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Depression, But Not Burnout, Linked With Suicidal Ideation in Physicians

January 05, 2021

Depression, but not burnout, is directly linked with suicidal ideation in physicians, according to a study published online in JAMA Network Open.

“The findings of this study suggest that burnout without depression does not increase suicide risk and can therefore be safely addressed outside of mental health care,” researchers wrote.

The cross-sectional investigation included 1354 physicians in the United States. Among them, 67.4% were non-primary care physicians, 69% were attending physicians, and 60.9% were younger than 45 years. 

Initially, the study found 85% increased odds of suicidal ideation with each standard deviation-unit increase in burnout. However, after adjusting for depression, the association disappeared. Instead, adjusted models showed 202% increased odds of suicidal ideation with each standard deviation-unit increase in depression.

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“Previously observed associations between burnout and suicidal ideation may have resulted from failure to adjust for depression or from adjustment for depression using a screening instrument (ie, the PRIME-MD) that does not optimally capture symptom severity or specificity,” researchers wrote.

“The absence of a direct association of burnout with suicidal ideation is also consistent with the World Health Organization’s definitions of these constructs: burnout is an occupational distress syndrome rather than a clinical psychiatric diagnosis indicating distress in multiple life domains.”

The study did find that burnout was associated with increased odds of self-reported medical errors; depression, on the other hand, was not.

“Future investigation might examine whether burnout represents an upstream intervention target to prevent suicidal ideation by preventing depression,” researchers advised.

—Jolynn Tumolo


Menon NK, Shanafelt TD, Sinsky CA, et al. Association of physician burnout with suicidal ideation and medical errors. JAMA Network Open. 2020;3(12):e2028780.

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