chuka_lis (chuka_lis) wrote,
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chuka_lis

Риск психических расстройств у психиатров и психологов

Есть ли данные о том, что среди психиатров, психотерапевтов  и психологов людей с  "психическими отклонениями от нормы" больше, чем  в среднем по популяции?
Представляют ли эти профессии больший риск?
Да, эта профессия добавляет рисков - если судить по частоте заболеваемости "душевными расстройствами".
ВОЗ оценивает, что в среднем в мире каждый четвертый человек страдает или страдал "душевным (психическим) расстройством" http://www.who.int/whr/2001/media_centre/press_release/en/
"One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide."
и к докторам за лечением ображается меньшинство:
"Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. Stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders, says the World Health Organization (WHO)".

Впрочем, вообще, быть врачом - это тоже риск для появления "психического  расстройства" - среди докторов, и в частности, психиатров, доля людей с душевными расстройствами- выше, чем в среднем в популяции:[Spoiler (click to open)]

1 Research suggests that doctors have higher rates of mental disorder than the general population.
2-4 Up to 7% of doctors have a substance abuse problem during their lifetime.
5 Suicide rates are also high, particularly among female doctors, anaesthetists, General Practitioners and psychiatrists.
6 Among the risk factors and sources of stress that lead to mental health problems are: work pressure, high demand and low control work environment, poor relationship with colleagues and service pressures.
According to the General Medical Council, psychiatrists have one of the highest rates of psychiatric morbidity among hospital doctors which is not adequately recognized or managed and British Medical Association estimated that 1 in 15 doctors at some point in their lives will have problems with alcohol or drugs.
7 As mental illnesses carry a huge burden of stigma, the psychiatrists who suffer from it cannot escape the consequences of its devastating effects.
8 Stresses play a big role in the life of medical doctors which leads to mental health morbidity. Considerable number of psychiatrists however would treat themselves for depression according to a study.
9 Depression and suicide rates among psychiatrists have been reported as one of the highest among physicians. Self treatment is because of the reasons of stigma, permanent insurance record, fear of dismissal from a training programme, loss of hospital privileges, fear of losing referrals, looked down upon by peers and problems of ego/self-esteem.However, the issue of mental illness among the psychiatrists is a pertinent one as they are responsible for addressing mental health issues of the patients approaching them for treatment.
http://www.jpma.org.pk/PdfDownload/1703.pdf
 так же об этом здесь:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1704352/pdf/canmedaj01451-0033.pdf
 В группу риска получить депресиию итд,  будущие врачи вступают со студенческой скамьи и интернатуры (резидентуры)- во всяком случае, в США.
Среди студентов-медиков и врачей-резидентов, уровни диагностированной депрессии -15-20%- выше, чем   среди популяции в целом (10%),  с прогрессом- начиная с первых лет обучения
 Да, к тому же у врачей риск суицида выше:
"An analysis of 14 international studies conducted from 1963 to 1991, for instance, found that men in medicine had a risk of suicide 1.1 to 3.4 times as great as that of the general population. Among women, the risk was 2.5 to 5.7 times as high."
И, конечно, психиатрия не исключение - риск  самоубийств среди психиатров самый высокий среди врачей.
Далее, если обратитсья к наиболее часто встречающемуся душевному расстройству, депрессии, есть данные по исследованиям в среде психологов, что:
one study, 61% of their sample of psychologists had experienced at least one episode of clinical depression. Of the 84% who had received therapy treatment, 29% had reported suicidal feelings and 4% had made at least one suicide attempt.

Конечно, психиатры,  это чуть другое, чем психологи,
однако риски у них похожие, и шансы, что-то эдакое "заиметь"- тоже похожие:
"study stated that 73% of psychiatrists reported experiencing moderate to incapacitating anxiety during their early years of professional practice, and 58% indicated that they had suffered moderate to incapacitating depression."
https://www.ncbi.nlm.nih.gov/pubmed/7352561
У существенной доли психиатров, как минимум, присуствует ряд симптомов психических расстройств (хотя это и не назовешь заболеванием, и выборка, может быть, не идеально репрезентативная)

"Among Israeli psychiatrists, 89% self-reported DSM-IV symptoms, albeit on a low level of severity. Approximately 75% acknowledged both Axis I and Axis II symptoms. Among Israeli psychologists and social workers, 81.2% perceived themselves as having some psychiatric symptoms, usually of minimal severity. 70% reported both Axis I and Axis II symptoms. "
https://www.ncbi.nlm.nih.gov/pubmed/15754523


При этом, сами психологи (да и вообще врачи) не часто обращаются за помощью к коллегам, на то есть свои причины.
http://www.apa.org/pubs/journals/features/pro-a0031182.pdf
Немного о причинах:

1) Many doctors fail to seek treatment for psychiatric conditions out of fear that doing so will damage their careers. And those who do get treatment can suffer very real professional penalties.
2) Even when doctors do realize that they are ill, Dr. Hendin and others said, they find themselves trapped in a professional culture that discourages them from discussing their illness openly.
3) Medical training puts a premium on physical stamina and emotional resilience. Young doctors are taught to set aside delicate sensibilities, to accustom themselves to illness and death, to put the needs of their patients before their own.
4) Physicians are unbelievably busy,... They're very blind to seeing stress in their colleagues.
5)Treating a colleague is a delicate business, and sometimes patients' professional credentials can work against them. ''http://www.nytimes.com/2003/07/08/health/doctors-toughest-diagnosis-own-mental-health.html
 Может ли отражаться "душевное состояние" или здоровье доктора (и в частности психиатра) на его пациентах?
Наверное, может, во всяком случае,
"only 40 percent of Americans in treatment for depression received adequate care. Other studies have found that doctors fail to identify depression in their patients 40 to 60 percent of the time."
- не сильно впечатляет такая успешность диагностики и лечения депрессии.
Да,  и не только диагностирования и лечения депрессии это касается- в исследованиях обнаружено, что врачи с депрессией совершают врачебные ошибки в 6.2 раза чаще (Depression and suicide among physicians Current Psychiatry. 2011 April;10(4):16-30 Author(s):Robert P. Bright, MD).

Tags: здоровье, психиатрия
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