Suicide rates among physicians are higher than in the general population, and rates
among female physicians are particularly high. More female than male physicians report
suicidal thoughts, with suicidal ideation being a well-recognized precursor of suicide.
The urgent need to find the reasons for suicide risk in female physicians is underscored
by society's increasing dependence on this group of health care providers.
The aim of this paper was to identify potential risk and protective factors associated
with recent suicidal ideation in female physicians.
A cross-sectional survey analysis of work-related health, organizational culture,
career paths, and working conditions was performed among permanently employed female
physicians from the HOUPE (Health and Organisation among University Physicians in
four European countries) study: 385 in Sweden and 126 in Italy. The main outcome measure
was recent (within the prior 12 months) suicidal thoughts.
Overall, 13.7% and 14.3% of the participants from Sweden and Italy, respectively,
reported suicidal thoughts within the prior 12 months. Among the physicians from Sweden,
the most powerful multivariate model for such thoughts included 2 independent variables
related to work: degrading experiences/harassment at work (odds ratio [OR], 3.03;
95% CI, 1.48-6.23), and work meetings to discuss stressful situations (OR, 0.36; 95%
CI, 0.19-0.69). The model included self-diagnosis and self-treatment as a significant
factor. Work meetings to discuss stressful situations were also in the multivariate
model for the Italian physicians (OR, 0.21; 95% CI, 0.05-0.86), together with being
given work assignments without adequate resources (OR, 5.0; 95% CI, 1.32-18.8). Significant
non-work-related factors in the Italian model were younger age and seeking professional
help for depression or burnout.
In both Sweden and Italy, work stressors have been identified that may increase the
risk for suicide for female physicians. A potential protective factor was meetings
to discuss stressful work experiences. These findings suggest that such meetings should
be more broadly implemented.