Physician Suicide

Candice Espinoza, M.D., Paul S. Nestadt, M.D.
Physician Suicide is a topic covered in the Johns Hopkins Psychiatry Guide.

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DEFINITION

Suicide is a leading cause of death in the U.S., and physicians face unique risks.

  • While some early research indicated that physicians suffered much higher than average suicide rates[1], it is becoming clear that, adjusting for demographics, this may not be the case[2]. Most precisely, female physicians are at higher risk of suicide than non-physician females and male physicians are at lower risk of suicide than non-physician males[3].
  • Globally, physician suicide has significantly decreased since 1980[3].
  • Physicians who die by suicide are less likely to be receiving mental health treatment than non-physicians who die by suicide[4].
  • The most common mental disorders in physicians are depression and/or substance abuse[3].
  • Common means of suicide used by physicians include poisoning, firearms, asphyxiation, and cutting.[3][5]
    • Self‐poisoning with drugs was more common in the doctors than in general population suicides as was self-cutting[5].
      • “A retrospective toxicology screening of suicide data finds physicians are more likely than non-physicians to have positive results for antipsychotics, benzodiazepines, and barbiturates but not antidepressants. This links to physicians being undertreated for depression despite current effective treatments, whereas the positive toxicology findings may indicate substance abuse, self-medication, or intentional toxicity” [4].

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DEFINITION

Suicide is a leading cause of death in the U.S., and physicians face unique risks.

  • While some early research indicated that physicians suffered much higher than average suicide rates[1], it is becoming clear that, adjusting for demographics, this may not be the case[2]. Most precisely, female physicians are at higher risk of suicide than non-physician females and male physicians are at lower risk of suicide than non-physician males[3].
  • Globally, physician suicide has significantly decreased since 1980[3].
  • Physicians who die by suicide are less likely to be receiving mental health treatment than non-physicians who die by suicide[4].
  • The most common mental disorders in physicians are depression and/or substance abuse[3].
  • Common means of suicide used by physicians include poisoning, firearms, asphyxiation, and cutting.[3][5]
    • Self‐poisoning with drugs was more common in the doctors than in general population suicides as was self-cutting[5].
      • “A retrospective toxicology screening of suicide data finds physicians are more likely than non-physicians to have positive results for antipsychotics, benzodiazepines, and barbiturates but not antidepressants. This links to physicians being undertreated for depression despite current effective treatments, whereas the positive toxicology findings may indicate substance abuse, self-medication, or intentional toxicity” [4].

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Last updated: August 6, 2020