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

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Abstract

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.

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