Prevalence of Alcohol Use Disorders Among American Surgeons | Depressive Disorders | JAMA Surgery | JAMA Network
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1.
Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences.  Arch Surg. 2009;144(4):371-37619380652PubMedGoogle ScholarCrossref
2.
Balch CM, Shanafelt TD. Burnout among surgeons: whether specialty makes a difference.  Arch Surg. 2011;146(4):385-38621502446PubMedGoogle ScholarCrossref
3.
Balch CM, Shanafelt TD, Dyrbye L,  et al.  Surgeon distress as calibrated by hours worked and nights on call.  J Am Coll Surg. 2010;211(5):609-61920851643PubMedGoogle ScholarCrossref
4.
Balch CM, Shanafelt TD, Sloan J, Satele DV, Kuerer HM. Burnout and career satisfaction among surgical oncologists compared with other surgical specialties.  Ann Surg Oncol. 2011;18(1):16-2520953718PubMedGoogle ScholarCrossref
5.
Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Freischlag J. Physicians married or partnered to physicians: a comparative study in the American College of Surgeons.  J Am Coll Surg. 2010;211(5):663-67121035046PubMedGoogle ScholarCrossref
6.
Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Sloan J, Freischlag J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex.  Arch Surg. 2011;146(2):211-21721339435PubMedGoogle ScholarCrossref
7.
Shanafelt TD, Balch CM, Bechamps G,  et al.  Burnout and medical errors among American surgeons.  Ann Surg. 2010;251(6):995-100019934755PubMedGoogle ScholarCrossref
8.
Shanafelt TD, Balch CM, Bechamps GJ,  et al.  Burnout and career satisfaction among American surgeons.  Ann Surg. 2009;250(3):463-47119730177PubMedGoogle Scholar
9.
Substance Abuse and Mental Health Services Administration.  Results from the 2009 National Survey on Drug Use and Health, volume I: summary of national findings. SAMHSA Web site, Data, Outcomes, and Quality page. Rockville, MD: Office of Applied Studies; 2010. NSDUH Series H-38A, Health and Human Services publication SMA 10-4586. http://www.oas.samhsa.gov. Accessed May 1, 2011
10.
Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates.  Arch Gen Psychiatry. 2002;59(2):115-12311825131PubMedGoogle ScholarCrossref
11.
McAuliffe WE, Rohman M, Breer P, Wyshak G, Santangelo S, Magnuson E. Alcohol use and abuse in random samples of physicians and medical students.  Am J Public Health. 1991;81(2):177-1821990855PubMedGoogle ScholarCrossref
12.
Hughes PH, Brandenburg N, Baldwin DC Jr,  et al.  Prevalence of substance use among US physicians.  JAMA. 1992;267(17):2333-23391348789PubMedGoogle ScholarCrossref
13.
Niven RG, Hurt RD, Morse RM, Swenson WM. Alcoholism in physicians.  Mayo Clin Proc. 1984;59(1):12-166694426PubMedGoogle Scholar
14.
McAuliffe WE, Rohman M, Santangelo S,  et al.  Psychoactive drug use among practicing physicians and medical students.  N Engl J Med. 1986;315(13):805-8103748091PubMedGoogle ScholarCrossref
15.
Lutsky I, Hopwood M, Abram SE, Cerletty JM, Hoffman RG, Kampine JP. Use of psychoactive substances in three medical specialties: anaesthesia, medicine and surgery.  Can J Anaesth. 1994;41(7):561-5678087901PubMedGoogle ScholarCrossref
16.
Vaillant GE, Brighton JR, McArthur C. Physicians' use of mood-altering drugs: a 20-year follow-up report.  N Engl J Med. 1970;282(7):365-3705411130PubMedGoogle ScholarCrossref
17.
Hughes PH, Storr CL, Brandenburg NA, Baldwin DC Jr, Anthony JC, Sheehan DV. Physician substance use by medical specialty.  J Addict Dis. 1999;18(2):23-3710334373PubMedGoogle ScholarCrossref
18.
Maslach C, Jackson S, Leiter M. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996
19.
Rafferty JP, Lemkau JP, Purdy RR, Rudisill JR. Validity of the Maslach Burnout Inventory for family practice physicians.  J Clin Psychol. 1986;42(3):488-4923711351PubMedGoogle ScholarCrossref
20.
Lee RT, Ashforth BE. A meta-analytic examination of the correlates of the three dimensions of job burnout.  J Appl Psychol. 1996;81(2):123-1338603909PubMedGoogle ScholarCrossref
21.
Leiter M, Durup J. The discriminant validity of burnout and depression: a confirmatory factor analytic study.  Anxiety Stress Coping. 1994;7:357-373Google ScholarCrossref
22.
Ware J, Kosinski M, Turner-Bowker D, Gandek B, Keller SD. How to Score Version 2 of the SF-12 Health Survey. Lincoln, RI: Quality Metric Inc; 2002
23.
Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.  Med Care. 1996;34(3):220-2338628042PubMedGoogle ScholarCrossref
24.
Spitzer RL, Williams JB, Kroenke K,  et al.  Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 study.  JAMA. 1994;272(22):1749-17567966923PubMedGoogle ScholarCrossref
25.
Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression: two questions are as good as many.  J Gen Intern Med. 1997;12(7):439-4459229283PubMedGoogle ScholarCrossref
