JAMA Psychiatry最新文献

{"title":"Announcing \"Technology and Psychiatry\" and Expanding Evidence-Based Comments and Reviews in JAMA Psychiatry.","authors":"Dost Öngür, Roy H Perlis","doi":"10.1001/jamapsychiatry.2024.4573","DOIUrl":"10.1001/jamapsychiatry.2024.4573","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"215"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bright Light Therapy for Nonseasonal Depressive Disorders.","authors":"Hirofumi Hirakawa","doi":"10.1001/jamapsychiatry.2024.4480","DOIUrl":"10.1001/jamapsychiatry.2024.4480","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"324"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders.","authors":"Lizanne J S Schweren, Sanne P A Rasing, Monique Kammeraat, Leah A Middelkoop, Ruthie Werner, Saskia Y M Mérelle, Julian M Garcia, Daan H M Creemers, Sisco M P van Veen","doi":"10.1001/jamapsychiatry.2024.4006","DOIUrl":"10.1001/jamapsychiatry.2024.4006","url":null,"abstract":"<p><strong>Importance: </strong>In the Netherlands, a growing group of young people request medical assistance in dying based on psychiatric suffering (MAID-PS). Little is known about this group, their characteristics, and outcomes.</p><p><strong>Objective: </strong>To assess the proportion of requests for and deaths by MAID-PS among young patients, outcomes of their application and assessment procedures, and characteristics of those patients who died by either MAID or suicide.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included Dutch individuals younger than 24 years requesting MAID-PS between January 1, 2012, and June 30, 2021, whose patient file had been closed by December 1, 2022, at the Expertisecentrum Euthanasie, a specialized health care facility providing MAID consultation and care.</p><p><strong>Main outcomes and measures: </strong>Outcomes of the MAID-PS assessment procedure (discontinued, rejected, or MAID-PS) and clinical characteristics of patients who died by MAID or suicide.</p><p><strong>Results: </strong>The study included 397 processed applications submitted by 353 individuals (73.4% female; mean [SD] age, 20.84 [1.90] years). Between 2012 and the first half of 2021, the number of MAID-PS applications by young patients increased from 10 to 39. The most likely outcome was application retracted by the patient (188 [47.3%]) followed by application rejected (178 [44.8%]). For 12 applications (3.0%), patients died by MAID. Seventeen applications (4.3%) were stopped because the patient died by suicide during the application process and 2 (0.5%) because the patient died after they voluntarily stopped eating and drinking. All patients who died by suicide or MAID (n = 29) had multiple psychiatric diagnoses (most frequently major depression, autism spectrum disorder, personality disorders, eating disorder, and/or trauma-related disorder) and extensive treatment histories. Twenty-eight of these patients (96.5%) had a history of suicidality that included multiple suicide attempts prior to the MAID application. Among 17 patients who died by suicide, 13 of 14 (92.9%) had a history of crisis-related hospital admission, and 9 of 12 patients who died by MAID (75.0%) had a history of self-harm.</p><p><strong>Conclusions and relevance: </strong>This cohort study found that the number of young psychiatric patients in the Netherlands who requested MAID-PS increased between 2012 and 2021 and that applications were retracted or rejected for most. Those who died by MAID or suicide were mostly female and had long treatment histories and prominent suicidality. These findings suggest that there is an urgent need for more knowledge about persistent death wishes and effective suicide prevention strategies for this high-risk group.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"246-252"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Vaccination Really Mitigate Psychiatric Implications of COVID-19?-Reply.","authors":"Venexia M Walker, Praveetha Patalay, Jonathan A C Sterne","doi":"10.1001/jamapsychiatry.2024.4099","DOIUrl":"10.1001/jamapsychiatry.2024.4099","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"323-324"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What the Experiences of Young Persons Can Teach Us About Medical Aid in Dying for Psychiatric Illness.","authors":"Brent Kious","doi":"10.1001/jamapsychiatry.2024.3963","DOIUrl":"10.1001/jamapsychiatry.2024.3963","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"216-217"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Outpatient Psychotherapy Among Adults in the US.","authors":"Mark Olfson, Chandler McClellan, Samuel H Zuvekas, Melanie Wall, Carlos Blanco","doi":"10.1001/jamapsychiatry.2024.3903","DOIUrl":"10.1001/jamapsychiatry.2024.3903","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;While access to psychotherapy has recently increased in the US, concern exists that