job problems, legal issues, and diversion investigations.”
Physician women vs nonphysicians had higher rates of suicide in 2017 (incident rate ratio [IRR], 1.88; 95% CI, 1.19-2.83) and in 2019 (IRR, 1.75; 95% CI, 1.09-2.65), and an overall higher suicide risk from 2017 to 2021 (IRR, 1.53; 95% CI, 1.23-1.87), though this was not a statistically significant finding (P=0.80). During COVID-19 (2020 to 2021) suicide rates were more comparable (IRR, 1.34; 95% CI, 0.92-1.90), although higher by percentage among the general population vs women physicians.
Conversely, in men, physicians vs nonphysicians had lower suicide risk from 2017 to 2021 (IRR, 0.84; 95% CI, 0.75-0.93, P=0.20). Physician men also had a lower risk of suicide during the COVID-19 period (IRR, 0.88; 95% CI, 0.77-1.00).
Overall, compared to the general population, physicians had higher odds of depressed mood (adjusted odds ratio [aOR], 1.35; 95% CI, 1.14-1.61; P <.001). Higher odds of problems preceding suicide were more common among physicians vs general population for legal issues (aOR, 1.40; 95% CI, 1.06-1.84; P=.02), job concerns (aOR, 2.66; 95% CI, 2.11-3.35; P <.001), and mental health (aOR, 1.66; 95% CI, 1.39-1.97; P <.001), as was use of poisoning (aOR, 1.85; 95% CI, 1.50-2.30; P <.001) and use of sharp instruments (aOR, 4.58; 95% CI, 3.47-6.06; P <.001).
Higher odds of positive toxicology were also noted among physicians compared to the general population for cardiovascular agents; caffeine; benzodiazepines; poison; anxiolytics, nonbenzodiazepines, or hypnotics; and drugs not prescribed for home use.
The study authors wrote, “Comprehensive and multimodal suicide prevention strategies remain warranted for physicians, with proactive consideration for those experiencing mental health issues, job problems, legal issues, and diversion investigations.”
Study limitations include possible lack of US national representation, and the retrospective design lacks causality between possible precipitating factors and suicide.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.