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Prevalence of trauma- and stress-related symptoms in psychiatrists and trainees following patient suicide in the United States

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Abstract

Purpose

Global studies show patient suicides among psychiatrists, including trainees, range from 33 to 80%. To our knowledge, there is no such data in the United States following a single study in 1988 regarding psychiatrists’ or resident trainees’ emotional response to patient suicide. The objective of our study was to assess the stress- and trauma-related symptoms following patient suicide in practicing psychiatrists and trainees.

Methods

Data were collected by sending an online version of the survey to randomly selected psychiatrists and residency programs throughout the United States. Program directors were requested to share the questionnaires with their residents and fellows in training. Participants’ stress was assessed by the impact of event scale–revised version (IES-R).

Results

Our study shows 324 (63.6%) of the participants experienced patient suicide, which included 292 psychiatrists (76.1%) and 31 trainees (27.2%). Among the respondents, 3.8% of the psychiatrists and 9.7% of the trainees had clinically significant stress- and trauma-related disorders.

Conclusion

The presence of higher levels of emotional exhaustion and depression than medical or surgical colleagues depicts the need for training programs, formal and informal support, workshops, or curricular changes to address this almost inevitable issue in a psychiatrist’s career.

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References

  1. Schwartz AC, Kaslow NJ, McDonald WM (2007) Encountering patient suicide: a requirement of the residency program curriculum. Acad Psychiatry 31:338–339

    Article  Google Scholar 

  2. Gibbons R, Brand F, Carbonnier A, Croft A, Lascelles K, Wolfart G et al (2019) Education and Training Effects of patient suicide on psychiatrists: survey of experiences and support required BJPsych. Bulletin 43:236–241

    Google Scholar 

  3. Landers A, O’brien S, Phelan D, (2010) Impact of patient suicide on consultant psychiatrists in Ireland. Psychiatrist 34:136–140

    Article  Google Scholar 

  4. Pilkinton P, Etkin M (2003) Encountering suicide: The experience of psychiatric residents. Acad Psychiatry 27:93–99

    Article  Google Scholar 

  5. Kozlowska K, Nunn K, Cousens P (F) Adverse experiences in psychiatric training, Part 2. Aust N Z J Psychiatr 31:641–652.

  6. Rothes A, Scheerder G, Van Audenhove C, Henriques MR (2013) Patient Suicide: The Experience of Flemish Psychiatrists. Suicide Life Threat Behav 43:379–394

    Article  Google Scholar 

  7. Centers for Disease Control and Prevention (2013) Ten leading causes of Death by Age Group, UnitedStates-2013. http://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2013-a.pdf. Accessed May 10, 2020

  8. Pajonk FG, Gruenberg KAS, Moecke H, Naber D (2002) Suicides and suicide attempts in emergency medicine. Crisis 23:68–73

    Article  Google Scholar 

  9. Joint Commission: Sentinel event alert: A follow-up report on preventing suicide: Focus on medical/surgical units and the emergency department (2010) The Joint Commission Sentinel event alert, 46. http://www.jointcommission.org/assets/1/18/SEA_46.pdf. Accessed May 10, 2020

  10. Chemtob CM, Hamanda R, Bauer G, Kinney B, Torigoe RY (1988) Patient’s suicides: frequency and impact on psychiatrists. Am J Psychiatry 145:224–228

    Article  CAS  Google Scholar 

  11. Courtenay KP, Stephens JP (2001) The experience of patient suicide among trainees in psychiatry. Psychiatr Bull 25:51–52

    Article  Google Scholar 

  12. Brown HN (1987) The impact of suicide on psychiatrists in training. Compr Psychiatry 28:101–112

    Article  CAS  Google Scholar 

  13. Ruskin R, Sakinofsky I, Bagby RM, Dickens S, Sousa G (2004) Impact of patient suicide on psychiatrists and psychiatric trainees. Acad Psychiatry 28:104–110

    Article  CAS  Google Scholar 

  14. Dewar I, Eagles JM, Klein S, Gray N, Alexander DA (1999) Psychiatric trainees’ experience of, and reactions to, patient suicide. Psychiatr Bull 24:20–23

    Article  Google Scholar 

  15. Tsai A, Moran S, Shoemaker R, Bradley J (2012) Patient suicides in psychiatric residencies and postvention responses: A national survey of psychiatry chief residents and program directors. Acad Psychiatry 36:34–38

    Article  Google Scholar 

  16. Kaye NS, Soreff S (1991) The psychiatrist’s role, responses, and responsibilities when a patient commits suicide. Am J Psychiatry 148:739–743

    Article  CAS  Google Scholar 

  17. Puttagunta R, Lomax ME, McGuinness JE, Coverdale J (2014) What is the Prevalence of the Experience of Death of a Patient by Suicide Among Medical Students and Residents? A Systematic Review. Acad Psychiatry 38:538–541

