Suicidal Patients Slip by Physicians

A recently published study indicates that primary care physicians may not be inquiring about suicide as much as they should with their patients.

Suicide accounts for hundreds of thousands of deaths each year in the United States, yet many people, including family friends, and even primary care physicians neglect to recognize the warning signs of suicide before it is too late. The researchers of the most recently published study on suicide estimate that 2-7% of patients who visit their physicians are considering committing suicide. Further, an estimated 75% of patients who committed suicide visit their primary care physicians in the 30 days prior to ending their lives.

Dr. Mitchell Feldman, professor of medicine at the University of California, San Francisco and lead author of this study, and his colleagues conducted a study involving 152 primary care physicians. These researchers wanted to determine how often physicians inquired about suicidal thoughts when "patients" presented with warning signs of suicide such as depression.

The researchers recruited 18 actresses to play the part of patients. When they visited physicians, they either acted as having major depression or as having an adjustment disorder.

One hundred and fifty-two physicians located in Rochester, New York and northern California participated in this study. All physicians were told by the researchers that they would be receiving unannounced visits from actors acting as patients. The researchers also informed all the doctors that their conversation with these "patients" would be recorded.

The researchers discovered that only 36% of physicians asked "patients" about suicidal ideation. However, the researchers indicate that when the "patients" told physicians that they had major depression or asked for medication, doctors were more likely to ask about suicidal ideation.