Suicide among doctors in Turkey: Differences across gender, medical specialty and the method of suicide.

BACKGROUND: Doctors have higher rates of mental illness and suicide than the general population worldwide. Suicides of doctors are known to be underreported in developing countries. To the best of our knowledge, there are no studies investigating suicides among medical students and doctors in Turkey. OBJECTIVES: To investigate the characteristics of suicides in medical school students and doctors in Turkey. MATERIAL AND METHODS: In this retrospective study, newspaper websites and Google search engine were searched for information on medical school student and doctor suicides in Turkey between 2011 and 2021. Cases of suicide attempt, parasuicide or deliberate self-harm were not included in the study. RESULTS: Sixty-one suicides were reported between 2011-2021. There was a male predominance (45 (73.8%)), and more than half of the suicides (32 (52.5%)) occurred among specialist doctors. Self-poisoning, jumping from heights and firearms were the most common methods of suicide (18 (29.5%), 17 (27.9%) and 15 (24.6%), respectively). Cardiovascular surgery, family medicine, gynecology, and obstetrics specialties had the highest numbers of suicide deaths. Depression/mental illness was the most common speculated etiology. These results show that suicides among medical students and doctors in Turkey have characteristics that differ from both suicided among the general population in Turkey and doctor suicides in other countries. CONCLUSIONS: In this study, we identified the suicidal characteristics of medical students and doctors in Turkey for the first time. The results help us to better understand this understudied topic and provide an avenue for future studies. The data also indicate that it is important to monitor the individual and systemic difficulties experienced by doctors, starting from the medical education stage, and to provide individual and environmental support to help decrease the risk of suicide.

Growing burden of nonalcoholic fatty liver disease in Turkey: A single-center experience.

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD), which consists of nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH), is a growing epidemic in Turkey, considering the recent alarming prevalence of 48.3%. Patients with NASH and/or liver fibrosis are more likely to progress to advanced liver disease. In this single-center study, we sought to describe the clinical and histological characteristics of a sample of Turkish patients with biopsy-proven NAFLD, who were enrolled over a 4-year period. MATERIALS AND METHODS: This is a retrospective analysis of prospectively collected data from a total of 468 patients (224 males, 244 females; median age, 47 [18-71]. The study cohort consisted of patients with biopsy-proven NAFLD who were followed up at our outpatient clinic from 2009 to 2010 and from 2017 to 2018. Histological classification of the biopsies was performed according to the Steatosis, Activity and Fibrosis (SAF) scoring allowing the use of Fatty Liver Inhibition of Progression (FLIP) algorithm and the NAFLD Activity Score (NAS) scoring system. RESULTS: Based on the SAF scoring, most patients (90.4%) had biopsy-proven NASH, whereas the NAFL was much rarer (9.6%). The prevalence of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F=4) was 35.0%, 17.5%, and 3.8%, respectively. The percentage of lean, overweight, and obese patients with NAFLD was 6.4%, 32.6%, and 61%, respectively. Metabolic syndrome was prevalent in 63% of the patients and Type 2 diabetes mellitus in 33.5%. CONCLUSION: The growing burden of NAFLD as a public health problem in Turkey is underscored by its marked histological severity in terms of NASH and fibrosis. Well-conducted clinical trials will be essential for slowing down the NASH progression.