Plunkett E, Costello A, Yentis S M, Hawton K
Department of Anaesthesia, University Hospitals Birmingham, Birmingham, UK.
Department of Anaesthesia, Milton Keynes University Hospitals, Milton Keynes, UK.
Anaesthesia. 2021 Oct;76(10):1392-1403. doi: 10.1111/anae.15514. Epub 2021 Jun 1.
Evidence suggests that healthcare professionals are at an increased risk of dying by suicide, with anaesthetists at particularly high risk. However, much of the data on which this is based are historical. With a focus on the epidemiology and methods used, we conducted a systematic review of evidence regarding suicide and suicidal behaviour among anaesthetists to provide a more contemporary summary. The systematic review process was adapted from a previous similar study in veterinary surgeons and was consistent with recommended guidance. We identified 54 articles published in or after 1990 that had anaesthetist-specific data and met the inclusion criteria. Seven of these reported epidemiological data, of which four were published after 2000. Although none of the more recent studies reported standardised mortality rates specific to suicide in anaesthetists, the proportion of anaesthetists dying by suicide was increased with respect to comparator groups, which is consistent with previous findings. Eleven studies that included information on suicidal behaviour reported suicidal ideation in 3.2-25% of individuals (six studies) and suicide attempts in 0.5-2% (four studies). Studies reporting methods of suicide highlighted the use of anaesthetic drugs, particularly propofol, supporting the suggestion that the increased risk of suicide in anaesthetists may be related to the availability of the means. We discuss our findings in relation to other recently published data and guidance concerning mental health problems in anaesthetists.
有证据表明，医疗保健专业人员自杀死亡的风险增加，麻醉师的风险尤其高。然而，作为该结论依据的许多数据都是历史性的。我们聚焦于流行病学和所使用的方法，对有关麻醉师自杀及自杀行为的证据进行了系统综述，以提供更具时效性的总结。该系统综述过程改编自先前针对兽医的一项类似研究，并符合推荐指南。我们确定了1990年及以后发表的54篇包含麻醉师特定数据且符合纳入标准的文章。其中7篇报告了流行病学数据，其中4篇是2000年以后发表的。尽管最近的研究均未报告麻醉师自杀的标准化死亡率，但与对照群体相比，麻醉师自杀死亡的比例有所增加，这与先前的研究结果一致。11项包含自杀行为信息的研究报告称，3.2%至25%的个体有自杀意念（6项研究），0.5%至2%的个体有自杀未遂情况（4项研究）。报告自杀方法的研究强调了麻醉药物的使用，尤其是丙泊酚，这支持了麻醉师自杀风险增加可能与自杀手段的可得性有关的观点。我们将结合最近发表的其他有关麻醉师心理健康问题的数据和指南来讨论我们的研究结果。