recent gains may be unevenly distributed despite teletherapy expansion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To characterize recent trends and patterns in outpatient psychotherapy by US adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This is a repeated cross-sectional study of psychotherapy use among adults (ages ≥18 years) in the 2018 to 2021 Medical Expenditure Panel Surveys, which are nationally representative surveys of the civilian noninstitutionalized population. Data were analyzed from March to August 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Age-, sex-, and distress-adjusted differences between 2018 and 2021 in use of any psychotherapy and video-based psychotherapy (teletherapy) in 2021 with tests for trend differences (interactions) across levels of sociodemographic characteristics and distress were assessed. Psychological distress was measured using the Kessler-6 scale, with scores of 13 or higher defining serious psychological distress, 1 to 12 defining mild to moderate distress, and 0 defining no distress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis involved 89 619 participants (47 838 female [51.5%] and 41 781 male [48.5%]; 22 510 aged 18-34 years [29.0%], 43 371 aged 35-64 years [48.8%], and 23 738 aged ≥65 years [22.2%]). Between 2018 and 2021, psychotherapy use increased significantly faster for females (931/12 270 females [7.7%] to 1207/12 237 females [10.5%]) than males (547/10 741 males [5.2%] to 655/10 544 males [6.3%]), younger (455/6149 individuals [8.0%] to 602/5296 individuals [11.9%] aged 18-34 years) than older (217/5550 individuals [3.6%] to 304/6708 individuals [4.6%] aged ≥65 years) adults, college graduates (503/6456 adults [7.6%] to 810/7277 adults [11.4%]) than those without a high school diploma (193/3824 adults [5.5%] to 200/3593 adults [7.0%]), privately insured (881/14 387 adults [6.1%] to 1154/13 414 adults [8.9%]) than publicly insured (558/6511 adults [8.8%] to 659/7453 adults [8.8%]) individuals, adults at 2 to 4 times the poverty level (370/6670 adults [5.7%] to 488/6370 adults [8.2%]) than those below the poverty level (384/4495 adults [9.7%] to 428/4760 adults [10.0%]), employed persons overall (733/13 358 adults [5.7%] to 1082/12 365 adults [8.9%]) than unemployed persons aged 65 years and younger (547/5138 adults [10.8%] to 519/4905 adults [10.5%]), and urban (1335/20 682 adults [6.5%] to 1729/20 590 adults [8.7%]) than rural (143/2329 adults [6.4%] to 133/2191 adults [5.9%]) residents. In 2021, after controlling for distress level, teletherapy use was significantly higher among younger than middle-aged (aged 35-64 years: difference, -3.7 percentage points; 95% CI, -5.1 to -2.3) or older (aged ≥65 years: difference, -6.5 percentage points (95% CI, -8.0 to -5.0 percentage points) adults, females (difference, 1.9 percentage points; 95% CI, 0.9 to 2.9 percentag","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"253-263"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment Nondiscrimination Protection and Mental Health Among Sexual Minority Adults.","authors":"Michael Liu, Vishal R Patel, Sahil Sandhu, Rishi K Wadhera, Alex S Keuroghlian","doi":"10.1001/jamapsychiatry.2024.4318","DOIUrl":"10.1001/jamapsychiatry.2024.4318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;In the 2020 Bostock v Clayton County decision, the US Supreme Court extended employment nondiscrimination protection to sexual minority adults. The health impacts of this ruling and similar policies related to sexual orientation-based discrimination are not currently known.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To estimate changes in mental health following the Bostock decision among sexual minority adults in states that gained employment nondiscrimination protection (intervention states) compared with those in states with protections already in place (control states).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This cross-sectional study used 2018-2022 data from the Behavioral Risk Factor Surveillance System and a difference-in-differences approach to evaluate changes in mental health after the Bostock decision by comparing sexual minority adults (aged ≥18 years and identifying as lesbian, gay, or bisexual) in 12 intervention states with those residing in 9 control states. Models were estimated for all participants and separately for employed participants. Data were analyzed between February and September 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Residing in a state that gained employment nondiscrimination protection after the Bostock decision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was number of poor mental health days during the past 30 days, and the secondary outcome was severe mental distress (defined as 14 or more past-month poor mental health days).