Suicide Of Physicians

Yıl 2013, , 33 - 39, 01.06.2013

Serdar Süleyman Can Buket Güngör Rustem Aşkın

https://doi.org/10.1501/Kriz_0000000336

Öz

Suicide is the act of taking one’s own life intentionally. Suicides occur in people with mental disorders or medical illnesses as well as in healthy individuals who have hopelessness and desperate thoughts related to life conditions. Suicide rates among physicians are higher than those of other professionals in United States. Previous studies indicated that physicians who commit suicide suffer from a mental illness generally. A common suicide method of physicians is drug overdose and in addition using firearms is less common than general population. Physicians having more information and easy access to drugs play a major role. A previous study showed that risk of losing their medical license, fear of discrimination prevents physicians from asking help for suicide treatment. Suicide rate is 35 % among early death reasons of physicians. Suicide is responsible for 3 % of male physician deaths and 6.5 % of female physicians’ deaths. A lot of hypothesis exists for explaining suicides of physicians which are psychiatric diseases, alcohol and drug abuse, stress of medical applications, unreal expectations, role confusions, lack of professional support, resistance to psychiatric treatment, personality characteristics and psychosocial factors. In conclusion, stigma, licensing concerns and other barriers to treatment should be overcome

Anahtar Kelimeler

Medical doctor, suicide, mental illness

Hekim intiharları

Öz

İntihar, insanın bilerek ve isteyerek
yaşamına son vermesidir. İntihar ağır ruhsal ve
bedensel hastalıkları olan kişilerde görülebildiği
gibi, zorlu yaşam koşullarına karşı çaresizlik
ve umutsuzluk tepkisi veren normal bireylerde
de görülebilir. Amerika Birleşik Devletleri’nde
mesleki sıralama içerisinde intihar bakımından
hekimler ön sıralarda bulunmaktadır.
Çalışmalar, tamamlanmış hekim intiharlarında
genellikle altta yatan bir psikiyatrik bozukluğun
olduğunu göstermektedir. Hekimler sıklıkla
aşırı dozda maddeyle intihar eylemini
gerçekleştirmekteyken genel topluma kıyasla
daha az ateşli silah kullanmaktadır. Hekim
intiharlarında ilaçlara kolay ulaşabilme ve
ilaçlarla ilgili bilgiye sahip olmaları önemli rol
oynar. Bir çalışmada hekimlerin depresyon,
intihar ve tedavi açısından yardım almasına
engel olan faktörler: tıbbi lisanslarının tehlikeye
girmesi çekincesi, mesleki gelişim ve yetkileri
konusunda ayrımcılığa maruz kalma korkusu
olarak saptanmıştır. Hekimlerin erken ölüm
nedenleri arasında intihar %35 oranında
sorumlu tutulmuştur. ABD’de erkek hekimlerin
%3, kadın hekimlerin %6,5 oranında ölüm
sebebi intihardır. Hekim intiharlarını açıklamak
üzere birçok hipotez kurulmuştur. Bunlar
arasında psikiyatrik hastalıklar, alkol ve madde
kötüye kullanımı, tıbbi uygulamaların stres
oluşturması, gerçekçi olmayan beklentiler, rol
karmaşası, profesyonel destek azlığı,
hekimlerin yetersiz psikiyatrik tedavisi,
psikiyatrik tedaviye direnç, kişilik özellikleri ve
psikososyal faktörler sayılabilir. Sonuç olarak,
stigma, mesleki kaygılar ve tedavi önündeki
diğer engellerin üstesinden gelinmesi
gerekmektedir.

Anahtar Kelimeler

Hekim, intihar, ruhsal hastalık

Kaynakça

• American Medical Association Council on Scientific Affairs: Physician Mortality and Suicide: Results and Implications of the AMA- APA Physician Mortality Project, Stage II. Chicago (1986). AMA.
• Arana GW (1982) The impaired physician: a medical and social dilemma. Gen Hosp Psychiatry, 4:147–154.
• Arnetz BB, Horte LG, Hedberg A, Theorell T, Allander E, Malker H (1987) Suicide patterns among physicians related to other academics as well as to the general population. Acta Psychiatry Scand,75: 139- 143.
• Cartwright LK (1987) Occupational stress in women physicians, in Stress in Health Professionals. Edited by Payne R, Firth- Cozens J. New York, John Wiley & Sons, s. 71–87.
• Center C. (2003) Confronting depression and suicide in physicians; a concensus statement. JAMA, 289(23): 3161-3166.
• Chambers R, Maxwell R (1996) Helping sick doctors. Br Med J, 312:722–723.
• Elliot DL, Girard DE (1986) Gender and the emotional impact of internship. J Am Med Wom Assoc, 4:54–56.
• Frank E, Dingle AD (1999) Self-reported depression and suicide attempts among U.S. women physicians. Am J Psychiatry, 156/12: 1887-94.
• Gold KJ, Sen A, Schwenk TL (2012) Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry. doi: 10.1016/j.genhosppsych.2012.08.005
• Heim E.J. (1991) Stressors and coping in health professions. Psychother Psychosom, 55: 90-99.
• Hendrie HC, Clair DK, Brittain HM, Fadul PE (1990) A study of anxiety/depressive symptoms of medical students, house staff, and their spouses/partners. J Nerv Ment Dis, 178:204–207.
• Holmes VF, Rich CL (1990) Suicide among physicians, in Suicide Over the Life Cycle: Risk Factors, Assessment, and Treatment of Suicidal Patients. Edited by Blumenthal SJ, Kupfer DJ. Washington, DC, American Psychiatric Press, s. 599–618.
• Hsu K, Marshall V (1987) Prevalence of depression and distress in a large sample of Canadian residents, interns, and fellows. Am J Psychiatry, 144:1561–1566.
• Öztürk MO, Uluşahin A (2008) Ruh Sağlığı ve Bozuklukları. Ankara Nobel Tıp Kitabevleri, 11. Baskı.
• Rich CL, Pitts FN (1980) Suicide by psychiatrists: a study of medical specialists among 18730 consecutive physician deaths during a five-year period1967-72. J Clin Psychiatry, 41: 261-263.
• Roy A. Psychiatric emergencies. Sadock BJ, Sadock VA, editors. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (2000). Philadelphia: Lippincott Williams and Wilkins, s. 2031-2040.
• Sadock BJ, Sadock VA (2005) Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams Wilkins.
• Scheiber SC. (1986) Stress in physicians, in Stress in Health Professionals. Edited by Payne R, Firth-Cozens J. New York, John Wiley & Sons, s. 23–44.
• Schernhammer ES, Colditz G (2004) Suicide rates among physicians:a quantitative and gender assessment(meta-analysis). Am J Psychiatry, 161: 2295-2302.
• Simon W. Suicide among physicians: prevention and postvention, in Suicide and Its Prevention: The Role of Attitude and Imitation (1989) Edited by Diekstra RFW, Manis R, Platt S, Schmidtke A, Sonnek C. New York, EJ Brill, s.186–198.
• Stack S (2003) Media coverage as a risk factor in suicide. J Epidemiol Community Health, 57(4): 238-240.
• Thomas CB (1976) What becomes of medical students: the dark side. Johns Hopkins Med J, 130:105–195.
• http://tuikapp.tuik.gov.tr./ demografiapp.
• http:// www.who.int/mental-health/ prevention/suicide/resource-media.pdf.