FACTORS IMPACTING SUICIDE RISK
Risk Factors
• Psychiatric diagnosis: mood
disorders, schizophrenia,
substance use disorders,
cluster B personality disorders
• Past history of attempts,
self-injurious behavior
• Family history of suicide or
psychiatric hospitalization
• Clear precipitants or stressors (i.e relationship loss,
financial or job loss
• Health status: ongoing
medical disorders esp. CNS,
inflammatory or pain
• Firearms accessible
study cited elevated C-reactive protein as an increased hazard ratio.
Screening for suicide risk becomes important not just for patients
with a history of depression and anxiety, but for many patients with
a chronic medical illness as well.
On average, 400 physicians die annually from completed suicide.
As a profession we are at increased risk for burnout, depression and
suicide. Rates of depression among medical students have been cited
at between 15-30 percent, a number significantly higher than the
general population. Suicide rates are 250-400 percent higher among
female physicians than women in other comparable professions.
Among medical professionals there is loss of the gender ratio, with
female suicide completion equal to or greater than their male counterparts. Physician knowledge and access to lethal means contribute
to a suicide completion rate twice that of the general population.
We know that psychological distress, mental illnesses such as
depression, anxiety and substance-use disorders all increase the
risk for suicide. Our profession has been facing a perfect storm, as
physicians are experiencing burnout and demoralization at epidemic
proportions. For many physicians, the increasing loss of autonomy
represents the loss of the dream, instilling doubt about oneself and
one’s career choice. Layer this on top of nearly 1/3 of physicians in
training and early career stating they have not developed a social life
outside of medicine, and the double whammy places our healers at
Protective Factors
• Resilience and ability to
cope with stress, spiritual
belief system, absence of
psychosis or thought disorder, frustration tolerance
• Positive therapeutic relationships, social supports,
responsibility for family,
children, pets
significant risk. This crisis has led to the expansion of the triple aim
to the quadruple aim to include a health care delivery system that
improves the caregivers’ experience. GLMS is one of several medical
societies that has recognized physician distress and has developed
a program to assist distressed physicians in obtaining help.
Suicide is a conundrum that the medical profession must address. We have to actively engage in identifying both patients and
colleagues at risk, and lobbying for treatment access. At the same
time, we have to monitor and discuss the emerging trends and
ethical dilemmas that have the potential to arise through changing
legislation and practices both in this country and abroad.
Dr. Davis is an Associate Clinical Professor of Psychiatry at the University Of Louisville School Of Medicine and is in private practice
with the physician group, Integrative Psychiatry.
As a membership benefit GLMS Physicians are invited
to participate in the Physician Wellness Program, a
confidential counseling program for active members. For
more information see information on page 29 or visit
www.glms.org
OCTOBER 2016
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