Female physicians had a 53% higher suicide risk than female nonphysicians from 2017 to 2021, while male physicians had a significantly lower overall risk compared to male nonphysicians during the same period, according to a recent study.
Researchers conducted a retrospective cohort study analyzing physician suicide incidence in the U.S. using data from the National Violent Death Reporting System across 30 states and Washington, DC, from 2017 to 2021. The study, published in JAMA Psychiatry, included 448 physician suicides (79% male, 21% female) and 97,467 suicides in the general population (79% male, 21% female). Male physicians were significantly older than male nonphysicians at the time of suicide (mean [SD] age, 62 [16] vs 51 [17] years; P < .001). A disproportionate number of physician decedents were White (>80%) in contrast to the 2022 physician workforce (57%).
Led by Hirsh Makhija of the Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, and colleagues found that female physicians had a significantly higher risk of suicide than female nonphysicians in 2017 (incidence rate ratio [IRR], 1.88; 95% CI, 1.19-2.83) and 2019 (IRR, 1.75; 95% CI, 1.09-2.65), with an overall increased risk from 2017 to 2021 (IRR, 1.53; 95% CI, 1.23-1.87). Male physicians, however, had a lower overall suicide risk compared to male nonphysicians during the same period (IRR, 0.84; 95% CI, 0.75-0.93).
Female physicians had a significantly higher risk of suicide than female nonphysicians before the COVID-19 pandemic (2017 to 2019; IRR, 1.65; 95% CI, 1.26-2.11) but comparable rates after (2020 to 2021; IRR, 1.34; 95% CI, 0.92-1.90). Both male and female physicians had higher suicide incidence per 100,000 person-years before vs after COVID-19 (male, 27.71 vs 24.43; female, 13.74 vs 9.87).
Multivariable logistic regression models, adjusted for age, sex, race, ethnicity, and marital status, demonstrated that physicians had higher odds of experiencing depressed mood prior to suicide (adjusted odds ratio [aOR], 1.35; 95% CI, 1.14-1.61; P < .001), mental health issues (aOR, 1.66; 95% CI, 1.39-1.97; P < .001), job-related stress (aOR, 2.66; 95% CI, 2.11-3.35; P < .001), and legal problems (aOR, 1.40; 95% CI, 1.06-1.84; P = .02) compared to nonphysicians. Physicians also had higher odds of leaving a suicide note (aOR, 1.61; 95% CI, 1.37-1.91; P < .001).
Regarding method of suicide, physicians had significantly higher odds of using poisoning (aOR, 1.85; 95% CI, 1.50-2.30; P < .001) and sharp instruments (aOR, 4.58; 95% CI, 3.47-6.06; P < .001). Toxicology reports indicated that physicians had higher odds of positive toxicology for caffeine (aOR, 1.38; 95% CI, 1.03-1.86; P = .03); poison (aOR, 1.39; 95% CI, 1.00-1.93; P = .049); cardiovascular agents (aOR, 1.53; 95% CI, 1.05-2.23; P = .03); benzodiazepines (aOR, 1.74; 95% CI, 1.36-2.23; P < .001); anxiolytics, nonbenzodiazepines, or hypnotics (aOR, 1.78; 95% CI, 1.19-2.65; P = .005); and drugs not prescribed for home use (aOR, 2.80; 95% CI, 1.80-4.34; P < .001).
The study found that female physicians had a higher suicide risk than female nonphysicians, while male physicians had a lower risk than male nonphysicians. The researchers reported that suicide prevention strategies should address occupational stressors, mental health concerns, and access to lethal means, particularly for female physicians.
Full disclosures can be found in the published study.
