Doctors who kill themselves: A study of the methods used for suicide

Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK.
QJM: monthly journal of the Association of Physicians (Impact Factor: 2.5). 07/2000; 93(6):351-7. DOI: 10.1093/qjmed/93.6.351
Source: PubMed


Medical practitioners have a relatively high rate of suicide. Death entry data for doctors who died by suicide or undetermined cause between 1979 and 1995 in England and Wales were used to compare methods used for suicide by doctors with those used by the general population. Methods used were analysed according to gender, occupational status and speciality, to assess the extent to which access to dangerous means influences the pattern of suicide. Self-poisoning with drugs was more common in the doctors than in general population suicides (57% vs. 26.6%; OR=3.65, 95% CI 2.85-4. 68), including in retired doctors. Barbiturates were the most frequent drugs used. Half of the anaesthetists who died used anaesthetic agents. Self-cutting was also more frequently used as a method of suicide. The finding that the greater proportion of suicide deaths in doctors were by self-poisoning may reflect the fact that doctors have ready access to drugs, and have knowledge of which drugs and doses are likely to cause death. The specific finding that a large proportion of suicides in anaesthetists involved anaesthetic agents supports this explanation. Availability of method may be a factor contributing to the relatively high suicide rate of doctors. This fact might influence clinical management of doctors who are known to be depressed or suicidal.

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Available from: Keith Hawton, Apr 02, 2015
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    • "In many European nations, overdose is the leading method of suicide, but our study found firearms most common for both physicians and non-physicians [28] [32] [34]. This is consistent with prior US studies on suicide as well as data showing that the availability of firearms within different geographic regions in the US is directly linked with the method used for suicide [34] "
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    ABSTRACT: Objective: Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide. We sought to evaluate these factors among physicians versus non-physician suicide victims. Methods: We used data from the United States National Violent Death Reporting System to evaluate demographics, mental health variables, recent stressors and suicide methods among physician versus non-physician suicide victims in 17 states. Results: The data set included 31,636 suicide victims of whom 203 were identified as physicians. Multivariable logistic regression found that having a known mental health disorder or a job problem which contributed to the suicide significantly predicted being a physician. Physicians were significantly more likely than non-physicians to have antipsychotics, benzodiazepines and barbiturates present on toxicology testing but not antidepressants. Conclusions: Mental illness is an important comorbidity for physicians who complete a suicide but postmortem toxicology data shows low rates of medication treatment. Inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians.
    General hospital psychiatry 11/2012; 35(1). DOI:10.1016/j.genhosppsych.2012.08.005 · 2.61 Impact Factor
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    • "We found that several of the occupations with the highest suicide rates in Britain during the late 1970s and the early 1980s were veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth). These mainly professional occupations were considered to have high suicide risks because of an easy occupational access to a method of suicide, pharmaceuticals or guns (Charlton, 1995 ; Hawton et al. 1998, 2000 ; Marzuk et al. 2002 ; Thoresen et al. 2003 ; Mahon et al. 2005 ; Mann et al. 2005 ; Meltzer et al. 2008 ; Platt et al. 2010). Suicide rates for these occupations fell sharply over time whereas occupations that had significant increases over time in suicide rates were manual occupations. "
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    ABSTRACT: Background High occupational suicide rates are often linked to easy occupational access to a method of suicide. This study aimed to compare suicide rates across all occupations in Britain, how they have changed over the past 30 years, and how they may vary by occupational socio-economic group. Method We used national occupational mortality statistics, census-based occupational populations and death inquiry files (for the years 1979–1980, 1982–1983 and 2001–2005). The main outcome measures were suicide rates per 100 000 population, percentage changes over time in suicide rates, standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs). Results Several occupations with the highest suicide rates (per 100 000 population) during 1979–1980 and 1982–1983, including veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth), have easy occupational access to a method of suicide (pharmaceuticals or guns). By 2001–2005, there had been large significant reductions in suicide rates for each of these occupations, so that none ranked in the top 30 occupations. Occupations with significant increases over time in suicide rates were all manual occupations whereas occupations with suicide rates that decreased were mainly professional or non-manual. Variation in suicide rates that was explained by socio-economic group almost doubled over time from 11.4% in 1979–1980 and 1982–1983 to 20.7% in 2001–2005. Conclusions Socio-economic forces now seem to be a major determinant of high occupational suicide rates in Britain. As the increases in suicide rates among manual occupations occurred during a period of economic prosperity, carefully targeted suicide prevention initiatives could be beneficial.
    Psychological Medicine 10/2012; 43(6):1-10. DOI:10.1017/S0033291712002024 · 5.94 Impact Factor
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    • "Hypoglycemia in a non-diabetic can be due to either exogenous or endogenous hyperinsulinemia, in addition to drugs, tumors, critical illness, and hormone deficiencies. Exogenous hyperinsulinemia due to surreptitious use of insulin is diagnosed when during hypoglycemia, insulin level is elevated (at least 3 μIU/mL) with low c-peptide (less than 0.6 ng/mL).[2] Consumption of sulfonylurea was excluded in our patient as there was no increase in c-peptide. "
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    ABSTRACT: We report a 27-year-old paramedical lady with no known comorbidities, who presented with rapid-onset coma with hypoglycemia (plasma glucose at admission was 35 mg/dL). Clinical alertness suspected and confirmed the diagnosis of exogenous insulin administration probably with suicidal intent. During the course of her ICU stay, she developed bradycardia and hypotension which required ionotropic support. She remained in coma for 90 hours. A total of 470 g of dextrose was infused until she regained consciousness. No other complications of insulin overdose were observed during her stay in the hospital. Recovery was complete without any residual neurological deficits. Insulin administration should be kept in differential diagnosis when any case presents with coma and hypoglycemia, especially in paramedical personnel.
    03/2012; 16 Suppl 1(Suppl1):S120-2. DOI:10.4103/2230-8210.94254
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