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Centre for Suicide Research | Research | Suicide in high risk occupations | Doctors

 

Suicide in high risk occupational groups - Doctors

 

The Centre for Suicide Research was commissioned by the Department of Health to carry out research into suicide in doctors. This work included a psychological autopsy study, and studies of methods used for suicide by doctors and suicide risk according to gender, seniority and speciality.

 

Psychological autopsy study

We carried out a psychological autopsy study of 38 working doctors who died by suicide in England and Wales between January 1991 and December 1993. This involved an in-depth investigation of the circumstances of the deaths, personal and family history, social circumstances, physical and mental health, personality factors, treatments received, and problems at home and work in the year before death, using interviews with relatives or friends of the deceased together with information from coroners' records, general practitioner records and psychiatric casenotes. Psychiatric illness was present in 25 of the 29 doctors for whom there was sufficient information to assess psychopathology. Depressive illness and drug or alcohol abuse were the most common diagnoses. 25 doctors had significant problems related to work, 14 had relationship problems and 10 had financial problems. Multiple and interrelated problems were often present. The most common method of suicide was self-poisoning, often with drugs taken from work. Prevention of suicide in doctors requires a range of strategies, including improved management of psychiatric disorder, measures to reduce occupational stress and restriction of access to means of suicide when doctors are depressed.

Publication:

Hawton, K., Malmberg, A., Simkin, S. Suicide in doctors: a psychological autopsy study. (2004) Journal of Psychosomatic Research, 57, 1-4

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Methods used for suicide by doctors

We compared methods of suicide used by 329 doctors who died between 1979 and 1995 in England and Wales with those used by the general population. Self-poisoning with drugs was more common in doctors than in general population suicides (57% v 26.6%), including in retired doctors. Barbiturates were the most frequent drug used. Half of the anaesthetists who died used anaesthetic agents. Self-cutting was also more frequently used as a method of suicide. The finding that the greater proportion of suicide deaths in doctors were by self-poisoning may reflect the fact that doctors have ready access to drugs, and have knowledge of which drugs and doses are likely to cause death. This is supported by the finding that a large proportion of suicides in anaesthetists involved anaesthetic agents. Availability of method may be a factor contributing to the relatively high suicide rate in doctors.

Publication:

Hawton, K., Clements, A., Simkin, S., Malmberg, A. (2000) Doctors who kill themselves: a study of the methods used for suicide. Quarterly Journal of Medicine, 93, 351-357

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Suicide in doctors according to gender, seniority and speciality

We investigated suicide risk according to gender, seniority and speciality in 223 doctors in the National Health Service who died by suicide in England and Wales between 1979 and 1995. 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, whereas the rate in male doctors was less than in the general population. The difference between the mortality ratios of the female and male doctors was statistically significant, although the absolute suicide risk was similar in the two genders. There were significant differences between specialities, with anaesthetists, community health doctors, general practitioners and psychiatrists having significantly increased rates compared with general hospital doctors. There were no differences with regard to seniority or time period. 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.

Publication:

Hawton, K., Clements, A., Sakarovitch, C., Simkin, S., Deeks, J.J. (2001) Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995. Journal of Epidemiology and Community Health, 55, 296-300

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