Suicide among physicians in the state of Sao Paulo, Brazil, across one decade

Objective: To describe mortality by suicide among physicians in the state of sao Paulo, Brazil, between 2000 and 2009. Methods: Secondary analysis of government mortality data. The variable of interest was "underlying cause of death", specifically deaths classified by the ICD-10 as intentional self-harm (X60 to X84). Results: The analyses examined 2,297 declarations of death, among which suicide accounted for 50 cases, i.e., 1.7% of all causes of death. Women comprised 13.2% of the total sample and represented 24% of the death-by-suicide group, indicating an overrepresentation of women in the latter (p = 0.02). Deaths by suicide occurred on average 20 years earlier than deaths by other causes (46.8 +/- 14.2 years and 68.1 +/- 15.8 years, respectively; p = 0.001). There was a significant association between single and/or divorced status and suicide (p < 0.001). The average mortality rate during the study period was 4.2 deaths per 100,000 physicians registered with the Regional Board of Medicine of the State of Sao Paulo. Conclusion: Deaths by suicide occurred 20 years earlier than deaths by other causes. Medical institutions should develop strategies for the prevention and early detection of mental disorders and occupational stressors that elevate the risk of suicide among physicians.