Psychiatric Illness in the Medical Profession

Abstract

This paper reports the findings of a study of 192 medically qualified patients seen during the ten-year period 1 January 1954 to 1 January 1964. Of these, 78 were seen as out-patients and 114 were admitted for in-patient treatment. They were reviewed in terms of personal information, psychiatric history, outcome, and the patient's attitudes to his illness and its relation to his profession. The main findings of this study were: 1. Psychiatrists were over-represented in the out-patient group. 2. There was a significantly lower incidence of psychoneurosis in the total sample than in the total non-medical control sample. 3. There was a significantly higher incidence of drug addiction. 32.8 per cent. of the patients in this sample were addicted to alcohol or other drugs. The late onset of addiction was a notable feature in many of those addicted to drugs. 4. There was no significant difference between the incidence of schizophrenia, affective psychoses, or the other diagnostic categories in our sample and in the non-medical control group. 5. 78 per cent. of these patients broke down within twenty years of qualification, and approximately 40 per cent. within the first ten years. Reasons for these findings are discussed. Also discussed are the stress factors, the high incidence of suicide in the profession, the difficulties of treatment, and the question of competence to practise. Recommendations are made regarding improved selection and training of doctors, and the treatment and management of the psychiatrically ill doctor.