Prevalence and Professional Impact of Mental Health Conditions Among Cardiologists
- One in four responding cardiologists reported experiencing a mental health condition (MHC), including psychological distress or major or other psychiatric disorder, with the highest prevalence among South American respondents.
- Cardiologists who reported a hostile work environment, defined as experiencing discrimination and emotional and sexual harassment, were more likely to have MHCs than those who did not.
- Nearly one-half of cardiologists reporting MHCs felt dissatisfied on at least one professional metric, including feeling valued, treated fairly, and adequate compensation.
- Approximately one-third of cardiologists reporting MHC sought help; barriers included lack of privacy, lack of time, embarrassment, impact on professional advancement, impact on practice, and lack of resources.
What is the global prevalence of mental health conditions (MHCs) among cardiologists?
The investigators conducted an online survey through the American College of Cardiology (ACC). The survey was sent to 71,022 cardiologists in Africa; Asia; Eastern Europe; the European Union; the Middle East; Oceania; and South, Central, and North America who were ACC members or nonmember cardiologists listed in the ACC database as of 2019. Medical students, trainees, and cardiovascular team members or administrators were excluded from the study. Only those who answered the MHC question were included in the present study. MHC was defined as self-reported experience with alcohol/drug use disorder, suicidal tendencies, psychological distress (i.e., anxiety, irritability, and anger), other psychiatric disorders (i.e., panic disorder, post-traumatic stress, and eating disorders), and major psychiatric disorder (i.e., major depressive disorder, bipolar disorder, or schizophrenia). Characteristics associated with MHCs and associations with professional activities were examined.
Of the 71,022 cardiologists who were sent survey invitations, a total of 5,931 cardiologists responded to the survey, of which 5,830 cardiologists (77.4% men) answered questions on mental health. Approximately two-thirds of respondents were 40 years or older, 53% were White, 16.9% were Asian, Hispanic 16.7%, and non-Hispanic Black 3.4%. The majority of the cardiologists were married (75.5%), had children (74.9%), and lived in a dual-income household (57.2%). Over 80% of respondents worked full-time. One in four respondents reported experiencing an MHC, including psychological distress or major or other psychiatric disorder. Significant geographic variation was observed, with the highest prevalence among South American respondents (39.3%) and the lowest prevalence among Asian respondents (20.1%). Predictors of MHCs included experiencing emotional harassment (odds ratio [OR], 2.81; 95% confidence interval [CI], 2.46-3.20), discrimination (OR, 1.85; 95% CI, 1.61-2.12), being divorced (OR, 1.85; 95% CI, 1.27-2.36), and age <55 years (OR, 1.43; 95% CI, 1.24-1.66). Women were more likely to consider suicide within the past 12 months (3.8% vs. 2.3%) but were also more likely to seek help (42.3% vs. 31.1%) as compared with men (all p < 0.001). Approximately one-third of cardiologists reporting MHC sought help; barriers included lack of privacy, time, embarrassment, professional advancement, impact on practice, and lack of resources.
The authors concluded that >1 in 4 cardiologists experience self-reported MHCs globally, and the association with adverse experiences in professional life is substantial. Dedicated efforts toward prevention and treatment are needed to maximize the contributions of affected cardiologists.
Although limitations to this survey data exist, the findings are concerning and consistent with the high prevalence of physician burnout reported. MHC among cardiologists is prevalent and associated with hostile work environments. These data support the urgent need for strategies to promote a healthy workplace for cardiovascular providers.
Clinical Topics: Cardiovascular Care Team, Prevention, Stress
Keywords: Anger, Anxiety, Bipolar and Related Disorders, Burnout, Psychological, Burnout, Professional, Cardiologists, Depressive Disorder, Depression, Divorce, Embarrassment, Mental Health, Occupational Stress, Panic Disorder, Primary Prevention, Professional Role, Schizophrenia, Social Discrimination, Students, Substance-Related Disorders, Suicidal Ideation, Workplace
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