title: Risky alcohol use in Danish physicians: Associated with alexithymia and burnout?
abstract: BACKGROUND
  Alcohol abuse may be elicited by psychological problems and can influence physicians' health and patient safety. To act on it, we need knowledge on the prevalence of the disorder and its associations with psychological factors and physicians' well-being. The aim of this study was to explore whether burnout and alexithymia are associated with risky alcohol consumption in physicians and whether burnout mediates the association between alexithymia and risky alcohol consumption.
  
  
  METHODS
  In this cross-sectional study, 4,000 randomly selected physicians received an electronic questionnaire by email containing the Alcohol Use Disorders Identification Test (AUDIT), the Maslach Burnout Inventory Human-Services-Survey (MBI-HSS) and the Toronto Alexithymia Scale (TAS-20). A total of 1,841 physicians completed the questionnaire (46%).
  
  
  RESULTS
  18.8% reached the criteria for risky alcohol consumption. The likelihood of having risky alcohol consumption was associated with high levels of alexithymia (OR=1.93, 95%CI=1.37-2.74, P<0.001). Moreover, risky alcohol consumption was associated with burnout (OR=1.86, 95%CI=1.13-3.05, P<0.014) and each individual burnout dimension: emotional exhaustion (OR=1.89, 95%CI=1.33-2.69, P<0.001), depersonalisation (OR=2.23, 95%CI=1.53-3.25, P<0.001) and low levels of personal accomplishment (OR=1.66, 95%CI=1.14-2.41, P=0.008). Mediation analysis suggested that the association between alexithymia and risky alcohol consumption was partially mediated through depersonalisation.
  
  
  CONCLUSIONS
  The results emphasize a need for enhancing emotional self-awareness in physicians as psychological traits, work-pressure and alcohol dependence might be self-reinforcing aspects for the individual physician. As alcohol dependence and burnout may have consequences for patient safety separately, the aggregated influence of these factors has to be examined.
authors.affiliation: Research Centre for Cancer Diagnosis in Primary Car-CaP, The Research Unit for General Practice, Aarhus University, Denmark. Electronic address: afp@ph.au.dk.
authors.forename: Anette Fischer
authors.initials: AF
authors.lastname: Pedersen
authors.affiliation: The Research Unit for General Practice, Aarhus University, Denmark.
authors.forename: Johanne Korsdal
authors.initials: JK
authors.lastname: Sørensen
authors.affiliation: Department of Public Health, Institute of General Medical Practice, Aarhus University, Denmark.
authors.forename: Niels Henrik
authors.initials: NH
authors.lastname: Bruun
authors.affiliation: Department of Public Health, Institute of General Medical Practice, Aarhus University, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Christensen
authors.affiliation: Research Centre for Cancer Diagnosis in Primary Car-CaP, The Research Unit for General Practice, Aarhus University, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology; D002055:Burnout, Professional / Q000523:psychology*; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D012309:Risk-Taking; D011795:Surveys and Questionnaires
keywords: Alcohol use disorder; Alexithymia; Burnout; Physicians; Survey