Department of Medicine, University of Ottawa, Ottawa, Canada.
Division of Nephrology, Department of Medicine, the Ottawa Hospital, Ottawa, Canada.
Can J Psychiatry. 2022 Oct;67(10):778-786. doi: 10.1177/07067437221099774. Epub 2022 May 12.
Studies of occupation-associated suicide suggest physicians may be at a higher risk of suicide compared to nonphysicians. We set out to assess the risk of suicide and self-harm among physicians and compare it to nonphysicians.
We conducted a population-based, retrospective cohort study using registration data from the College of Physicians and Surgeons of Ontario from 1990 to 2016 with a follow-up to 2017, linked to Ontario health administrative databases. Using age- and sex-standardized rates and inverse probability-weighted, cause-specific hazards regression models, we compared rates of suicide, self-harm, and a composite of either event among all newly registered physicians to nonphysician controls.
Among 35,989 physicians and 6,585,197 nonphysicians, unadjusted suicide events (0.07% vs. 0.11%) and rates (9.44 vs. 11.55 per 100,000 person-years) were similar. Weighted analyses found a hazard ratio of 1.05 (95% confidence interval: 0.69 to 1.60). Self-harm requiring health care was lower among physicians (0.22% vs. 0.46%; hazard ratio: 0.65, 95% confidence interval: 0.52 to 0.82), as was the composite of suicide or self-harm (hazard ratio: 0.70, 95% confidence interval: 0.57 to 0.86). The composite of suicide or self-harm was associated with a history of a mood or anxiety disorder (odds ratio: 2.84, 95% confidence interval: 1.17 to 6.87), an outpatient mental health visit in the past year (odds ratio: 3.08, 95% confidence interval: 1.34 to 7.10) and psychiatry visit in the preceding year (odds ratio: 3.87, 95% confidence interval: 1.67 to 8.95).
Physicians in Ontario are at a similar risk of suicide deaths and a lower risk of self-harm requiring health care relative to nonphysicians. Risk factors associated with suicide or self-harm may help inform prevention programs.
职业相关自杀研究表明，与非医生相比，医生的自杀风险可能更高。我们着手评估医生的自杀和自残风险，并与非医生进行比较。
我们使用安大略省医师和外科医生学院从 1990 年到 2016 年的注册数据进行了一项基于人群的回顾性队列研究，并在 2017 年进行了随访，与安大略省卫生行政数据库进行了链接。使用年龄和性别标准化率和逆概率加权，特定原因危害回归模型，我们比较了所有新注册医生与非医生对照组的自杀、自残和任何一种事件的复合发生率。
在 35989 名医生和 6585197 名非医生中，未经调整的自杀事件（0.07%比 0.11%）和发生率（9.44 比 11.55/100000 人年）相似。加权分析发现，危险比为 1.05（95%置信区间：0.69 至 1.60）。医生中需要医疗保健的自残发生率较低（0.22%比 0.46%；危险比：0.65，95%置信区间：0.52 至 0.82），自杀或自残的复合发生率也较低（危险比：0.70，95%置信区间：0.57 至 0.86）。自杀或自残的复合与心境或焦虑障碍病史（比值比：2.84，95%置信区间：1.17 至 6.87）、过去一年门诊心理健康就诊（比值比：3.08，95%置信区间：1.34 至 7.10）和前一年精神科就诊（比值比：3.87，95%置信区间：1.67 至 8.95）相关。
安大略省的医生在自杀死亡风险方面与非医生相似，而在需要医疗保健的自残风险方面较低。与自杀或自残相关的风险因素可能有助于为预防计划提供信息。
