E2 ModerateModerate confidencePEM not requiredCross-SectionalPeer-reviewedMachine draft
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Self-reported depression and suicide attempts among U.S. women physicians.
Frank, E, Dingle, A D · The American journal of psychiatry · 1999 · DOI
Quick Summary
This study surveyed over 4,500 U.S. women doctors to understand how often they experience depression and attempt suicide. The researchers found that about 1 in 5 women physicians have experienced depression at some point in their lives, and about 1.5% have attempted suicide. Several factors increased the risk, including a history of abuse, substance use, chronic fatigue syndrome, and work-related stress.
Why It Matters
This study is relevant to ME/CFS patients because it identifies chronic fatigue syndrome as a significant risk factor associated with depression in a large, well-characterized professional population. Understanding the mental health burden and risk factors in ME/CFS patients—including occupational stress and comorbid conditions—can help inform better screening and support strategies for this vulnerable population.
Observed Findings
Approximately 19.5% (808/4,501) of U.S. women physicians reported a lifetime history of depression
Approximately 1.5% (61/4,501) of U.S. women physicians reported lifetime suicide attempts
Women physicians with chronic fatigue syndrome were significantly more likely to report depression
Depression was associated with lack of partner/marriage, childlessness, alcohol use, poor health status, and job dissatisfaction
Suicide attempt risk was elevated in those with smoking history, substance abuse, sexual abuse, domestic violence, and family psychiatric history
Inferred Conclusions
Depression prevalence in U.S. women physicians is similar to that in the general population of U.S. women
Suicide attempt rates may be lower in women physicians than previously reported in smaller studies
Multiple overlapping risk factors—including trauma, substance use, psychiatric comorbidities, occupational stress, and chronic illness—identify subgroups of women physicians at higher risk for depression and suicide attempts
Chronic fatigue syndrome is one of several medical comorbidities associated with increased depression risk in this population
Remaining Questions
Why is chronic fatigue syndrome specifically associated with depression risk in women physicians, and what is the directionality of this relationship?
What This Study Does Not Prove
This study does not establish causation between any risk factors and depression or suicide attempts; it only identifies associations through cross-sectional data. The study is limited to self-reported diagnoses and retrospective recall, which may underestimate or misclassify cases. Notably, the study does not prove that ME/CFS causes depression, only that the two conditions frequently co-occur.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →