Doctors Must Look After Their Health Too - British Medical Journal
Main Category: Primary Care / General PracticeAlso Included In: Depression; Psychology / Psychiatry
Article Date: 13 Nov 2008 - 4:00 PDT
Short term counselling followed by a modest cut in work hours may help reduce emotional exhaustion (burnout) and sick leave in doctors, according to a study published on bmj.com today.
It is well known that doctors have higher rates of depression and suicide than the general population and are less likely to seek help. There have been calls for early intervention programmes to help doctors with mental distress and burnout before their problems interfere with the welfare of patients.
Although such programmes have been shown to reduce stress and exhaustion, it is not clear what type of intervention is best suited to which individual or personal characteristics, or which factors contribute to positive changes.
Dr Karin Rø and colleagues from Norway examined levels of burnout and predictors of reduction in emotional exhaustion after one year, in 227 stressed doctors who participated in voluntary counselling.
Initially, 187 doctors attended a one day individual session, and 40 a one week group based course. Of the 185 doctors who completed follow-up assessments, 70 returned for an additional intervention during the follow-up year, 51 to a one week course and 19 to an individual session.
They completed self report assessments in the four weeks before and the three weeks after the counselling, and a follow-up questionnaire after one year. The data was compared with data obtained from a representative sample of Norwegian doctors in 2003.
One year after a counselling intervention stressed doctors reported a reduction in emotional exhaustion and job stress similar to the level found in a representative sample of Norwegian doctors.
The researchers also found that the number of doctors on full time sick leave had reduced substantially in the year after counselling (35% to 6%), and that the use of psychotherapy also substantially increased from 20% to 53% in the follow-up year.
Interestingly, they found that reduction in work hours after the intervention was also associated with a reduction in emotional exhaustion.
"Our findings indicate that seeking a counselling intervention could be conducive to reduction of burnout among doctors. Considering doctors' reluctance to seek help…it is important to offer interventions that facilitate access", conclude the authors.
"Research paper: Counselling for burnout in Norwegian doctors: one year cohort study."
Karin E Isaksson Rø, Tore Gude, Reidar Tyssen, Olaf G Aasland
BMJ 2008;337:a2004
Click here to view abstract online
British Medical Journal
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Acomplia
posted by lee nel on 10 Dec 2008 at 12:50 amI am a 59 year old female who was diagnosed with an underactive thyroid later than most. I had an unhelpful G.P. at the time who said it's harder to lose weight when you're older. End Of.
Another doctor finally got it right but I was already a size 20 from a 14 so the Thyroxine wasn't a lot of help.
As I asked to be put onto the obesity clinic list at the ROYAL LONDON HOSPITAL, WHITECHAPEL which is my local hospital they obviously thought I was showing willing. One of the doctors at that clinic put me on to Acomplia with no warnings of side effects but I did read the paperwork that comes with it. It did warn of problems for people with psychiatric problems but as I've never had any it shouldn't have been an issue.
The first few days I was permanently dizzy and gave up driving lessons as the dizziness carried on at odd times. For months after I was fine except for the whoozy feeling. One day I was having a normal row with my husband and against all my normal behaviour I took a load of pain killers. I did stop and realised what I was doing but still ended up at the hospital. As I'm normally level headed it wasn't even reported to my G.P. Life went on until the end of November this year when, because of other health problems, I didn't get to renew my prescription. I put in for it but because it was a weekend I wouldn't get them for 5 days. This started the COLD TURKEY 2 days.
The first day without the pill I just felt ill. Tired, dizzy, listless and generally couldn't care less. I tried to look on the internet for any information concerning stopping taking these pills but found nothing.
By the next day I had stopped washing, was sleeping in my clothes 19 hours on and off. Uncontrollable crying and screaming abuse at my husband. I stopped eating and taking all of my medication of which there is quite a lot. I told my husband that as he didn't give a damn I wasn't going to eat or drink until I died, simple as that, I said. I was totally manic most of the time while sleeping the rest and having an odd sip of water. In my head I knew what was happenening and tried to stop but the behaviour had a life of it's own. After approx 48 hours I calmed down enough to go to my husband and ask for help as well as apologise. Luckily enough he realised it was the pills but of course as luck would have it it had to be a weekend so no G.P's.
I saw my doctor on the Monday who took the pills off of my list and won't give it to anyone else but let's not forget that they were prescribed by a doctor at the obesity clinic at the hospital. I have a friend who is a psychiatric nurse and she says that she has heard similar horror stories.
I hope this has been of some help to you. If you need to ask any questions please do get in touch. I'm fine now by the way. Losing weight but with more of an effort and awaiting a gastric bypass ( I hope ).
Yours.. Lee Nel.
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