SUICIDES AMONG DOCTORS AND HEALTH CARE WORKERS: REVIEW OF LITERATURE

According to the World Health Organization, suicide (SU) accounts for almost 1.5% of all deaths worldwide, and it is one of the 20 main causes of death. Suicidal behavior varies markedly between sexes, age groups and occupational groups, which underlines its possible etiological heterogeneity. The aim of the study was to summarize information about prevalence, factors associated with the risk of SU among doctors and health care workers, as well as the ways to prevent their suicidal behavior. According to different reviews, the level of SU for doctors and health care workers is 1.5-4 times higher than for representatives of a number of other professions and the population at large. Moreover, this is typical for both women and men working in health care. The level of SU for health professionals with easy access to medicines is higher than among those who do not have such an opportunity. It is no coincidence that poisoning is one of the main methods of SU among health care workers. According to this indicator, this professional group is significantly different from the general population. The factors that contribute to SU among doctors and healthcare providers are stress at the workplace, depressive states and other mental disorders (MD), burnout syndrome (BS), low job satisfaction, anhedonia. The prerequisites for the development of depression can be traced from the time of study at university that is further facilitated by professional stresses such as long working hours, lack of sleep, demands for a high degree of professionalism and responsibility for patients, daily conflicts between ethical values and economic goals, as well as lawsuits about negligence (risks of medical errors). In recent decades, doctors' work with patients has become more difficult due to increased workload, administrative responsibilities and reduced autonomy. BS in doctors and healthcare providers depends on specialty (more often among neurologists (53-75%), surgeons (4647%), obstetrician-gynecologists (45%), sex (more often among female doctors - 50%), weekly workload (the higher, the more common BS is) and lack of respect from patients, administration and colleagues. Economic issues related to the cost of treatment, reduction of public image and uncertainty in the profession, responsibility for terminally ill patients, and strained interpersonal relationships with colleagues affect the perception of job satisfaction. Early detection and proper treatment of major depressive disorder (MD), BS, optimization of interpersonal relationships at work and recognition of the importance of family (immediate environment) support comprise the strategy for prevention of SU among doctors and health care workers. Conclusion. Suicidal behavior is considered a preventable cause of death. Timely psychological and medical treatment can contribute to its prevention. Colleagues' caution about a possible SU, socialization, behavioral, suggestive reflex therapy makes it possible to prevent implementation of suicidal intentions among doctors and health care workers. In Russia, the problem discussed in the review has not been studied much, although the factors contributing to SU are described in the literature. Therefore, there is every reason to talk about an extreme relevance of suicidal behavior and its prevention among members of the medical community of our country.