title: Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers.
abstract: BACKGROUND
  Suicide risk may be elevated in 'medical' occupational groups, although results of studies are inconsistent. National data are required to examine this issue. It is also important to investigate the possible contribution of psychiatric disorder and access to specific suicide methods.
  
  
  METHODS
  In a nested case-control design we used data from Danish national registers for 1981-2006 to examine risk of suicide in nurses, physicians, dentists, pharmacists and veterinary surgeons compared to teachers and the general population, and associations with psychiatric service contact and suicide methods.
  
  
  RESULTS
  Crude age- and gender-adjusted rate ratios for suicide compared to teachers were significantly elevated in nurses (RR 1.90, 95% CI 1.63-2.21), physicians (RR 1.87, 95% CI 1.55-2.26), dentists (RR 2.10, 95% CI 1.58-2.79) and pharmacists (RR 1.91, 95% CI 1.26-2.87), but not veterinary surgeons. Risk was also elevated in nurses, physicians and dentists compared with the rest of the general population, the relative risk increasing following adjustments for psychiatric service contact, marital status, gross income and labour market status. Results were similar in both genders. The elevated risk in nurses and dentists decreased during the study period. Elevated risks were not associated with greater psychiatric service contact. Medicinal drugs were commonly used for suicide by nurses, physicians and pharmacists.
  
  
  CONCLUSIONS
  The study was based in one country.
  
  
  CONCLUSIONS
  Risk of suicide is increased in nurses, physicians, dentists and pharmacists in Denmark. This is not reflected in excess psychiatric service contact. Ready access to medicinal drugs may influence risk in nurses, physicians and pharmacists.
authors.affiliation: University of Oxford, Oxford, UK. keith.hawton@psych.ox.ac.uk
authors.forename: Keith
authors.initials: K
authors.lastname: Hawton
authors.forename: Esben
authors.initials: E
authors.lastname: Agerbo
authors.forename: Sue
authors.initials: S
authors.lastname: Simkin
authors.forename: Belinda
authors.initials: B
authors.lastname: Platt
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Mellanby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D003815:Dentists; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007182:Income; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D010595:Pharmacists; D010820:Physicians / Q000523:psychology; D012042:Registries; D012306:Risk; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult