Oreskovich Michael R, Shanafelt Tait, Dyrbye Lotte N, Tan Litjen, Sotile Wayne, Satele Daniel, West Colin P, Sloan Jeff, Boone Sonja
University of Washington, Seattle, WA.
Am J Addict. 2015 Jan;24(1):30-8. doi: 10.1111/ajad.12173.
There have been few studies on the prevalence of substance use disorders (SUDS) in the physician population at large nor have any studies compared the prevalence of SUDS in American physicians by specialty.
We conducted a national study of SUDS in a large sample of U.S. physicians from all specialty disciplines using the AMA Physician Masterfile. Substance Use Disorders (SUDS) were measured using validated instruments.
Of the 27,276 physicians who received an invitation to participate, 7,288 (26.7%) completed surveys. 12.9% of male physicians and 21.4% of female physicians met diagnostic criteria for alcohol abuse or dependence. Abuse of prescription drugs and use of illicit drugs was rare. Factors independently associated with alcohol abuse or dependence were age (OR = .985; p < .0001), hours worked (OR = .994; p = .0094), male gender (OR = .597; p < .0001), being married (OR 1.296; p = .0424) or partnered (OR 1.989; p = .0003), having children (OR .745; p = .0049), and being in any specialty other than internal medicine (OR 1.757; p = .0060). Specialty choice was strongly associated with alcohol abuse or dependence (p = .0011). Alcohol abuse or dependence was associated with burnout (p < .0001), depression (p < .0001), suicidal ideation (p = .0004), lower quality of life (p < .0001), lower career satisfaction (p = .0036), and recent medical errors (p = .0011).
Alcohol abuse or dependence is a significant problem among American physicians. Since prognosis for recovery of physicians from chemical dependency is exceptionally high, organizational approaches for the early identification of problematic alcohol consumption in physicians followed by intervention and treatment where indicated should be strongly supported.
关于广大医生群体中物质使用障碍（SUDS）的患病率的研究很少，也没有任何研究按专业比较美国医生中SUDS的患病率。
我们使用美国医学协会医生主文件对来自所有专业学科的大量美国医生样本进行了一项关于SUDS的全国性研究。使用经过验证的工具测量物质使用障碍（SUDS）。
在收到参与邀请的27276名医生中，7288名（26.7%）完成了调查。12.9%的男医生和21.4%的女医生符合酒精滥用或依赖的诊断标准。滥用处方药和使用非法药物的情况很少见。与酒精滥用或依赖独立相关的因素有年龄（OR = 0.985；p < 0.0001）、工作时长（OR = 0.994；p = 0.0094）、男性（OR = 0.597；p < 0.0001）、已婚（OR 1.296；p = 0.0424）或有伴侣（OR 1.989；p = 0.0003）、有孩子（OR = 0.745；p = 0.0049）以及从事内科以外的任何专业（OR = 1.757；p = 0.0060）。专业选择与酒精滥用或依赖密切相关（p = 0.0011）。酒精滥用或依赖与职业倦怠（p < 0.0001）、抑郁（p < 0.0001）、自杀意念（p = 0.0004）、较低的生活质量（p < 0.0001）、较低的职业满意度（p = 0.0036）以及近期医疗差错（p = 0.0011）相关。
酒精滥用或依赖在美国医生中是一个重大问题。由于医生从化学依赖中康复预后非常高，应大力支持通过组织方法早期识别医生中有问题的酒精消费，然后在有指征时进行干预和治疗。