26.
Thomas NK. Resident burnout.  JAMA. 2004;292(23):2880-288915598920PubMedGoogle ScholarCrossref
27.
Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program.  Ann Intern Med. 2002;136(5):358-36711874308PubMedGoogle Scholar
28.
West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.  J Gen Intern Med. 2009;24(12):1318-132119802645PubMedGoogle ScholarCrossref
29.
Fiellin DA, Reid MC, O’Connor PG. Screening for alcohol problems in primary care: a systematic review.  Arch Intern Med. 2000;160(13):1977-198910888972PubMedGoogle ScholarCrossref
30.
Buchsbaum DG, Buchanan RG, Centor RM, Schnoll SH, Lawton MJ. Screening for alcohol abuse using CAGE scores and likelihood ratios.  Ann Intern Med. 1991;115(10):774-7771929025PubMedGoogle Scholar
31.
Isaacson JH, Butler R, Zacharek M, Tzelepis A. Screening with the Alcohol Use Disorders Identification Test (AUDIT) in an inner-city population.  J Gen Intern Med. 1994;9(10):550-5537823225PubMedGoogle ScholarCrossref
32.
Bradley KA, Bush KR, McDonell MB, Malone T, Fihn SD. Screening for problem drinking: comparison of CAGE and AUDIT: Ambulatory Care Quality Improvement Project (ACQUIP).  J Gen Intern Med. 1998;13(6):379-3889669567PubMedGoogle ScholarCrossref
33.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA.Ambulatory Care Quality Improvement Project (ACQUIP).  The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking.  Arch Intern Med. 1998;158(16):1789-17959738608PubMedGoogle ScholarCrossref
34.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons With Harmful Alcohol Consumption–II.  Addiction. 1993;88(6):791-8048329970PubMedGoogle ScholarCrossref
35.
Bradley KA, Boyd-Wickizer J, Powell SH, Burman ML. Alcohol screening questionnaires in women: a critical review.  JAMA. 1998;280(2):166-1719669791PubMedGoogle ScholarCrossref
36.
American Psychiatric Association.  Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text revision. Washington, DC: American Psychiatric Association; 2000
37.
Sloan JA, Cella D, Hays RD. Clinical significance of patient-reported questionnaire data: another step toward consensus.  J Clin Epidemiol. 2005;58(12):1217-121916291464PubMedGoogle ScholarCrossref
38.
Sloan JA. Assessing the minimally clinically significant difference: scientific considerations, challenges and solutions.  COPD. 2005;2(1):57-6217136963PubMedGoogle ScholarCrossref
39.
Domino KB, Hornbein TF, Polissar NL,  et al.  Risk factors for relapse in health care professionals with substance use disorders.  JAMA. 2005;293(12):1453-146015784868PubMedGoogle ScholarCrossref
40.
Schwartz JS, Lewis CE, Clancy C, Kinosian MS, Radany MH, Koplan JP. Internists' practices in health promotion and disease prevention: a survey.  Ann Intern Med. 1991;114(1):46-531983932PubMedGoogle Scholar
41.
Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians' prevention-related practices: findings from the Women Physicians' Health Study.  Arch Fam Med. 2000;9(4):359-36710776365PubMedGoogle ScholarCrossref
42.
Lewis CE, Clancy C, Leake B, Schwartz JS. The counseling practices of internists.  Ann Intern Med. 1991;114(1):54-581983933PubMedGoogle Scholar
43.
Frank E, Segura C, Shen H, Oberg E. Predictors of Canadian physicians' prevention counseling practices.  Can J Public Health. 2010;101(5):390-39521214054PubMedGoogle Scholar
44.
Buhl A, Oreskovich MR, Meredith CW. Prognosis for the recovery of surgeons from chemical dependency: a 5-year outcome study.  Arch Surg. 2011;146(11):1286-1291Google ScholarCrossref
45.
McLellan AT, Skipper GS, Campbell M, DuPont RL. Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States.  BMJ. 2008;337:a203818984632PubMedGoogle ScholarCrossref
46.
Kuerer HM, Eberlein TJ, Pollock RE,  et al.  Career satisfaction, practice patterns and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology.  Ann Surg Oncol. 2007;14(11):3043-305317828575PubMedGoogle ScholarCrossref
47.
Bertges Yost W, Eshelman A, Raoufi M, Abouljoud MS. A national study of burnout among American transplant surgeons.  Transplant Proc. 2005;37(2):1399-140115848732PubMedGoogle ScholarCrossref
48.
Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals.  J Clin Epidemiol. 1997;50(10):1129-11369368521PubMedGoogle ScholarCrossref
49.
Kellerman SE, Herold J. Physician response to surveys: a review of the literature.  Am J Prev Med. 2001;20(1):61-6711137777PubMedGoogle ScholarCrossref
50.
Gallagher AG, Boyle E, Toner P,  et al.  Persistent next-day effects of excessive alcohol consumption on laparoscopic surgical performance.  Arch Surg. 2011;146(4):419-42621502449PubMedGoogle ScholarCrossref
Original Article
Feb 2012

