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Lifetime Psychiatric and Substance Use Disorders Among Impaired Physicians in a Physicians Health Program: Comparison to a General Treatment PopulationPsychopathology of Impaired Physicians

Cottler, Linda B. PhD, MPH; Ajinkya, Shaun MPH; Merlo, Lisa J. PhD, MPE; Nixon, Sara Jo PhD; Ben Abdallah, Arbi PhD; Gold, Mark S. MD

doi: 10.1097/ADM.0b013e31827fadc9
Original Research
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Objectives: The prevalence of substance abuse and other psychiatric disorders among physicians is not well-established. We determined differences in lifetime substance use, and abuse/dependence as well as other psychiatric disorders, comparing physicians undergoing monitoring with a general population that had sought treatment for substance use.

Methods: Participants were 99 physicians referred to a Physician's Health Program (PHP) because of suspected impairment, who were administered the Computerized Diagnostic Interview Schedule Version IV (CDIS-IV) to assess the presence of psychiatric disorders. Referred physicians were compared with an age, gender, and education status-matched comparison group from National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave 1, in a 1:1 ratio.

Results: Although referred physicians did not differ from their counterparts on lifetime use of alcohol, opiates, or sedatives, they did have significantly higher conditional odds of meeting criteria for alcohol, opiate, and sedative The Diagnostic and Statistical Manual of Mental Disorders IV abuse/dependence disorders. Physicians referred to the PHP had significantly lower odds of obsessive-compulsive disorder, major depression, and specific phobia compared with their counterparts.

Conclusions: Physicians referred to a PHP have significantly higher odds of abuse/dependence disorders for cannabinoids and cocaine/crack compared with a matched general population sample that had ever sought treatment for substance use, even though physicians were less likely to report use of those substances. Although the rate of alcohol use was similar between the 2 populations, physicians had higher odds of abuse/dependence for opiates, sedatives, and alcohol. More research is needed to understand patterns of use, abuse/dependence, and psychiatric morbidity among physicians.

From the Dean's Professor and Chair, Department of Epidemiology (LBC), Colleges of Medicine and Public Health and Health Professions, University of Florida; Research Statistician (SA), Department of Epidemiology, Colleges of Medicine and Public Health and Health Professions, University of Florida; Assistant Professor, Department of Psychiatry (LJM), College of Medicine, University of Florida and Director of Research, Professionals Resource Network, Inc.; Professor and Chief of Addiction Research (SJN), Department of Psychiatry, College of Medicine, University of Florida; Research Assistant Professor, INQUIRI (ABA), Department of Anesthesiology, School of Medicine, Washington University in St. Louis; and Distinguished Professor, Alumni Distinguished Professor, Donald R. Dizney Eminent Scholar, Chair, Department of Psychiatry (MSG); Departments of Psychiatry, Neuroscience, Anesthesiology, Community Health and Family Medicine, College of Medicine and McKnight Brain Institute, University of Florida.

Send correspondence and reprint requests to Linda B. Cottler, PhD, MPH, Dean's Professor and Chair, Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 1225 Center Drive, PO Box 100231, Gainesville, Florida 32611.

Supported by NIDA (NIH): R01-DA020791-S2, and Professionals Resource Network, Inc. (an integral part of the Florida Medical Association).

The authors declare no conflicts of interest.

Received May 02, 2012

Accepted November 25, 2012

© 2013 American Society of Addiction Medicine