Abstract
Background : 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<0.001) of suicidal ideation in physicians. Insufficient data precluded meta-analysis onother health-care workers.Conclusion : Physicians are an at-risk profession of suicide, with women particularly at risk. The rate ofsuicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefitsfor preventive strategies at the workplace. Finally, the lack of data on other health-careworkers suggest to implement studies investigating those occupations.