Suicide rates among doctors have declined over time but are still significantly higher for female doctors compared with the general population, according to an analysis of evidence from 20 countries published by the British Medical Journal.
The researchers acknowledge that the suicide risk varies across different countries and regions, but say the results highlight the need for continued research and prevention efforts, particularly among female physicians.
The researchers analysed the results of observational studies published between 1960 and March 2024 that compared suicides rates among physicians with the general population.
A total of 39 studies from 20 countries (mainly Europe, the USA and Australia) were included. Together they reported 3,303 male and 587 female suicides over two observation periods.
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Across all studies the researchers found no overall increase in suicide risk for male doctors compared with the general population. For female doctors, however, suicide risk was significantly higher (76 per cent) than the general population.
Analysis of the 10 most recent studies versus older studies showed a decline in suicide rates for both male and female physicians over time, although the rate for female physicians remained significantly elevated (24 per cent higher) compared with the general population.
The exact causes of this decline are unknown, but more mental health awareness and workplace support for physicians in recent years might have played a role, the authors said.
The high level of variation between studies also suggests that physician suicide risk is not consistent across different populations, they add. This is likely to be due to training and work environments across healthcare systems, and varying attitudes and stigma regarding mental health and suicide.
The researchers acknowledge several limitations including scarcity of studies from outside Europe, the US, and Australia/New Zealand and likely underreporting of suicide as a cause of death because of stigma.
A separate analysis published in the British Medical Journal suggests that high doses of psilocybin – the active ingredient in magic mushrooms – appears to have a similar effect on depressive symptoms as the selective serotonin reuptake inhibitor (SSRI) drug escitalopram.
The findings show that patients treated with high dose psilocybin showed better responses than those treated with placebo in antidepressant trials, although the effect size was small.
The researchers point out that flaws in study designs may have overestimated the effectiveness of psychedelics, but say high dose psilocybin “appeared to have the potential to treat depressive symptoms”.
The researchers trawled scientific databases to identify randomised controlled trials published up to October 12th, 2023, that assessed the effects of psychedelics or escitalopram in adults with acute depressive symptoms. To be eligible psychedelic treatment had to be given orally with no additional use of antidepressants, while escitalopram trials had to compare at least two different oral doses (maximum 20 mg/day) with placebo.
Trials comparing psychedelic therapy directly with escitalopram were also included.
Overall, 811 people (average age 42; 54 per cent women) were included in 15 psychedelic trials and 1,968 people (average age 39; 63 per cent women) were included in five escitalopram trials.
If you are affected by any of the issues in this story, please contact The Samaritans at 116 123 or email at jo@samaritans.ie
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