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 597 462 participants (306 365 in intervention states [77.7% aged 18-64 years and 22.3% aged ≥65 years; 51.7% female] and 291 097 in control states [77.5% aged 18-64 years and 22.5% aged ≥65 years; 50.6% female]), 5.1% in intervention states and 6.0% in control states self-identified as sexual minority adults. The mean (SE) number of past-month poor mental health days was unchanged after the Bostock decision among sexual minority adults in both intervention (from 8.70 [0.27] to 9.59 [0.24] days; adjusted difference, 0.57 [95% CI, -1.02 to 2.16] days) and control (from 8.53 [0.21] to 10.15 [0.20] days; adjusted difference, 1.17 [95% CI, -0.46 to 2.79] days) states, resulting in no differential change between the 2 groups (difference-in-differences, -0.60 days; 95% CI, -1.25 to 0.06 days). Among the subset of employed sexual minority adults, the mean (SE) number of poor mental health days did not change in intervention states (from 7.99 [0.38] to 8.83 [0.30] days; adjusted difference, 0.87 [95% CI, -0.49 to 2.22] days) but increased in control states (from 7.75 [0.27] to 9.75 [0.26] days; adjusted difference, 1.84 [95% CI, 0.44-3.24] days). These findings corresponded to a significant relative reduction in poor mental health days among employed sexual minority adults in intervention vs control states (difference-in-differences, -0.97 days; 95% CI, -1.74 to -0.21 days). Mean (SE) rates of sever","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"237-245"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms and Amyloid Pathology.","authors":"Wietse A Wiels, Julie E Oomens, Sebastiaan Engelborghs, Chris Baeken, Christine A F von Arnim, Mercè Boada, Mira Didic, Bruno Dubois, Tormod Fladby, Wiesje M van der Flier, Giovanni B Frisoni, Lutz Fröhlich, Kiran Dip Gill, Timo Grimmer, Helmut Hildebrandt, Jakub Hort, Yoshiaki Itoh, Takeshi Iwatsubo, Aleksandra Klimkowicz-Mrowiec, Dong Young Lee, Alberto Lleó, Pablo Martinez-Lage, Alexandre de Mendonça, Philipp T Meyer, Elisabeth N Kapaki, Piero Parchi, Matteo Pardini, Lucilla Parnetti, Julius Popp, Lorena Rami, Eric M Reiman, Juha O Rinne, Karen M Rodrigue, Pascual Sánchez-Juan, Isabel Santana, Marie Sarazin, Nikolaos Scarmeas, Ingmar Skoog, Peter J Snyder, Reisa A Sperling, Sylvia Villeneuve, Anders Wallin, Jens Wiltfang, Henrik Zetterberg, Rik Ossenkoppele, Frans R J Verhey, Stephanie J B Vos, Pieter Jelle Visser, Willemijn J Jansen, Daniel Alcolea, Daniele Altomare, Simone Baiardi, Ines Baldeiras, Randall J Bateman, Kaj Blennow, Michel Bottlaender, Anouk den Braber, Mark A van Buchem, Min Soo Byun, Jirí Cerman, Kewei Chen, Elena Chipi, Gregory S Day, Alexander Drzezga, Marie Eckerström, Laura L Ekblad, Stéphane Epelbaum, Stefan Förster, Juan Fortea, Yvonne Freund-Levi, Lars Frings, Eric Guedj, Lucrezia Hausner, Sabine Hellwig, Edward D Huey, Julio F Jiménez-Bonilla, Keith A Johnson, Ane Iriondo Juaristi, Ramesh Kandimalla, George Paraskevas, Silke Kern, Bjørn-Eivind S Kirsebom, Johannes Kornhuber, Julien Lagarde, Susan M Landau, Nienke Legdeur, Jorge J Llibre Guerra, Nancy N Maserejian, Marta Marquié, Shinobu Minatani, Silvia Daniela Morbelli, Barbara Mroczko, Eva Ntanasi, Catarina Resende de Oliveira, Pauline Olivieri, Adelina Orellana, Richard J Perrin, Oliver Peters, Sudesh Prabhakar, Inez H Ramakers, Eloy Rodríguez-Rodriguez, Agustín Ruiz, Eckart Rüther, Per Selnes, Dina Silva, Hilkka Soininen, Luiza Spiru, Akitoshi Takeda, Marc Teichmann, Betty M Tijms, Charlotte E Teunissen, Loisa I Thompson, Jonathan Vogelgsangs, Jonathan Vöglein, Gunhild Waldemar, Åsa K Wallin, Mary Yannakoulia, Dahyun Yi, Anna Zettergren","doi":"10.1001/jamapsychiatry.2024.4305","DOIUrl":"10.1001/jamapsychiatry.2024.4305","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the association between depressive symptoms and amyloid pathology and its dependency on age, sex, education, and APOE genotype in older individuals without dementia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;Cross-sectional analyses were performed using data from the Amyloid Biomarker Study data pooling initiative. Data from 49 research, population-based, and memory clinic studies were pooled and harmonized. The Amyloid Biomarker Study has been collecting data since 2012 and data collection is ongoing. At the time of analysis, 95 centers were included in the Amyloid Biomarker Study. The study included 9746 individuals with normal cognition (NC) and 3023 participants with mild cognitive impairment (MCI) aged between 34 and 100 years for whom data on amyloid biomarkers, presence of depressive symptoms, and age were available. Data were analyzed from December 2022 to February 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Amyloid-β1-42 levels in cerebrospinal fluid or amyloid positron emission tomography scans were used to determine presence or absence of amyloid pathology. Presence of