Posted by Neal on February 23, 2009, at 22:07:37
In the summer of 1995, Dr. Steven Miles, a well-known specialist in internal medicine at the University of Minnesota, fell into a deep depression.
At night, he lay in bed unable to sleep. He became preoccupied with suicide. '
Dr. Miles, 45 at the time, realized that he was ill and sought help from a psychiatrist, who diagnosed a nonpsychotic form of manic depression and prescribed medication. A month later, with no interruption in his teaching or his clinical work, he was well on the way to recovery.
And that might have been the end of it, a small rough patch in a career of otherwise uninterrupted success.
But the medical profession, Dr. Miles and 14 other authors contend in a recent article in The Journal of the American Medical Association, has been slow to accept that depression and other mental disorders are illnesses like any other, at least when they occur in its own members.
Many doctors fail to seek treatment for psychiatric conditions out of fear that doing so will damage their careers. And those who do get treatment can suffer very real professional penalties. Dr. Miles, for example, spent three years battling state licensing officials who wanted access to his private psychiatric records.
In the journal article, Dr. Miles and his colleagues, who gathered last October to discuss doctors' mental health at a workshop convened by the American Foundation for Suicide Prevention, noted that the profession's sluggishness in addressing the issue stands in contrast to its involvement in other public health problems.
In combating tobacco, for example, medical practitioners have taken the lead. Deaths from smoking-related illnesses like cancer and heart disease are lower among doctors than in the population at large, and they have dropped 40 to 60 percent over the last four decades, the authors noted.
But the rate of depression among doctors -- about 12 percent suffer an episode of clinical depression at some point in life, according to one study -- parallels that of the general public, and research suggests that they are at higher risk for suicide. An analysis of 14 international studies conducted from 1963 to 1991, for instance, found that men in medicine had a risk of suicide 1.1 to 3.4 times as great as that of the general population. Among women, the risk was 2.5 to 5.7 times as high.
Johns Hopkins researchers have been following a group of 1,300 doctors who entered medical school from 1948 to 1964. Of those doctors, 26 have taken their own lives, said Dr. Daniel E. Ford, a professor of psychiatry and medicine at Johns Hopkins. The average age of the doctors at their deaths was 45, Dr. Ford said. Psychiatrists had the highest suicide rate of any specialty.
Part of the difficulty, Dr. Miles and his colleagues say, is that doctors are, in general, unskilled both in recognizing the symptoms of depression and in treating the illness. The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care. Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time.
But the rate of depression among doctors -- about 12 percent suffer an episode of clinical depression at some point in life, according to one study -- parallels that of the general public, and research suggests that they are at higher risk for suicide. An analysis of 14 international studies conducted from 1963 to 1991, for instance, found that men in medicine had a risk of suicide 1.1 to 3.4 times as great as that of the general population. Among women, the risk was 2.5 to 5.7 times as high.Johns Hopkins researchers have been following a group of 1,300 doctors who entered medical school from 1948 to 1964. Of those doctors, 26 have taken their own lives, said Dr. Daniel E. Ford, a professor of psychiatry and medicine at Johns Hopkins. The average age of the doctors at their deaths was 45, Dr. Ford said. Psychiatrists had the highest suicide rate of any specialty.
Part of the difficulty, Dr. Miles and his colleagues say, is that doctors are, in general, unskilled both in recognizing the symptoms of depression and in treating the illness. The findings of a national survey published in June indicated that only 40 percent of Americans in treatment for depression received adequate care. Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time.
poster:Neal
thread:882063
URL: http://www.dr-bob.org/babble/work/20071028/msgs/882063.html