Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995
Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995
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DOI：
10.1136/jech.55.5.296
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发表时间：
2001-05-01
影响因子：
6.3
通讯作者：
Deeks, JJ
中科院分区：
文献类型：
--
作者：
Hawton, K;Clements, A;Deeks, JJ
研究目的 - 根据性别、资历和专业，调查英格兰和威尔士医生的自杀风险。
设计 - 回顾性队列研究。按性别、年龄、专业、资历和时间段计算自杀率。计算1991 - 1995年自杀的标准化死亡率（SMR），并根据年龄和性别进行调整。
地点 - 英格兰和威尔士。
研究对象 - 1979年至1995年间通过自杀死亡的国民医疗服务体系（NHS）的医生，通过死亡证明确定。根据卫生部人力数据确定处于风险中的人群。
主要结果 - 确定了223名国民医疗服务体系中因自杀或死因不明死亡的医生。男性和女性医生的年自杀率分别为每10万人19.2人和18.8人。女性医生的自杀率高于普通人群（SMR 201.8；95%置信区间99.7，303.9），而男性医生的自杀率低于普通人群（SMR 66.8；95%置信区间46.6，87.0）。尽管两性的绝对自杀风险相似，但女性和男性医生的死亡率比值差异具有统计学意义（p = 0.01）。不同专业之间存在显著差异（p = 0.0001），麻醉师、社区卫生医生、全科医生和精神科医生的自杀率与综合医院内科医生相比显著增加。在资历和时间段方面没有差异。
结论 - 女性医生自杀风险增加，但男性医生似乎比普通人群中的男性风险更低。女性医生自杀风险过高凸显了更有效地解决医生压力和心理健康问题的必要性。鉴于进入医学领域的女性人数大幅增加，需要对这一风险进行特别监测。
Study objective-To investigate the suicide risk of doctors in England and Wales, according to gender, seniority and specialty.Design-Retrospective cohort study. Suicide rates calculated by gender, age, specialty, seniority and time period. Standardised mortality ratios calculated for suicide (1991-1995), adjusted for age and sex.Setting-England and Wales.Subjects-Doctors in the National Health Service who died by suicide between 1979 and 1995, identified by death certificates. Population at risk based on Department of Health manpower data.Main results-Two hundred and twenty three medical practitioners in the National Health Service who died by suicide or undetermined cause were identified. The annual suicide rates in male and female doctors were 19.2 and 18.8 per 100 000 respectively. The suicide rate in female doctors was higher than in the general population (SMR 201.8; 95% CI 99.7, 303.9), whereas the rate in male doctors was less than that of the general population (SMR 66.8; 95% CI 46.6, 87.0). The difference between the mortality ratios of the female and male doctors was statistically significant (p=0.01), although the absolute suicide risk was similar in the two genders. There were significant differences between specialties (p=0.0001), with anaesthetists, community health doctors, general practitioners and psychiatrists having significantly increased rates compared with doctors in general hospital medicine. There were no differences with regard to seniority and time period.Conclusions-There is an increased risk of suicide in female doctors, but male doctors seem to be at less risk than men in the general population. The excess risk of suicide in female doctors highlights the need to tackle stress and mental health problems in doctors more effectively. The risk requires particular monitoring in the light of the very large increase in the numbers of women entering medicine.