Flaherty J A, Richman J A
Department of Psychiatry, University of Illinois, College of Medicine, Chicago.
Psychiatr Clin North Am. 1993 Mar;16(1):189-97.
When turning to our original questions, we offer the following tentative conclusions: 1. Although medical students as a group have a slightly higher percentage of use of alcohol, the pattern and prevalence of alcohol dependence is very consistent with their age mates in the general population. 2. There appears to be a pattern of increased alcohol problems with age among physicians and attorneys, as opposed to the general US population, which shows a diminution of alcohol-related problems over time. 3. There is no evidence for a marked increase in drug addiction and use of other prescription drugs among physicians. In fact, with the exception of tranquilizers and alcohol and psychedelics, which were used equally by physicians, medical students, residents, and their age mates, most other drug usage was slightly more prevalent in the general population than among students and residents. 4. Of particular concern is the finding of a lack of gender differences in problematic drinking with the pattern of female drinking rates for women approximating that of men by the end of medical school. 5. The most consistent predictive factor in alcoholism among physicians is the same as that in the general population: a family history of alcoholism. 6. Additional predictive factors of physician alcohol-related problems include a narcissistic type personality style that endorses the exploitation of others, a perception of low parental warmth in childhood, and particular stressors in the working or student environment such as being abused by others. Further predictive factors related to occupational stress await the results of ongoing perspective studies. 7. Physicians as a group probably respond more favorably to alcohol and drug addiction programs than do members of the general population. To a great extent, this is directly or indirectly due to the dire consequences of continued use, which include loss of hospital privileges and state licensure. It also would appear that required treatment and monitoring for alcohol and substance abuse has a positive effect on abstinence rates.
在回到我们最初的问题时，我们给出以下初步结论：1. 尽管医学生群体中酒精使用的比例略高，但酒精依赖的模式和患病率与普通人群中的同龄人非常一致。2. 与美国普通人群不同，医生和律师中似乎存在随着年龄增长酒精问题增加的模式，而普通人群中与酒精相关的问题随时间减少。3. 没有证据表明医生中药物成瘾和其他处方药使用有显著增加。事实上，除了医生、医学生、住院医生及其同龄人使用程度相同的镇静剂、酒精和迷幻药外，大多数其他药物在普通人群中的使用比学生和住院医生中略为普遍。4. 特别令人担忧的是，发现有问题饮酒方面不存在性别差异，到医学院学习结束时，女性的饮酒率模式接近男性。5. 医生中酒精成瘾最一致的预测因素与普通人群相同：酗酒家族史。6. 医生与酒精相关问题的其他预测因素包括认可剥削他人的自恋型人格风格、童年时对父母温暖感的低感知，以及工作或学生环境中的特定压力源，如被他人虐待。与职业压力相关的进一步预测因素有待正在进行的前瞻性研究结果。7. 作为一个群体，医生可能比普通人群对酒精和药物成瘾项目的反应更积极。在很大程度上，这直接或间接地归因于持续使用的可怕后果，包括失去医院特权和州执照。此外，对酒精和药物滥用的强制治疗和监测似乎对戒酒率有积极影响。
