Physicians and Mental Illness

Welcome to Weekly Health Update




New research confirms that physicians frequently suffer from mental illness, and are more reluctant than non-physicians to seek help.



PHYSICIANS AND MENTAL ILLNESS

While physicians are less likely than the general population to die from heart disease or cancer, we doctors are significantly more likely to die from suicide than our lay brothers and sisters.  Indeed, a very troubling statistic is that suicide is the second most common cause of death among medical students (accidents are the number one cause of death).

Multiple studies have shown that physicians are at greater risk of developing significant mental health problems when compared to the general population, including depression and bipolar disorder.  Physicians also have higher rates of alcoholism, and other forms of substance abuse, when compared to the general public.  Although the potential reasons behind this higher incidence of mental illness among physicians continue to be debated, most experts agree that doctors with mental health problems are notoriously reluctant to seek help.  They often do not recognize that they are ill, in the first place; and when they do become aware that they are not well, they are less likely than non-physicians to seek professional help.  Moreover, there are still tremendous stigmas associated with mental illness among health care professionals, causing many impaired physicians to avoid reaching out for help.  As if these adverse factors that discourage physicians from seeking help are not already bad enough, most state medical boards require physicians to disclose whether or not they have ever been diagnosed or treated for a mental illness (or substance abuse) as a precondition for initial licensure or renewal of an existing medical license.  (In many cases, disclosing a prior or current history of mental illness, even if the physician is receiving appropriate treatment, can result in very negative professional and financial consequences for physicians who disclose their history of depression or other mental health problems.)

 

 

In view of these disturbing statistics regarding physicians and mental illness, I find the results of a newly published clinical research study to be quite revealing (and disturbing).  In this study, 108 physicians were asked to confidentially complete a 56-item questionnaire that assessed their distress levels and their willingness to accept various forms of assistance for their feelings of severe distress.  This study appears in the current issue of the Archives of Surgery.

Within the preceding year, fully 79 percent of the surveyed physicians had experienced either a serious adverse patient event or a traumatic personal event that left them feeling very distressed.

When asked about their willingness to seek support or assistance regarding stressful issues in their lives, 72 percent of the doctors indicated that they would be willing to seek help for legal problems, while 67 percent would do so after being involved in a serious medical error.  Another 67 percent of the physicians were willing to seek help for substance abuse issues, while 62 percent were open to seeking medical help for physical illness.  Tellingly, only half (50 percent) of the physicians indicated that they would seek help for mental illness, and an equally small number also indicated that they would be open to assistance regarding serious interpersonal conflicts at work.

When asked about barriers to seeking help, 89 percent of the doctors indicated that they did not have time to get help with the causes of their distress, while 69 percent also responded that they were either uncertain about how to get help or that they had experienced difficulty in obtaining assistance.  A total of 68 percent of the physicians also cited lack of confidentiality, a potentially negative impact on their career, and the stigma associated with seeking help as barriers.

Regarding the most likely sources of support that they would be willing to seek, 88 percent expressed a preference for their physician colleagues, while only 48 percent were willing to be seen by mental health professionals, and only 29 percent were open to participating in employee assistance programs.

 

 

The findings of this study are hardly surprising.   The prevalence of major distress and mental health issues among physicians continues to be very high, relative to the general population.  At the same time, only half of the physicians participating in this study indicated a willingness to seek help for mental health problems.  Similarly, only half of these doctors would be willing to seek help for serious interpersonal difficulties (a common marker for certain psychological and personality disorders) in the workplace.  Among the most often cited reasons for not seeking help were “lack of time” and uncertainty about how to obtain help.  Additionally, the physicians who participated in this confidential study expressed serious concerns regarding confidentiality, the potential for negative career impact, and the perceived stigma associated with asking for help for mental health issues.

 

 

From my own experience as a physician over the past 23 years, I can honestly say that these disturbing statistics and findings regarding physician stress, distress, and mental health problems are, if anything, most likely understated.  Within the medical profession, it is no secret that the true incidence of depression, bipolar disorder, personality disorders, interpersonal strife, marital duress, domestic abuse, and divorce is very high among physicians, in comparison to the general population.  Ironically, and unfortunately, however, as bad as the stigma associated with mental illness is in the general public, it is even more severe within the medical profession.

Over the years, I have known numerous physicians with various forms of mental illness and personality disorders, and I cannot recall a single one of them ever voluntarily reaching out to mental health professionals for help.  Sadly, in view of the strong aversion on the part of physicians with mental illness towards seeking help from mental health professionals,  proactive and progressive steps to eliminate the perceived stigma of mental health problems within the medical profession, as well as removing the potentially punitive sanctions that many physicians would otherwise be subjected to if they sought professional help, will be necessary before troubled or impaired physicians can begin to feel free to seek help and support for the problems that torment them.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-Million,Vroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (More than 1.2 million health-conscious people visited Weekly Health Update in 2010!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




Bookmark and Share



































Post to Twitter

Oxytocin Gene Variations May Determine Kindness

Welcome to Weekly Health Update



A new clinical study has found that our level of empathy and compassion may be determined by the oxytocin receptor gene, and that even strangers can detect which version of this gene we possess.



OXYTOCIN GENE VARIATIONS MAY DETERMINE KINDNESS

A fascinating new study reveals how profoundly our genetic make-up can influence not only our personality and behavior, but the perceptions that others (including strangers) may have of us, as well.  This new research study appears in the journal,Proceedings of the National Academy of Sciences.

