Suicide among physicians and health-care workers: A systematic review and meta-analysis

International audienceBackground : Medical-related professions are at high suicide risk. However, data are contradictory andcomparisons were not made between gender, occupation and specialties, epochs of times.Thus, we conducted a systematic review and meta-analysis on suicide risk among healthcare workers.Method : The PubMed, Cochrane Library, Science Direct and Embase databases were searchedwithout language restriction on April 2019, with the following keywords: suicide* AND(« health care worker* » OR physician* OR nurse*). When possible, we stratified results bygender, countries, time, and specialties. Estimates were pooled using random-effect metaanalysis. Differences by study-level characteristics were estimated using stratified metaanalysis and meta-regression. Suicides, suicidal attempts, and suicidal ideation wereretrieved from national or local specific registers or case records. In addition, suicideattempts and suicidal ideation were also retrieved from questionnaires (paper or internet).Results : The overall SMR for suicide in physicians was 1.44 (95CI 1.16, 1.72) with an important heterogeneity (I2 = 93.9%, p<0.001). Female were at higher risk (SMR = 1.9; 95CI 1.49, 2.58;and ES = 0.67; 95CI 0.19, 1.14; p<0.001 compared to male). US physicians were at higherrisk (ES = 1.34; 95CI 1.28, 1.55; p <0.001 vs Rest of the world). Suicide decreased overtime, especially in Europe (ES = -0.18; 95CI -0.37, -0.01; p = 0.044). Some specialties mightbe at higher risk such as anesthesiologists, psychiatrists, general practitioners and generalsurgeons. There were 1.0% (95CI 1.0, 2.0; p<0.001) of suicide attempts and 17% (95CI 12,21; p