From the FDA Drug Label
In pooled analyses of placebo-controlled trials of antidepressant drugs (SSRIs and other antidepressant classes) that included approximately 77,000 adult patients and over 4,400 pediatric patients, the incidence of suicidal thoughts and behaviors in pediatric and young adult patients was greater in antidepressant-treated patients than in placebo-treated patients.
The FDA drug label does not answer the question about risk factors for suicide among medical residents or colleagues. The provided text discusses the risk of suicidal thoughts and behaviors in pediatric and young adult patients treated with antidepressants, but it does not specifically address medical residents or colleagues. 1
From the Research
Medical residents and physicians face several key suicide risk factors, including burnout, depression, substance abuse, work-related stress, sleep deprivation, and limited access to mental health care, and effective interventions should prioritize prevention and crisis response, as supported by the most recent study 2. The risk factors for suicide among medical residents and colleagues are multifaceted and include:
- Burnout and depression, which can be exacerbated by work-related stress and sleep deprivation 3
- Substance abuse, which can be a coping mechanism for underlying mental health issues 4
- Limited access to mental health care, which can be due to stigma or lack of resources 5
- Gender differences, with high-risk female trainees and physicians more likely to endorse feeling worried, irritable, and stressed, while high-risk male trainees and physicians are more likely to endorse suicidal thoughts and intense anger 4 Effective interventions should focus on both prevention and crisis response, and may include:
- Implementing wellness programs and reducing work hours to mitigate burnout and stress
- Providing confidential mental health services and creating supportive environments where seeking help is normalized
- Screening for depression and suicidal ideation, with clear pathways to immediate care for those at risk
- Offering cognitive behavioral therapy and other evidence-based treatments, along with peer support programs that connect struggling residents with colleagues who understand their unique challenges
- Developing crisis response protocols that include immediate access to psychiatric evaluation, potential medical leave without career penalties, and careful monitoring during the recovery period
- Considering medication options, such as SSRIs, for underlying depression, though treatment must be individualized and based on the most recent evidence 2, 6 The medical culture needs fundamental change to reduce stigma around mental health issues and create sustainable work environments that don't sacrifice physician wellbeing for productivity, and early intervention is critical, as many physicians who die by suicide show warning signs but don't receive adequate support due to fears about professional consequences.