Doctors and substance misuse: types of doctors, types of problems.
The casenotes of 144 doctors who had received treatment for substance misuse were analysed. There were no differences between general practitioners (n = 61) and hospital doctors (n = 58) in terms of their substance misuse histories or the problems they incurred. Differences emerged between the consultant (n = 24) and the non-consultant (n = 34) grades of hospital doctor. The consultants were older at onset of problematic use (42.6 +/- 8.6 vs. 29.9 +/- 9.8 years); they suffered fewer career problems and misused fewer substances. The most frequent pathways into substance use were personality difficulties (76 subjects, 52.8%) and anxiety or depression (46 subjects, 31.9%). A history of depression (n = 36) was associated with perceived stress at work (p = 0.014), and at home (p = 0.06). Past neurotic disturbances (n = 20) were associated with personality difficulties (p = 0.035), anxiety or depression (p = 0.004), and with an earlier onset of problematic substance use (30.2 +/- 8.3 vs. 36.5 +/- 9.8 years, p = 0.014). Principal components of possible antecedents yielded one major component on which all elements loaded; this was labelled the 'disturbance score'. This score showed a reduction with increasing age of onset of problematic substance use.
Addiction Research Unit, Institute of Psychiatry, London, UK.
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D
Brooke
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G
Edwards
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Andrews
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D015994:Incidence; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D010815:Physician Impairment / Q000523:psychology / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs; D012189:Retrospective Studies; D013038:Specialization; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation
D013287:Illicit Drugs; D011619:Psychotropic Drugs