Female physicians still at a greater risk for suicide

Key takeaways:

• Female physicians had substantially increased risk for suicide vs. the general population across all studies.
• However, suicide risk is inconsistent across different physician populations, the researchers noted.

Female physicians face an increased risk for suicide despite suicide rates among physicians decreasing over time, a systematic review and meta-analysis published in BMJ showed.

According to background information from the American College of Emergency Physicians, around 300 to 400 doctors die by suicide in the United States annually.

Claudia Zimmermann, from the Medical University of Vienna in Austria, and colleagues pointed out that physicians are one of several occupations tied to a greater risk for suicide, “and the medical community has a longstanding and often conflicted history in addressing this issue,” they wrote.

Zimmerman and colleagues evaluated currently available research by searching several databases and compiling studies on suicide deaths among physicians that were published between 1960 to March 2024.

The analysis included 39 studies from 20 countries — mainly from the United States, Australasia and Europe.

Together, the studies reported 3,303 male suicides from 1935 to 2020 and 587 female suicides from 1960 to 2020.

Zimmermann and colleagues determined a suicide rate ratio, or RR, of 1.05 (95% CI, 0.9-1.22) for male physicians and 1.76 (95% CI, 1.4-2.21) for female physicians across all studies.

An analysis of the 10 most recent studies compared with older studies showed a decline in suicide rates among male and female physicians, although female physicians still maintained a 24% higher risk (RR = 1.24; 95% CI, 1-1.55) for suicide vs. the general population.

Male physicians had an 81% increased risk (RR = 1.81; 95% CI, 1.55-2.12) for suicide in a further analysis that compared suicide rates of physicians with those of other professions of similar socioeconomic status.

The results seemed similar for female physicians, “but we deemed the number of eligible studies too low for a random effects meta-analysis,” the researchers wrote.

They explained that the high heterogeneity seen in the studies suggests that the risk for suicide among male and female physicians is not consistent across different physician populations.

This heterogeneity may have been due to multiple reasons, such as training, work environments, different risk factors and different stigmas about mental health, Zimmermann and colleagues noted.

“Future studies on suicide risk in physicians should bear in mind that the specific settings of any physician population might influence their risk and resilience factors to a much higher degree than previously assumed,” they concluded.

In an accompanying editorial, Clare Gerada, DBE, FRCP, FRCGP, FRCPsych, president of the Royal College of General Practitioners in the U.K., and colleagues underlined that female physicians require urgent attention from health leaders, researchers and policymakers. Meanwhile studies that examine potential contributors — like sexual harassment and discrimination — are needed.

All physicians “must have access to early intervention and confidential treatment services so that they do not suffer in silence,” they wrote.

References:

• Gerada C, et al. BMJ. 2024;doi:10.1136/bmj.q1758.
• Physician suicide. Available at: https://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide. Accessed Aug. 23, 2024.
• Suicide rates among doctors have declined, but female doctors still at high risk. Available at: https://www.eurekalert.org/news-releases/1055097. Published Aug. 21, 2024. Accessed Aug. 23, 2024.
• Zimmermann C, et al. BMJ. 2024;doi:10.1136/bmj-2023-078964.