Risk factors for suicide among Thai physicians.

To investigate the risk factors for suicide in Thai physicians. The study focused on 18 doctors who had committed suicide before January 2002, identified by death certificates and the reported data from Thai Medical Council. Consensus case reports were assembled by using the psychological autopsy method. Study methods included semi-structured and in-depth interviews of next of kin and interviews of classmates, colleagues and medical or mental health services workers who had treated the suicide victims. The sample consisted of 18 subjects (17 males, one female). The age range was 30-49 years old. Most victims were specialists (11 out of 18; 3 gynecologists, 2 psychiatrists, 2 pediatricians, 2 surgeons and 1 internist, 1 radiologist). The methods of suicide were 6 hanging, 5 gun shots, 5 intravenous injections, 1 jumping and 1 drug over-dose. Psychiatric disorders were found in 11 out of 18 cases, and depressive disorder was the most common disorder. Interpersonal conflict and/or loss were the most common factors leading to suicide (6 out of 18), the second factor was psychiatric illness and the third factor was work problems. In assessing suicidal risk, a history of interpersonal conflicts and loss and the presence of co-morbid psychiatric disorders are particularly important. The important strategies for suicide prevention in Thai physicians are early detection and proper management of psychiatric illness especially depressive disorder and recognition the significance of family support.