Prevalence of Alcohol Use Disorders Among American Surgeons

Author Affiliations

Author Affiliations: American College of Surgeons, Chicago, Illinois (Drs Oreskovich, Kaups, Balch, and Hanks); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Drs Oreskovich and Meredith), and Washington Physicians Health Program (Dr Meredith and Ms Buhl), Seattle; Department of Surgery, University of California, San Francisco, Fresno (Dr Kaups); Department of Surgery, Johns Hopkins University, Baltimore, Maryland (Dr Balch); University of Virginia, Charlottesville (Dr Hanks); and Department of Medicine, Mayo Clinic, Rochester, Minnesota (Mr Satele and Drs Sloan, Dyrbye, and Shanafelt).

Arch Surg. 2012;147(2):168-174. doi:10.1001/archsurg.2011.1481
Abstract

Objectives To determine the point prevalence of alcohol abuse and dependence among practicing surgeons.

Design Cross-sectional study with data gathered through a 2010 survey.

Setting The United States of America.

Participants Members of the American College of Surgeons.

Main Outcome Measures Alcohol abuse and dependence.

Results Of 25 073 surgeons sampled, 7197 (28.7%) completed the survey. Of these, 1112 (15.4%) had a score on the Alcohol Use Disorders Identification Test, version C, consistent with alcohol abuse or dependence. The point prevalence for alcohol abuse or dependence for male surgeons was 13.9% and for female surgeons was 25.6%. Surgeons reporting a major medical error in the previous 3 months were more likely to have alcohol abuse or dependence (odds ratio, 1.45; P < .001). Surgeons who were burned out (odds ratio, 1.25; P = .01) and depressed (odds ratio, 1.48; P < .001) were more likely to have alcohol abuse or dependence. The emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse or dependence. Male sex, having children, and working for the Department of Veterans Affairs were associated with a lower likelihood of alcohol abuse or dependence.

Conclusions Alcohol abuse and dependence is a significant problem in US surgeons. Organizational approaches for the early identification of problematic alcohol consumption followed by intervention and treatment where indicated should be strongly supported.

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