title: Suicidal ideation among surgeons in Italy and Sweden - a cross-sectional study.
abstract: BACKGROUND
  Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons' suicidal ideation. A surgeon's work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions.
  
  
  METHODS
  A cross-sectional study of surgeons was performed in Italy (N = 149) and Sweden (N = 272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured.
  
  
  RESULTS
  Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective.
  
  
  CONCLUSIONS
  A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.
authors.affiliation: Department of Psychology, Stockholm University, Sweden, SE-10691 Sweden.
authors.forename: Maja
authors.initials: M
authors.lastname: Wall
authors.affiliation: Department of Medicine, Centre of Gender Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Schenck-Gustafsson
authors.affiliation: Departments of Obstetrics & Gynaecology, Padua University Hospital, Padua, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Minucci
authors.affiliation: Department of Psychology, Stockholm University, Sweden, SE-10691 Sweden.
authors.forename: Marie Gustafsson
authors.initials: MG
authors.lastname: Sendén
authors.affiliation: Department of Research and Development, Division of Mental Health Care, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Lise Tevik
authors.initials: LT
authors.lastname: Løvseth
authors.affiliation: Department of Psychology, Stockholm University, Sweden, SE-10691 Sweden ; Department of Medicine, Centre of Gender Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Fridner