- Female physicians in the U.S. had higher suicide rates compared with women in the general population.
- Male physicians had lower suicide rates than their non-physician counterparts.
- Physicians who died by suicide had more depression, work stress, and legal problems than non-physicians.
Female physicians in the U.S. had a higher incidence of suicide compared with non-physician women, while the opposite trend was observed among male physicians, retrospective data showed.
From 2017 to 2021, female physicians had a 53% higher rate of suicide than women in the general population (incidence rate ratio [IRR] 1.53, 95% CI 1.23-1.87), reported Sidney Zisook, MD, of the University of California San Diego (UCSD) School of Medicine in La Jolla, and co-authors.
Male physicians, however, had lower suicide rates compared with other men (IRR 0.84, 95% CI 0.75-0.93), the researchers said in JAMA Psychiatry.
Female physicians had notably higher suicide rates than their non-physician counterparts in both 2017 (IRR 1.88, 95% CI 1.19-2.83) and 2019 (IRR 1.75, 95% CI 1.09-2.65).
Preceding suicide, physicians had higher odds of depressed mood compared with non-physicians (adjusted OR 1.35, 95% CI 1.14-1.61, P<0.001), along with higher mental health (adjusted OR 1.66, 95% CI 1.39-1.97, P<0.001), job (adjusted OR 2.66, 95% CI 2.11-3.35, P<0.001), and legal (adjusted OR 1.40, 95% CI 1.06-1.84, P=0.02) problems.
The results were not surprising, the researchers said. Several studies comparing the incidence of suicide among physicians and non-physicians have been inconclusive, but other research has suggested suicide rates may be higher among female physicians, they noted.
“That physicians who die by suicide have more depressed mood, work stress, and legal problems than non-physicians provides unique opportunities for targeted suicide prevention strategies,” Zisook noted in an email to MedPage Today.
The study calls for increased suicide prevention efforts “specific to the healthcare space, where seeking care can be stigmatized or have perceived negative effects on licensure,” said co-author Hirsh Makhija, MS, also of UCSD.
This includes an increase in proactive and anonymous screening coupled with targeted treatment across all levels of training for physicians, Makhija pointed out.
“Work to increase physician wellness needs to be done at multiple levels — policy, institutions, society, leadership, relationships, and individual,” Makhija added. “We need to connect mental health resources to those who need them but are discouraged due to multiple roadblocks, including stigma.”
The findings also underscore the need to focus on factors that disproportionately affect women, observed Constance Guille, MD, of the Medical University of South Carolina in Charleston, and co-authors, in an accompanying editorial.
“Taken together with comparable data on female nurses and suicide risk, these findings suggest that there is something fundamentally different about the experience of female physicians in healthcare that disproportionately increases suicide risk compared to other work environments,” Guille and colleagues wrote.
“As women now represent the majority of medical school graduates and a growing proportion of the physician work force, the institution of medicine must recognize the unique combination of stressors that female physicians face and endeavor to make real change moving forward,” they emphasized.
“Strategic action to address the long-standing systemic gender inequities in medicine is critical to improving workplace conditions — for the benefit of all physicians and the communities they serve.”
Zisook and colleagues evaluated suicide deaths among 448 U.S. physicians and 97,467 non-physicians ages 25 years and older from January 2017 to December 2021, using data from the National Violent Death Reporting System (NVDRS) for 30 states and Washington, D.C.
Physicians had a mean age of 60, while non-physicians had a mean age of 51. In both groups, 79% were men.
Compared with non-physician suicides, physician suicides were more likely to involve poisoning (adjusted OR 1.85, 95% CI 1.50-2.30, P<0.001) or sharp instruments (adjusted OR 4.58, 95% CI 3.47-6.06, P<0.001). Physicians also had higher odds of positive toxicology for caffeine, poison, cardiovascular agents, benzodiazepines, anxiolytics, hypnotics, and drugs not prescribed for home use.
Both male and female physicians had a higher suicide incidence per 100,000 person-years before versus after the COVID-19 pandemic (men 27.71 vs 24.43; women 13.74 vs 9.87).
“Following publicly reported physician deaths during 2020 and 2021, societal pressure led to the development of the Lorna Breen Act and the Lorna Breen Foundation where, despite the absence of available U.S. data, change was stimulated through the emotional testimonies of personal tragedy,” Zisook and co-authors noted.
The U.S. Surgeon General, American Hospital Association, and CDC also have called for workplace changes to address suicide risk, they added.
The analysis was limited to retrospective data from available jurisdictions in the NVDRS and each may differ in protocol, the researchers acknowledged. Suicides in the NVDRS may be underreported.
If you or someone you know is considering suicide, call or text 988 or go to the 988 Suicide and Crisis Lifeline website.
Disclosures
The researchers reported no targeted funding.
Zisook reported grants from Compass Pathways outside the submitted work. One co-author reported a relationship with Biogen. No other disclosures were reported.
The editorialists reported no disclosures.
Primary Source
JAMA Psychiatry
Source Reference: Makhija H, et al “National incidence of physician suicide and associated features” JAMA Psychiatry 2025: DOI: 10.1001/jamapsychiatry.2024.4816.
Secondary Source
JAMA Psychiatry
Source Reference: Frank E, et al “Female physician suicide compared to the general population” JAMA Psychiatry 2025; DOI: 10.1001/jamapsychiatry.2024.4746.
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