Psychiatrists and occupational stress

Abstract

Background: Main features of antisocial personality disorder (APD) are aggression, tendency to violence, poor frustration tolerance, impulsivity, difficulties in learning from experiences. Attention deficit hyperactivity disorder (ADHD) is characterized with difficulty to sustain attention, hyperactivity and impulsivity. Association between ADHD and violent behavior is well known. Childhood onset ADHD carries a high risk of persisting into adulthood as antisocial behaviors. Aim: In the present study, comorbidity of adult ADHD was screened in a group of patients with APD. Executive functions and attention were assessed by using neuropsychological test instruments. In addition, their relation to ADHD subtypes was investigated. Methods: A total of 90 male subjects with APD were included. Also, 90 age-and sex-matched healthy control subjects were involved into the study. The patients and control subjects were assessed by a semi-structured socio-demographic form, SCID-II, Turgay's Adult ADHD Rating Scale, Wender Utah Rating Scale, Wisconsin Card Sorting Test, Stroop Test, Continuous Performance Test, and Trail-Making Test. Results: Comorbidity rate of adult ADHD was 83.3% in APD group while 6.7% of control subjects had a diagnosis of adult ADHD. The most frequently diagnosed ADHD subgroup was combined type in both APD and control group. In APD group, executive functions were significantly more deficient as compared to the control group. Among all ADHD subgroups, inattention subtype had the worst performance in neuropsychological assessments. Conclusion: Comorbidity of adult ADHD was quite common in APD subjects. Executive functions were generally deficient in APD patients with a co-diagnosis of adult ADHD.

Personal resilience in psychiatrists: systematic review

“…43 Those most vulnerable to stress were new starters, 29 those without children and with academic affiliations/ responsibilities, 45 those working with high-risk and difficult patients, 43 and those who expressed job dissatisfaction. 48 Causes of stress were excessive workload, 40,49 job and training demands, 40 career prospects (notably Modernising Medical Careers), 47 concerns over personal safety, 29 illness, 52 inadequate resources 27,40 and litigation. 48,52 Psychological illness and other factors.…”

“…32 Actively seeking support, confiding in supportive colleagues and socialising were also recognised as a positive coping strategies. 43,47 Changes to the workplace environment through better management of economical and administrative measures, 27 as well as the creation of functional teams, having crisis teams as gatekeepers, working in multidisciplinary teams, introducing generic/nurse-led services, and separating in-patient and community roles were also found to reduce stress levels among psychiatrists. 47 Job satisfaction and well-being.…”

“…Of the included studies, 28 were quantitative, [24][25][26][27][28][29][30][33][34][35][36][37][38][39][40][44][45][46][47][48][49][50][51][52][53][54][55][56] two were qualitative, 31,32 one was interventional 41 and two had mixed methodology. 42,43 Countries of origin Studies originated from Australia, 29,40,48,55 New Zealand, 28,31,38,39 the UK, 30,34,43,47 the USA, 24,26,52 Canada, 35,50 Italy, 25,…”

“…42,43 Countries of origin Studies originated from Australia, 29,40,48,55 New Zealand, 28,31,38,39 the UK, 30,34,43,47 the USA, 24,26,52 Canada, 35,50 Italy, 25,54 Finland, 33,36 Portugal 44 and Romania. 27 Several studies involved a combination of countries 40,45,46,49 and six studies did not specify location. 32,37,41,51,53,56 Populations Twenty studies involved psychiatry doctors only, comprising psychiatrists, 25,27,31,32,[37][38][39][40][41][43][44][45]47,48,52 psychiatry trainees…”

“…27 Several studies involved a combination of countries 40,45,46,49 and six studies did not specify location. 32,37,41,51,53,56 Populations Twenty studies involved psychiatry doctors only, comprising psychiatrists, 25,27,31,32,[37][38][39][40][41][43][44][45]47,48,52 psychiatry trainees 35,42,55 or a combination of both. 24,49 Only three studies provided an indication of subspecialty, including child and adolescent, 36,40 adult 36 and forensic psychiatry.…”