More Than 1-in-4 Cardiologists Report Mental Health Conditions, Survey Finds

Garima Sharma, MD

More than 1-in-4 cardiologists report experiencing mental health conditions, according to the results of an American College of Cardiology (ACC)-led survey.

Conducted by the ACC, the survey, which was conducted in 2019, found 28% of the more than 5800 respondents reported some form of mental health condition, with more than 40% of cardiologists reporting a mental health condition also reporting being dissatisfied with 1 or more career-related metrics.

“We highlight the need for the culture of cardiology to be more inclusive and supportive of those affected and encourage them to report their illness and seek treatment,” wrote investigators. “Given the high prevalence of mental health disorders among cardiologists globally, dedicated efforts are needed, on an individual and organizational level, to reduce the causes of mental illness and to create a safe environment for those affected by [mental health conditions].”

Led by Garima Sharma, MD, associate vice chair of Women’s Careers in Academic Medicine in the Department of Medicine at Johns Hopkins Medicine, and a team of colleagues that included Laxmi Mehta, MD, the vice chair of wellness for the Department of Internal Medicine at the Ohio State University Wexner Medical Center and chair of the ACC’s Task Force on Clinician Well-Being, the current study was led with the intent of estimating the global prevalence of mental health conditions among cardiologists and its relationships to professional life. Investigators obtained data for their analyses from a 50-item online anonymous questionnaire conducted by the ACC in the latter half of 2019 that was administered to 71,022 cardiologists across Africa, Asia, Europe, Oceania, and South and North America.

For the purpose of analysis, mental health conditions of interest included alcohol/drug use disorder, suicidal tendencies, psychological distress, other psychiatric disorder, and major psychiatric disorder. Investigators pointed out ACC member and nonmember cardiologists listed within the ACC database were considered eligible for inclusion.

Of the 71,022 cardiologists who were sent survey invitations 5931 responded, with 5830 answering questions related to mental health. Among respondents with mental health data, 77.4% were men, 33.5% were less than 40 years of age, 53.5% identified as White, 16.9% identified as Asian, 16.7% identified as Hispanic, 3.4% identified as non-Hispanic Black, and less than .5% identified as Native American of native Hawaiian. Investigators pointed out 75.5% of cardiologists were married and 74.9% had children.

Overall, 28.0% of respondents reported having a mental health condition, with the prevalence varying across subgroups. Investigators pointed out women cardiologists were more likely to report having a mental health condition (33.7% vs 26.3%; P <.001), a major psychiatric disorder (4.1% vs 2.1%), or other psychiatric disorder (10.8% vs 8.0%). Investigators also highlighted those with 5-10 years of practice post-training were more likely to report having a mental health condition than their counterparts with 20 years of experience or more (31.9% vs 22.6%; P <.001).

When assessing the influence of race and ethnicity, results suggest Hispanic cardiologists (35.3%) were more likely to report mental health conditions than their White (27.8%), non-Hispanic Black (26.3%), or Asian (21.6%) counterparts (P <.001). Investigators pointed out 71% of Hispanic cardiologists were from South America or Central America.

Investigators also called attention to the rate of cardiologists considering suicide, with 2.7% of those reporting a mental health condition reporting considering suicide in the past 12 months, 2.9% reporting considering suicide more than 12 months ago, and 0.4% reporting having attempted suicide. Further analysis of this group revealed women were more likely to consider suicide in the last 12 months (3.8% vs 2.3%) but were also more likely to seek (42.3% vs 31.1%) help compared with men (all P <.001).

When assessing association between mental health conditions and professional life, results suggested 44% of respondents with a mental health condition reporting being dissatisfied with at least one aspect of their professional life. Analyses revealed experiencing emotional harassment (OR, 2.81 [95% CI, 2.46-3.20]), discrimination (OR, 1.85 [95% CI, 1.61-2.12]), being divorced(OR, 1.73 [95% CI, 1.27-2.36]), and being less than 55 years of age (OR, 1.43 [95% CI, 1.24-1.6]) were all considered positive predictors of mental health conditions.

In an editorial comment, Andrew Sauer, MD, a cardiologist at Saint Luke’s Mid America Heart Institute, paints a picture of the hurdles and struggles faced by early career as well as established cardiologists. Sauer describes the need for implementing interventions at multiple stages of the mental illness progression cycle and finishes by touching on what he interprets as a cause for hope.

“Pursuing a career in cardiology can be a masterclass in delayed gratification and quiet suppression of self-care. We commonly defer life timelines all in the spirit of commitment to patient-care excellence. And the intrinsic rewards of easing the suffering of our patients while experiencing the enrichment of the patient-doctor relationship cannot be understated,” Sauer opined. “But medicine is increasingly isolating for many. Burnout, psychological distress, overt mental illness, and suicidal ideation are legitimate threats to healthcare’s central aims.”

This study, “Prevalence and Professional Impact of Mental Health Conditions Among Cardiologists,” was published in the Journal of the American College of Cardiology.