Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Psychiatry, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands.
Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands.
Addict Sci Clin Pract. 2023 Jan 13;18(1):4. doi: 10.1186/s13722-022-00356-9.
Problematic substance use and Substance Use Disorders (SUD) are common in all layers of the population. Several studies suggest higher prevalence rates of problematic substance use among physicians compared to the general population, which is harmful for themselves and potentially impairs quality of care. However, nationwide comparison with a highly educated reference group is lacking. Using nationwide register data, this study compared the prevalence of clinical SUD diagnoses and alcohol consumption patterns between physicians and a highly educated reference population.
A retrospective study was performed using registry data from 2011 up to and including 2019, provided by Statistics Netherlands. From the data, a highly educated reference group was selected and those with an active medical doctor registration were identified as "physicians". Clinical SUD diagnoses were identified by DSM-IV codes in mental healthcare registries. Benchmark analyses were performed, without statistical testing, to compare the prevalence of SUD diagnoses and alcohol consumption patterns between physicians and the reference population.
Clinical SUD diagnoses were found among 0.3% of the physicians and 0.5% of the reference population, with higher proportions of sedative use disorder among physician patients. Among drinkers, the prevalence rates of heavy and excessive drinking were respectively 4.0% and 4.3% for physicians and 7.7% and 6.4% for the reference population.
Prevalence rates of SUD diagnoses were fairly comparable between physicians and the highly educated reference population, but physicians displayed more favorable alcohol consumption patterns. The use of sedatives by physicians might deserve attention, given the relatively higher prevalence of sedative use disorder among physicians. Overall, we observed relatively low prevalence rates of SUD diagnoses and problematic alcohol use, which may reflect a treatment gap and social desirable answers.
在所有人群中，物质使用问题和物质使用障碍（SUD）都很常见。有几项研究表明，与普通人群相比，医生中物质使用问题的患病率更高，这对他们自己有害，并可能损害医疗质量。然而，缺乏与高度受教育的参照人群进行全国性比较的研究。本研究利用全国性登记数据，比较了医生和高度受教育参照人群中临床 SUD 诊断和酒精消费模式的患病率。
本研究使用了荷兰统计局提供的 2011 年至 2019 年期间的登记数据进行回顾性研究。从数据中选择了一个高度受教育的参照组，并确定了有活跃医生登记的人为“医生”。通过精神保健登记处的 DSM-IV 编码来识别临床 SUD 诊断。进行了基准分析，没有进行统计学检验，以比较医生和参照人群中 SUD 诊断和酒精消费模式的患病率。
在医生中发现了 0.3%的临床 SUD 诊断，在参照人群中发现了 0.5%的临床 SUD 诊断，而医生患者中镇静剂使用障碍的比例更高。在饮酒者中，重度和过量饮酒的患病率分别为医生的 4.0%和 4.3%，参照人群的 7.7%和 6.4%。
医生和高度受教育的参照人群中 SUD 诊断的患病率相当，但医生的酒精消费模式更为有利。鉴于医生中镇静剂使用障碍的相对较高患病率，医生使用镇静剂可能值得关注。总的来说，我们观察到 SUD 诊断和物质使用问题的患病率相对较低，这可能反映了治疗差距和社会期望的答案。