    Article  CAS  Google Scholar 

  18. Horowitz MJ, Wilner N, Alvarez W (1979) Impact of Events Scale: a measure of subjective stress. Psychosom Med 41:209–218

    Article  CAS  Google Scholar 

  19. Weiss DS, Marmar CR (1997) The Impact of Event Scale-Revised. In: Wilson JP, Keane TM (eds) Assessing Psychological Trauma and PTSD. Guilford, New York, pp 399–411

    Google Scholar 

  20. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders DSM-IV-TR ( Fourth ed.). Washington D.C.: American Psychiatric Association

  21. Yousaf F, Hawthorne M, Sedgwick P (2002) Impact of patient suicide on psychiatric trainees. Psychiatr Bull 26:53–55

    Article  Google Scholar 

  22. Pieters G, De Gucht V, Joos G, DeHeyn E (2003) Frequency and impact of patient suicide on psychiatric trainees. Eur Psychiatry 18:345–349

    Article  Google Scholar 

  23. Cryan EMJ, Kelly P, Mccaffrey B (1995) The experience of patient suicide among Irish psychiatrists. Psychiatr Bull 19:4–7

    Article  Google Scholar 

  24. Linke S, Wojciak J, Day S (2002) The impact of suicide on community mental health teams: findings and recommendations. Psychiatr Bull 26:50–52

    Article  Google Scholar 

  25. Hamaoka DA, Fullerton CS, Benedek DM, Gifford R, Nam T, Ursano RJ (2007) Medical students’ responses to an inpatient suicide: opportunities for education and support. Acad Psychiatry 31:350–353

    Article  Google Scholar 

  26. Barrett NA (1989) The medical student and therapists in training. In: Jacobs D, Brown HN (eds) Suicide; understanding and responding. International Universities Press, Madison, pp 415–434

    Google Scholar 

  27. Zilberg NJ, Weiss DS, Horowitz MJ (1982) Impact of Event Scale: A cross-validation study and some empirical evidence supporting a model of stress response syndrome. J Consult Clin Psychol 50:407–414

    Article  CAS  Google Scholar 

  28. Horowitz MJ, Weiss DS, Kaltreider N, Krupnick J, Marmar C, Wilner N, DeWitt K (1984) Reactions to the death of a parent. J NervMent Dis 172:383–392

    Article  CAS  Google Scholar 

  29. Brown HN (1986) Patient suicide during residency training: Incidence, implications, and program response. J Psychiatr Education 11:201–216

    Google Scholar 

  30. Melton BB, Coverdale JH (2009) What do we teach psychiatric residents about suicide? A national survey of chief residents. Acad Psychiatry 33:47–50

    Article  Google Scholar 

  31. Prabhakar D, Aniza JM, Balon R et al (2013) “Collateral damage”: preparing residents for coping with patient suicide. Acad Psychiatry 37:429–430

    Article  Google Scholar 

  32. Lerner U, Brooks K, Mc Neil DE, Cramer RJ, Haller E (2012) Coping with a patient’s suicide: a curriculum for psychiatry residency training programs. Acad Psychiatry 36:29–33

    Article  Google Scholar 

  33. Figueroa S, Dalack GW (2013) Exploring the impact of suicide on clinicians: a multidisciplinary retreat model. J PsychiatrPract 19:72–77

    Google Scholar 

  34. Hendin H, Lipschitz A, Maltsberger JT, Haas AP, Wynecoop S (2000) Therapists’ reactions to patients’ suicides. Am J Psychiatry 157:2002–2027

    Article  Google Scholar 

  35. Deary I, Agius R, Sadler A (1996) Personality and stress in consultant psychiatrists. Int J Soc Psychiatry 42:112–123

    Article  CAS  Google Scholar 

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Acknowledgements

The authors would like to acknowledge the assistance and support of Melissa Adams and Terryee Trout, who helped in edits and circulating the survey to other programs.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Medicine, Berkeley Medical Center, Martinsburg, WV, USA

    Rajdip Barman

  2. Professor and Program Director of Clinical Trials Research, Department of Psychiatry and Behavioral Medicine, Virginia Tech-Carilion School of Medicine, Roanoke, VA, USA

    Anita Kablinger

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  1. Rajdip Barman
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  2. Anita Kablinger
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Correspondence to Rajdip Barman.

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On behalf of the authors, the corresponding author states that there is no conflict of interest.

Ethics approval

Compliance with the ethical standards. The study was approved by IRB.

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Barman, R., Kablinger, A. Prevalence of trauma- and stress-related symptoms in psychiatrists and trainees following patient suicide in the United States . Soc Psychiatry Psychiatr Epidemiol 56, 1283–1288 (2021). https://doi.org/10.1007/s00127-020-02023-3

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  • DOI: https://doi.org/10.1007/s00127-020-02023-3

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