ABSTRACT
BACKGROUND: Psychiatrists are at a high risk of becoming mentally ill at some point during their careers. AIMS: To compare the profile of psychiatrists admitted to the Barcelona Physicians' Health Programme (PHP) with other sick doctors in the programme. METHODS: A retrospective case review of electronic medical records was conducted for physicians registered at the 'Colegio de Médicos' in Barcelona and consecutively admitted to the Barcelona PHP from January 1998 until December 2013. RESULTS: One thousand two hundred eighteen records were reviewed. The 72 psychiatrists admitted to the programme were not statistically different from the other physicians in gender (54% versus 51% women), primary diagnosis (34% non-substance use mental disorders versus 29% substance use disorders), prevalence of adjustment disorders and median length of their first treatment episode (9.0 versus 8.4 months). Psychiatrists were significantly older (mean age 53 versus 50 years; t = 2.12; P < 0.05), more frequently had inpatient treatment during their first treatment episode (17% versus 10%; χ (2) = 4.57, P < 0.05) and had more referred (rather than self-referred) admissions (22% versus 13%; χ (2) = 4.57, P < 0.05) than other physicians. However, only the type of referral played a significant role when considering the simultaneous effect of all relevant variables (Wald = 4.43; P < 0.05). CONCLUSIONS: Psychiatrists with mental disorders may be more reluctant to ask for help from a PHP voluntarily than other physicians. Members of this professional group should be encouraged to seek help when affected by mental distress or addiction problems.
Subject(s)
Mental Disorders/epidemiology , Mental Health Services/statistics & numerical data , Occupational Diseases/epidemiology , Occupational Health , Patient Acceptance of Health Care/psychology , Psychiatry , Adult , Female , Hospitalization , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/psychology , Patient Acceptance of Health Care/statistics & numerical data , Prevalence , Psychiatry/statistics & numerical data , Referral and Consultation , Retrospective Studies , Spain/epidemiologyABSTRACT
Introducción. Estudios recientes sugieren que las conductas suicidas tendrían una predisposición genética independiente del aumento de riesgo suicida asociado al diagnóstico de enfermedades mentales como los trastornos afectivos, la esquizofrenia, o la dependencia de alcohol. Dada la heterogeneidad de las conductas suicidas y la complejidad de su herencia, parece necesario el uso de fenotipos intermedios demostrables que permitan establecer una ligazón entre los genes y las conductas suicidas (endofenotipos).El principal objetivo es revisar cuales son los endofenotipos candidatos para las conductas suicidas. Métodos. Se realiza una revisión no sistemática de la bibliografía publicada en MEDLINE en los idiomas inglés, francés y español. Los términos de búsqueda usados fueron endofenotipos y conductas suicidas. Conclusiones. Los principales endofenotipos candidatos provienen de áreas como la neuropsicología (toma de decisiones, funciones ejecutivas), los rasgos de personalidad(impulsividad, agresividad y neuroticismo), la neuroquímica(5-HIAA en líquido cefalorraquídeo) y los estudios de neuroimagen (el metabolismo de la amígdala cerebral medido a través de Resonancia Magnética Funcional y el metabolismo de la corteza pre-frontal medido a través de Tomografía por Emisión de Positrones) (AU)
Background. Recent studies have suggested that genetic predisposition to suicidal behavior may be independent of the risk of suicide associated to mental disorders, such as affective disorders, schizophrenia or alcohol dependence. Given the suicidal behavior heterogeneity and its hereditary complexity, the need to find demonstrable intermediate phenotypes that may make it possible to establish links between genes and suicide behaviors (endophenotypes) seems to be necessary. The main objective is to review which are the candidate endophenotypes of suicidal behaviors. Methods. We carried out a non-systematic review of all published literature in English, French and Spanish in MEDLINE. The search terms were endophenotypes and suicide behaviors. Conclusions. The main candidate endophenotypes of suicidal behaviors are neuropsychological (decision making, executive functions), personality traits (impulsivity, aggressiveness, and neuroticism), neurochemistry (5-HIAAin CNS) and neuroimaging (fMRI of cerebral amygdala or PET of prefrontal cortex metabolism) (AU)
Subject(s)
Humans , Phenotype , Suicide , Amygdala/physiopathology , Genetic Predisposition to Disease , Neuropsychological Tests , Diagnostic ImagingABSTRACT
BACKGROUND: Recent studies have suggested that genetic predisposition to suicidal behavior may be independent of the risk of suicide associated to mental disorders, such as affective disorders, schizophrenia or alcohol dependence. Given the suicidal behavior heterogeneity and its hereditary complexity, the need to find demonstrable intermediate phenotypes that may make it possible to establish links between genes and suicide behaviors (endophenotypes) seems to be necessary. The main objective is to review which are the candidate endophenotypes of suicidal behaviors. METHODS: We carried out a non-systematic review of all published literature in English, French and Spanish in MEDLINE. The search terms were endophenotypes and suicide behaviors. CONCLUSIONS: The main candidate endophenotypes of suicidal behaviors are neuropsychological (decision-making, executive functions), personality traits (impulsivity, aggressiveness, and neuroticism), neurochemistry (5-HIAA in CNS) and neuroimaging (fMRI of cerebral amygdala or PET of prefrontal cortex metabolism).
