The research team at the Center for Public Health led by study director Eva Schernhammer (Head of the Department of Epidemiology) and her colleague first author Claudia Zimmermann conducted a meta-analysis of the results of observational studies published between 1960 and 2024 comparing suicide rates among doctors with those of the general population. A total of 39 studies from 20 countries (mainly from Europe, the USA and Australia) were included. In total, they reported on 3,303 male and 587 female suicides in two observation periods (1935-2020 and 1960-2020).
The results showed that the suicide risk among male doctors was not increased compared to the general population. However, the suicide risk among female doctors was significantly higher (76%) than in the general population.
Analysis of the ten most recent studies compared to older studies showed that suicide rates have decreased over time for both male and female physicians, although the rate for female physicians remained significantly higher (24% higher) compared to the general population.
Greater awareness of mental health
The exact causes of this decline are not known, but greater awareness of mental health and support for doctors in the workplace in recent years may have played a role, the authors suggest.
The high degree of variation (heterogeneity) between studies also suggests that doctors' suicide risk is not uniform across different populations, they add. This is likely due to training and working environments in different healthcare systems, as well as different attitudes and stigmatisation around mental health and suicide.
An additional analysis also revealed a significantly (81%) higher suicide rate among male doctors compared to other occupational groups with a similar socio-economic status. The ratio was similar for female doctors, but the number of studies in question was too small for a separate analysis.
The authors acknowledge several limitations, such as the lack of studies from countries outside Europe, the US, and Australia and the likely under-reporting of suicide as a cause of death due to stigmatisation. Nonetheless, the analysis was based on a full assessment of the available data and examined a number of factors as possible causes of the differences.
The authors therefore call for further efforts in researching and preventing physician suicide, particularly among female physicians, and point out that future research is needed to assess any impact of Covid-19 on suicide rates among physicians around the world.
Publication: British Medical Journal
Suicide rates among physicians compared to the general population in studies from 20 countries: gender-stratified systematic review and meta-analysis
Claudia Zimmermann, Susanne Strohmaier, Harald Herkner, Thomas Niederkrotenthaler, Eva Schernhammer
doi: 10.1136/bmj-2023-078964