Shanafelt Tait D, Balch Charles M, Dyrbye Lotte, Bechamps Gerald, Russell Tom, Satele Daniel, Rummans Teresa, Swartz Karen, Novotny Paul J, Sloan Jeff, Oreskovich Michael R
Mayo Clinic, Rochester, MN 55905, USA.
Arch Surg. 2011 Jan;146(1):54-62. doi: 10.1001/archsurg.2010.292.
Suicide is a disproportionate cause of death for US physicians. The prevalence of suicidal ideation (SI) among surgeons and their use of mental health resources are unknown.
Members of the American College of Surgeons were sent an anonymous cross-sectional survey in June 2008. The survey included questions regarding SI and use of mental health resources, a validated depression screening tool, and standardized assessments of burnout and quality of life.
Of 7905 participating surgeons (response rate, 31.7%), 501 (6.3%) reported SI during the previous 12 months. Among individuals 45 years and older, SI was 1.5 to 3.0 times more common among surgeons than the general population (P < .02). Only 130 surgeons (26.0%) with recent SI had sought psychiatric or psychologic help, while 301 (60.1%) were reluctant to seek help due to concern that it could affect their medical license. Recent SI had a large, statistically significant adverse relationship with all 3 domains of burnout (emotional exhaustion, depersonalization, and low personal accomplishment) and symptoms of depression. Burnout (odds ratio, 1.910; P < .001) and depression (odds ratio, 7.012; P < .001) were independently associated with SI after controlling for personal and professional characteristics. Other personal and professional characteristics also related to the prevalence of SI.
Although 1 of 16 surgeons reported SI in the previous year, few sought psychiatric or psychologic help. Recent SI among surgeons was strongly related to symptoms of depression and a surgeon's degree of burnout. Studies are needed to determine how to reduce SI among surgeons and how to eliminate barriers to their use of mental health resources.
自杀是美国医生死亡的一个不成比例的原因。外科医生中自杀意念（SI）的患病率及其对心理健康资源的使用情况尚不清楚。
2008年6月，向美国外科医师学会会员发送了一份匿名横断面调查问卷。该调查包括有关SI和心理健康资源使用情况的问题、一种经过验证的抑郁筛查工具，以及职业倦怠和生活质量的标准化评估。
在7905名参与调查的外科医生中（回复率为31.7%），501名（6.3%）报告在过去12个月中有SI。在45岁及以上的人群中，外科医生的SI发生率比普通人群高1.5至3.0倍（P < 0.02）。在最近有SI的外科医生中，只有130名（26.0%）寻求过精神科或心理帮助，而301名（60.1%）因担心会影响其行医执照而不愿寻求帮助。最近的SI与职业倦怠的所有三个领域（情感耗竭、去个性化和低个人成就感）以及抑郁症状存在很大的、具有统计学意义的负相关关系。在控制个人和职业特征后，职业倦怠（优势比，1.910；P < 0.001）和抑郁（优势比，7.012；P < 0.001）与SI独立相关。其他个人和职业特征也与SI的患病率有关。
尽管16名外科医生中有1名报告在上一年有SI，但很少有人寻求精神科或心理帮助。外科医生最近的SI与抑郁症状和职业倦怠程度密切相关。需要开展研究以确定如何降低外科医生中的SI发生率以及如何消除他们使用心理健康资源的障碍。
