Clinical Prediction of Physician Suicide Based on Medical Student Data

Dependency and suicidality in psychiatric inpatients

“…Most importantly, this study used a concurrent/retrospective design, which can provide information regarding only the covariation of dependency levels and suicidality. The question of whether high levels of interpersonal dependency actually predispose an individual to suicidal ideation or behavior was not addressed in this investigation (however, see Epstein, Thomas, Shaffer, &Perlin, 1973, andPaykel &Dienelt, 1971, for preliminary findings in this area).…”

“…Table 1 summarizes the key features of extant investigations of this issue. This table includes all published studies wherein participants' scores on some measure of interpersonal dependency were compared to an Blatt et al (1996) 670 high school students Concur DEQ Suicidal Ideation .23 Brent et al (1994) 86 community subjects Retro DPD symptoms Completed suicide .02 Cantor (1976) 199 female college students Retro EPPS Suicide Attempt .63 Clark et al (1993) 56 psychiatric inpatients Concur SNAP Suicidal Ideation .34 Epstein et al (1973) 33 medical students Pro KAS Completed Suicide .57 Overholser et al (1989) 106 psychiatric inpatients Concur MCMI Suicidal Ideation .05 Pallis & Birtchnell (1976) (Navran, 1954); DEQ ϭ Depressive Experiences Questionnaire dependency scale (Blatt, D'Afflitti & Quinlan, 1976); DPD symptoms ϭ dependent personality disorder symptoms; EPPS ϭ Edwards Personal Preference Scale succorance score (Edwards, 1959); SNAP ϭ Schedule for Nonadaptive and Adaptive Personality (Clark, 1993); KAS ϭ Katz Adjustment Scales (Katz & Lyerly, 1963); MCMI ϭ Millon Clinical Multiaxial Inventory (Millon, 1982); LK orality ϭ Lazare-Klerman orality scale (Lazare, Klerman & Armor, 1966). Effect sizes are correlation coefficients (r's) representing the magnitude of the relationship between dependency level and suicide risk.…”

Physician Depression and Suicide: A Shared Responsibility

“…9 Physician suicide is notoriously difficult to study because suicides are not always accurately reported. 6,[11][12][13][14] In the early 1900s, physician suicide was considered to be an individual, preexisting psychopathology, and the solution was to prevent these troubled individuals from entering into the profession. 8 Today, researchers believe that physician suicide is a multifaceted problem involving individual factors, the training environment, and culture of medicine.…”

Stamina: the Thread of Human Life

“…A series of reports shows that good psycho logical health in youth (when the subjects were medical students in their early 20s) preceded good mental and physical health in middle age (when the subjects, for the most part physicians, are 40-60 years old). Aspects of youthful psychological health which were measured or categorized in med ical school by means of a variety of tests and questionnaires reflect impor tant facets of the healthy personality [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The following characteristics are outstanding: self-esteem [7,14]; a warm relationship with parents [8,11,18]; an open, flexible approach to life [13,21]; a spontaneous, outgoing temperament [17]; minimal nervous tension, depression, anxiety and anger under stress [7,12,15,16,20], and a lack of morbid, frightening psychody namic undertones in response to the Rorschach test [10], These character istics of healthy subjects were displayed by various groups of healthy con trols in our several studies of disease and death.…”

“…The mean inter val between testing and suicide was 10.8 years. Among the outstanding features of the future suicide group were: older parents [8,11]; lack of closeness to parents [8,11,15,18]; a tendency toward being underweight [8]; irritability, urinary frequency, and urge to be alone under stress [7,20]; increased depression and anger-hostility overall [8,9,15]; morbid, patho logical Rorschach content [10]; self-relatedness [13], and ambivalent feel ings in regard to self and others [13,21]. The predictive potential of the youthful traits did not diminish over time.…”