Special report: suicidal ideation among American surgeons.
BACKGROUND
Suicide is a disproportionate cause of death for US physicians. The prevalence of suicidal ideation (SI) among surgeons and their use of mental health resources are unknown.


METHODS
Members of the American College of Surgeons were sent an anonymous cross-sectional survey in June 2008. The survey included questions regarding SI and use of mental health resources, a validated depression screening tool, and standardized assessments of burnout and quality of life.


RESULTS
Of 7905 participating surgeons (response rate, 31.7%), 501 (6.3%) reported SI during the previous 12 months. Among individuals 45 years and older, SI was 1.5 to 3.0 times more common among surgeons than the general population (P < .02). Only 130 surgeons (26.0%) with recent SI had sought psychiatric or psychologic help, while 301 (60.1%) were reluctant to seek help due to concern that it could affect their medical license. Recent SI had a large, statistically significant adverse relationship with all 3 domains of burnout (emotional exhaustion, depersonalization, and low personal accomplishment) and symptoms of depression. Burnout (odds ratio, 1.910; P < .001) and depression (odds ratio, 7.012; P < .001) were independently associated with SI after controlling for personal and professional characteristics. Other personal and professional characteristics also related to the prevalence of SI.


CONCLUSIONS
Although 1 of 16 surgeons reported SI in the previous year, few sought psychiatric or psychologic help. Recent SI among surgeons was strongly related to symptoms of depression and a surgeon's degree of burnout. Studies are needed to determine how to reduce SI among surgeons and how to eliminate barriers to their use of mental health resources.
Mayo Clinic, Rochester, MN 55905, USA. shanafelt.tait@mayo.edu
Tait D
TD
Shanafelt
Charles M
CM
Balch
Lotte
L
Dyrbye
Gerald
G
Bechamps
Tom
T
Russell
Daniel
D
Satele
Teresa
T
Rummans
Karen
K
Swartz
Paul J
PJ
Novotny
Jeff
J
Sloan
Michael R
MR
Oreskovich
D000328:Adult; D000368:Aged; D002055:Burnout, Professional / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010820:Physicians / Q000523:psychology*; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States