Depression, burnout and suicidal ideation among Swedish and Italian physicians

1
Depression, burnout and suicidal ideation among
Swedish and Italian physicians
Ann Fridner, PhD and Massimo Marini, MSc
Karolinska Institute, Sweden University of
Padua, Italy
2
The HOUPE study

• Health and Organisation among University
  Hospital Physicians in four European countries
  Sweden, Norway, Iceland and Italy
• Help seeking behaviour - finding the balance

3
Swedish physicians
Italian physicians
N 841
N 372
Females 34.3
Females 45.8

Males 65,7
Males 54.2
4
Design

• Three levels of data collection
• A longitudinal study where individual physicians
  are answering validated scales
• (2005 and 2010)
• The actual university hospital register/statistics
  on sickness absence, pre-pensioning, work hours,
  salaries, turnover
• National frameworks medical and academic
  education, career paths, gender equality laws,
  rules for sick leave, parental leave, etc

5
Scales/questionnaires

• PCPQ - Physician Career Path Questionnaire
  (Fridner, 2004)
• GHQ -12 General Health Questionnaire (Goldberg
  and Williams, 1991)
• MOLBI - Mini Oldenburg Burnout Inventory
  (Demerouti et al., 2001, 2003)
• Professional Secrecy and Personal Support
  (Lövseth, 2002)
• Question About Suicidal Ideation and Attempted
  Suicide (Meehan et al., 1992)

6
QPS- Nordic (Lindström et al, 2000), selected
scales

• Role expectations
• Control at work
• Predictability at work
• Social interactions Leadership
• Organisational culture

7
Some results
8
How much of you work is taken up by

• Sweden Italy
• Patient care
• 54,2 61.2
• Research
• 10,9 13,8
• Administration
• 22,3 11,8
• Teaching
• 8,2 11,3

9
Health

• Sweden Italy
• GHQ 2.9 3.5 2.1 2.6
• Exhaustion ns
• Disengagement
• 11.1 2.4 10.6 2.7
• Suicidal ideation life time
• Yes 29.5 Yes 26.6

10
Suicide ideation last year among female physicians

• Swedish 13.7
• Degrading experiences/harassment (OR3.03,
  CI1.48-6.23)
• Work meeting to discuss stressful situations
  (OR0.36, CI0.19-0.69)
• Italian 14.3
• Work assignments without adequate resources
  (OR5.0, CI1.32-18.8)
• Work meeting to discuss stressful situations
  (OR0.21, CI0.05-0.86)
• Fridner,A., Marini, M., Belkic, K. et al
  (2008). Recent suicidal ideation among female
  university hospital physicians in Sweden and
  Italy (The HOUPE Study) Cross-sectional
  associations with work stressors. Gender
  Medicine. In press.

11
Help seeking behaviour

• Sweden Italy
• Yes 16.4 Yes 14.0

12
Predictors for help seeking behaviour in Italy

• Exhaustion (OR 1.2 , CI 1.04-1.4) scoring
  range 5-20
• Being single (OR 2.4 , CI 1.03-5.8)
• Being younger (OR 0.4 , CI 0.1-0.9)
• Holiday for stress (OR 1.9, CI 1.2-2.9)

13
Predictors for help seeking behaviour in Sweden

• Suicidal ideation life time (OR4.6 , CI
  3.03-7.04)
• Holiday for stress (OR 1.7 , CI 1.4-2.2)
• Self treatment (OR 1.9 , CI 1.2-3.0)
• Being younger (OR 0.57 , CI .37-.86)

14
A way to find a better balance

• We suggest that
• Older physicians who have searched out for
  help mentor younger physicians in this regard
• More attention to stress among Italian
  physicians and to Swedish physicians who self
  treat themselves