Confronting depression and suicide in physicians - A consensus statement

被引:442
作者
Center, C
Davis, M
Detre, T
Ford, DE
Hansbrough, W
Hendin, H
Laszlo, J
Litts, DA
Mann, J
Mansky, PA
Michels, R
Miles, SH
Proujansky, R
Reynolds, CF
Silverman, MM
机构
[1] Univ Calif San Francisco, Hastings Coll Law, San Francisco, CA 94102 USA
[2] Univ Calif San Francisco, Employment Law Ctr, San Francisco, CA USA
[3] George Washington Univ, Sch Publ Hlth & Hlth Serv, Washington, DC USA
[4] Univ Pittsburgh, Med Ctr, Dept Psychiat, Pittsburgh, PA USA
[5] Johns Hopkins Sch Med, Dept Med, Baltimore, MD USA
[6] Johns Hopkins Sch Med, Dept Epidemiol, Baltimore, MD USA
[7] Johns Hopkins Sch Med, Dept Hlth Policy & Management, Baltimore, MD USA
[8] Univ Calif San Diego, Med Ctr, Dept Educ Res & Dev, San Diego, CA 92103 USA
[9] New York Med Coll, Dept Psychiat, New York, NY USA
[10] Amer Canc Soc, Atlanta, GA 30329 USA
[11] Off US Surg Gen, Washington, DC USA
[12] Columbia Univ, Med Ctr, Dept Psychiat, New York, NY USA
[13] Med Soc State New York, Comm Phys Hlth, Albany, NY USA
[14] Albany Med Coll Union Univ, Albany Coll, Dept Psychopharmacol, Albany, NY 12208 USA
[15] Cornell Univ, Joan & Sanford I Weill Med Coll, Payne Whitney Clin, New York, NY USA
[16] Univ Minnesota, Sch Med, Dept Med & Geriatr, Minneapolis, MN 55455 USA
[17] Alfred I duPont Hosp Children, Wilmington, DE USA
[18] Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA
[19] Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Pittsburgh, PA USA
[20] Natl Suicide Prevent Resource Ctr, Newton, MA USA
[21] Univ Chicago, Sch Med, Dept Psychiat, Chicago, IL 60637 USA
[22] Amer Fdn Suicide Prevent, New York, NY 10005 USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2003年 / 289卷 / 23期
关键词
D O I
10.1001/jama.289.23.3161
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To encourage treatment of depression and prevention of suicide in physicians by calling for a shift in professional attitudes and institutional policies to support physicians seeking help. Participants An American Foundation for Suicide Prevention planning group invited 15 experts on the subject to evaluate the state of knowledge about physician depression and suicide and barriers to treatment. The group assembled for a workshop held October 6-7, 2002, in Philadelphia, Pa. Evidence The planning group worked with each participant on a preworkshop literature review in an assigned area. Abstracts of presentations and key publications were distributed to participants before the workshop. After workshop presentations, participants were assigned to 1, of 2 breakout groups: (1) physicians in their role as patients and (2) medical institutions and professional organizations. The groups-identified areas that required further research, barriers to treatment, and recommendations for reform. Consensus Process This consensus statement emerged from a plenary session during which each work group presented its recommendations. The consensus statement was circulated to and approved by all participants. Conclusions The culture of medicine accords low priority to physician mental health despite evidence of untreated mood disorders and an increased burden of suicide. Barriers to physicians' seeking help are often punitive, including discrimination in medical licensing, hospital privileges, and professional advancement. This consensus statement recommends transforming professional attitudes and changing institutional policies to encourage physicians to seek help. As barriers are removed and physicians confront depression and suicidality in their peers, they are more likely to recognize and treat these conditions in patients, including colleagues and medical students.
引用
收藏
页码:3161 / 3166
页数:6
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