C.J. Blacker is fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-3510-0696. C.P. Lewis is research fellow and instructor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0001-8791-657X. C.C. Swintak is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota. J.M. Bostwick is professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota. S.J. Rackley is assistant professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
Acad Med. 2019 Feb;94(2):274-280. doi: 10.1097/ACM.0000000000002430.
Physician suicide rates are reportedly higher than those of the general population, but medical student suicide rates are not well studied. It is difficult to determine whether physician suicide rates can be predicted by medical student risk factors for suicide and difficult to identify those risk factors without knowing medical student suicide rates. The authors systematically reviewed the literature to collate data on medical student suicide rates.
The authors searched the PubMed, Web of Science, and Library of Congress databases for papers published in any language before November 11, 2017. They identified 3,429 papers; after the initial screening process, they assessed 82 full-text articles for eligibility. Twelve ultimately met the full inclusion criteria; meta-analysis was not possible. Data regarding medical student suicide numbers and rates were extracted and compared with contemporaneous general population suicide rates using public epidemiological data, when available.
Medical student suicide rates were infrequently reported in the historical and international literature, and data collection techniques were inconsistent. Generally, U.S. medical student suicide rates were lower than those of the contemporaneous general population. Proportionate mortality of medical students (number of deaths by a particular cause such as suicide divided by total number of deaths) was not reported in the literature.
Gaps exist in knowledge of medical student suicide rates, risk factors, and targets for intervention. Significant barriers have impeded information collection. Yet, more comprehensive data collection is needed to understand suicide risk in this population and to implement and improve effective intervention strategies.
据报道，医生的自杀率高于普通人群，但医学专业学生的自杀率尚未得到充分研究。很难确定医生的自杀率是否可以通过医学生自杀的风险因素来预测，而如果不知道医学生的自杀率，就很难确定这些风险因素。作者系统地回顾了文献，以整理医学生自杀率的数据。
作者在 PubMed、Web of Science 和美国国会图书馆数据库中检索了截至 2017 年 11 月 11 日以任何语言发表的论文。他们共发现 3429 篇论文，经过初步筛选过程后，评估了 82 篇全文文章的资格。最终有 12 篇符合全部纳入标准；无法进行荟萃分析。提取了关于医学生自杀人数和比率的数据，并使用公共流行病学数据（如有）将其与同期普通人群的自杀率进行比较。
医学生的自杀率在历史和国际文献中很少被报道，且数据收集技术不一致。一般来说，美国医学生的自杀率低于同期普通人群。但文献中没有报告医学生的比例死亡率（特定原因（如自杀）的死亡人数除以总死亡人数）。
在医学生的自杀率、风险因素和干预目标方面存在知识空白。重大障碍阻碍了信息收集。然而，需要更全面的数据收集，以了解这一人群的自杀风险，并实施和改进有效的干预策略。