Oxytocin is a hormone that appears to have a variety of functions in humans, particularly in pregnant women and new mothers.  Oxytocin plays very important roles in labor and, following delivery, in the stimulation of milk secretion from the breast in response to suckling.  However, the biological effects of oxytocin are not limited to pregnant women and new mothers.  Oxytocin is often referred to as the “love hormone,” as it is thought contribute to the feelings of contentment, happiness, and bonding that typically occur in the early stages of romantic relationships.  Oxytocin has also been, more generally, linked to feelings of empathy and sensitivity towards others, while syndromes associated with little or no oxytocin production in the brain have been, conversely, associated with narcissistic, manipulative, and even sociopathic behavior.

As with most genes in the body, the gene which produces the oxytocin receptor (which is necessary for oxytocin to exert its effects within the body) has multiple different natural forms.  Some forms of the oxytocin receptor gene have been shown to increase the positive effects of oxytocin, while other variants of the oxytocin receptor gene appear to decrease the favorable effects of oxytocin.  In this fascinating study, researchers first tested 46 research volunteers to determine which variant of the oxytocin receptor gene was present in their bodies.  Next, these 46 volunteers were grouped into 23 pairs, in which one volunteer was asked to tell the other volunteer about a stressful or otherwise difficult experience in their life.  (These discussion sessions were videotaped for the second part of this research study.)  Subsequently, volunteer observers, none of whom knew the oxytocin receptor gene status of the other 46 volunteers, were then asked to watch the videotaped discussions, and to rate the 46 other volunteers in terms of empathy and kindness.

The findings of this innovative clinical research study were striking.  In the vast majority of cases, the “observer volunteers” watching the videotaped discussions could accurately select out the “discussion volunteers” who had the “AA” variant (which is associated with decreased levels of empathy and compassion) and the “GG” variant of the oxytocin receptor (which is the variant that has been most closely associated with the “empathy and kindness” effects of oxytocin).  While nobody is suggesting that our genetic make-up completely dictates our personality or behavior, the findings of this intriguing clinical research study suggest that, at least in the case of the oxytocin reception gene, naturally-occurring variations in our genetic make-up may, indeed, have a potentially profound impact on personality and behavior.  Even more provocative is the finding that, in the case of the oxytocin gene receptor, even casual observers are able to select out other people who possess a specific genetic variant with a high degree of accuracy, simply by assessing their interactions with others.  Once again, it is important to note that having a single specific form of one or more genes does not entirely predict an individual’s personality or behavior.  However, in the case of the oxytocin receptor gene, it appears that even strangers can readily identify which among us has the more “pro-social” variant of this gene, simply by observing how we interact with other people!


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-Million,Vroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (More than 1.2 million health-conscious people visited Weekly Health Update in 2010!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


Bookmark and Share



































Post to Twitter

Dietary Fiber and Colon and Rectal Cancer Prevention

Welcome to Weekly Health Update

 


A large new meta-analysis study indicates that a diet rich in whole grain foods significantly decreases colorectal cancer risk



DIETARY FIBER AND COLON AND RECTAL CANCER PREVENTION

For many years, it was widely believed that a diet rich in fiber, and rich in fresh fruits and vegetables in particular, significantly reduced the risk of developing colorectal cancer.  However, more recent public health studies have called this assumption into question.  As I extensively discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, there is ample clinical evidence that a so-called Mediterranean diet, which does include large amounts of fresh fruits and vegetables (as well as foods rich in unprocessed whole grains), dramatically reduces the risk of colorectal cancer and other GI tract cancers.  Now, a landmark new meta-analysis research study provides important new evidence that certain high-fiber foods may, indeed, be associated with a significantly reduced risk of colorectal cancer.  This comprehensive research study appears in the current issue of the British Medical Journal.

In this huge meta-analysis, 25 prospectively conducted public health studies, including 14,500 study volunteers, were analyzed; and the findings of this large clinical study may explain why recent large public health studies have not been able to confirm that a diet rich in all types of fiber can reduce colorectal cancer risk.  In this meta-analysis study, dietary fiber from fruit and vegetable intake did not appear to significantly reduce the risk of developing colorectal cancer.  However, whole grain foods, including cereals rich in whole grains, did appear to significantly reduce colorectal cancer risk.  In fact, for each 10 grams of whole grain fiber consumed per day, colorectal cancer risk was reduced by a very significant 10 percent.  Among research volunteers who consumed at least three servings of whole grains each day, the risk of developing colorectal cancer was reduced by 17 percent.

The health implications of this meta-analysis study are highly significant.  First of all, the authors of this study included only prospectively conducted public health studies in their analysis, thus eliminating some of the major limitations associated with the more common retrospective “case control” studies that make up the majority of public health studies on diet and disease prevention.  (As I have often mentioned, retrospective case control and case series studies are very often flawed by “recall bias,” wherein the data that is collected is based purely upon the recollections of volunteers recruited into such studies.)  Secondly, the findings of this meta-analysis are supported by higher level research studies that have found that highly refined grains and cereals are stripped of important cancer-preventing nutrients and bulk fiber during processing.

While fresh fruits and vegetables (and brightly colored and dark green leafy vegetables in particular) have been shown by other studies to reduce overall cancer risk, this landmark meta-analysis study appears to reconcile the contradictory findings of previous cancer prevention studies regarding the impact of dietary fiber intake on, specifically, colorectal cancer risk.  Based upon the findings of this very important study, a diet rich in unprocessed, or minimally, processed, whole grain foods appears to significantly protect against colorectal cancer.  (For a much broader and deeper review of evidence-based approaches to cancer prevention, see my book, A Cancer Prevention Guide for the Human Race.)


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-Million,Vroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (More than 1.2 million health-conscious people visited Weekly Health Update in 2010!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


Bookmark and Share



































Post to Twitter

Enter Google AdSense Code Here

Comments

Better Tag Cloud