Schlicht S M, Gordon I R, Ball J R, Christie D G
Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Fitzroy, Vic.
Med J Aust. 1990 Nov 5;153(9):518-21. doi: 10.5694/j.1326-5377.1990.tb126190.x.
A cohort of University of Melbourne medical graduates (1950-1959 graduates inclusive) was followed up until December 31, 1986. Vital status at the end of the study period was ascertained and, for those who had died, cause of death was determined. The cohort consisted of 1453 members (1279 men and 174 women). One hundred and twenty-six of the group had died (115 men and 11 women) and 68 (4.7%; 57 men and 11 women) were lost to follow-up. The major causes of death were cardiovascular disease and malignant neoplasms. The standardised mortality ratios (SMRs) for all-cause mortality were low (59 for the male doctors and 84 for the female doctors) indicating that male doctors experience a "force of mortality" 59% that of the general population and female doctors 84%. For the male doctors, the SMR for suicide was 113 (95% confidence interval [CI], 54-207) (10 of 115 deaths in male doctors) about double the SMR for mortality from all causes. For the female doctors, the SMR for suicide was 501 (95% CI, 103-1500) (3 of 11 deaths in female doctors). For deaths resulting from all accidents the SMR was low for the males (29) and higher for the females (126). The SMR for mental disorders for the male doctors was marginally raised (132). This study reveals some indication of a problem in doctors in regard to deaths by suicide, other violent deaths and mental disorders. A larger study involving a control group of equivalent social class is required to confirm the findings of this study.
对一组墨尔本大学医学毕业生（包括1950年至1959年毕业的学生）进行了随访，直至1986年12月31日。确定了研究期末的生命状态，并对那些已死亡的人确定了死因。该队列由1453名成员组成（1279名男性和174名女性）。该组中有126人死亡（115名男性和11名女性），68人（4.7%；57名男性和11名女性）失访。主要死因是心血管疾病和恶性肿瘤。全因死亡率的标准化死亡比（SMR）较低（男性医生为59，女性医生为84），这表明男性医生的“死亡力”是普通人群的59%，女性医生是84%。对于男性医生，自杀的SMR为113（95%置信区间[CI]，54 - 207）（男性医生死亡的115例中有10例），约为全因死亡率SMR的两倍。对于女性医生，自杀的SMR为501（95%CI，103 - 1500）（女性医生死亡的11例中有3例）。对于所有事故导致的死亡，男性的SMR较低（29），女性较高（126）。男性医生精神障碍的SMR略有升高（132）。这项研究揭示了医生在自杀死亡、其他暴力死亡和精神障碍方面存在问题的一些迹象。需要进行一项涉及同等社会阶层对照组的更大规模研究来证实本研究的结果。