depressive symptoms was determined on the basis of validated depression rating scale scores, evidence of a current clinical diagnosis of depression, or self-reported depressive symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In individuals with NC (mean [SD] age, 68.6 [8.9] years; 5664 [58.2%] female; 3002 [34.0%] APOE ε4 carriers; 937 [9.6%] had depressive symptoms; 2648 [27.2%] had amyloid pathology), the presence of depressive symptoms was not associated with amyloid pathology (odds ratio [OR], 1.13; 95% CI, 0.90-1.40; P = .29). In individuals with MCI (mean [SD] age, 70.2 [8.7] years; 1481 [49.0%] female; 1046 [44.8%] APOE ε4 carriers; 824 [27.3%] had depressive symptoms; 1668 [55.8%] had amyloid pathology), the presence of depressive symptoms was associated with a lower likelihood of amyloid pathology (OR, 0.73; 95% CI 0.61-0.89; P = .001). When considering subgroup effects, in individuals with NC, the presence of depressive symptoms was associated with a higher frequency of amyloid pathology in APOE ε4 noncarriers (mean difference, 5.0%; 95% CI 1.0-9.0; P = .02) but not in APOE ε4 carriers. This was not the case in individuals with MCI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Depressive symptoms were not consistently associated with a higher frequency of amyloid pathology in participants with NC and were associated with a lower likelihood of amyloid pathology in participants with MCI. These findings were not influenced by age, sex, or education level. Mechanisms other than amyloid accumula","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"296-310"},"PeriodicalIF":22.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Physician Suicide Compared to the General Population.","authors":"Elena Frank, Srijan Sen, Constance Guille","doi":"10.1001/jamapsychiatry.2024.4786","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.4786","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Incidence of Physician Suicide and Associated Features.","authors":"Hirsh Makhija, Judy E Davidson, Kelly C Lee, Arianna Barnes, Amanda Choflet, Sidney Zisook","doi":"10.1001/jamapsychiatry.2024.4816","DOIUrl":"10.1001/jamapsychiatry.2024.4816","url":null,"abstract":"<p><strong>Importance: </strong>Previous reports regarding comparative suicide incidence among US physicians vs nonphysicians have been inconclusive.</p><p><strong>Objective: </strong>To estimate the national incidence of male and female physician suicide and analyze associated factors, comparing findings to the general population.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study investigated suicides among physicians and nonphysicians aged 25 years and older in the US from January 2017 to December 2021. The analysis took place from November 2023 to September 2024. National Violent Death Reporting System data from 30 US states and Washington, DC, were used. Decedents with missing age or sex were excluded for incidence, and missing race, ethnicity, or marital status for further analyses.</p><p><strong>Exposure: </strong>Physician occupation.</p><p><strong>Main outcome and measures: </strong>Suicide incidence rate ratios (IRRs) and odds ratios (aORs) adjusted by age, sex, race, ethnicity, and marital status were used to compare preceding circumstances, primary method, and substances.</p><p><strong>Results: </strong>A total of 448 physician (354 [79%] male and 94 [21%] female; mean [SD] age, 60 [16] years) and 97 467 general population (76 697 [79%] male and 20 770 [21%] female; mean [SD] age, 51 [17] years) suicides were identified. Female physicians had higher rates of suicide than female nonphysicians in 2017 (IRR, 1.88; 95% CI, 1.19-2.83) and 2019 (IRR, 1.75; 95% CI, 1.09-2.65), with overall higher 2017 to 2021 suicide risk (IRR, 1.53; 95% CI, 1.23-1.87). Male physicians had lower 2017 to 2021 suicide risk than male nonphysicians (IRR, 0.84; 95% CI, 0.75-0.93). Compared to the general population and including all available jurisdiction data, physicians had higher odds of depressed mood (aOR, 1.35; 95% CI, 1.14-1.61; P < .001) as well as mental health (aOR, 1.66; 95% CI, 1.39-1.97; P < .001), job (aOR, 2.66; 95% CI, 2.11-3.35; P < .001), and legal (aOR, 1.40, 95% CI, 1.06-1.84; P = .02) problems preceding suicide as well as use of poisoning (aOR, 1.85; 95% CI, 1.50-2.30; P < .001) and sharp instruments (aOR, 4.58; 95% CI, 3.47-6.06; P < .001). Physicians also had higher odds of positive toxicology for caffeine; poison; cardiovascular agents; benzodiazepines; anxiolytics, nonbenzodiazepines, or hypnotics; and drugs not prescribed for home use.</p><p><strong>Conclusion and relevance: </strong>These findings show a higher incidence of suicide for US female physicians compared to female nonphysicians. Comprehensive and multimodal suicide prevention strategies remain warranted.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}