BACKGROUND
Résumé
Various factors are known to influence the suicidal risk assessment (SRA). Previous studies demonstrated the impact on SRA of patients’s clinical characteristics, past psychological and suicidal behaviors history, and sociodemographic factors, as well as of institutional context. However, research on the clinician’s side remains limited and the specific influence of the patient’s and the clinician’s gender has hardly been studied, even though behavioral differences between men and women are important regarding suicidal behaviors. The present study aims to examine the influence of patient’s and clinician’s gender on SRA. We hypothesized that physicians would give lower scores to patient of the same gender as them.
METHODS
In this vignette study, an anonymous online survey was distributed to Swiss psychiatrists and non-psychiatrists with previous experience of SRA. Participants read two clinical vignettes about fictional patients encountered in the psychiatric emergency unit. The patient was a male in the vignette n°1 and a female in the vignette n°2, or the reverse. Respondents were then asked to rate the suicidal risk and the need for hospitalization, on a scale of 0 to 10 each. The following clinicians’ characteristics were also collected: canton of practice, gender, year of birth, level of training, field of specialization, years of clinical experience and place of practice.
RESULTS
A total of 473 physicians participated in this study, of which 407 were eligible for further analyses (239 women [58.7%], mean age 41.1 years, SD = 11.6 years, 247 practicing in the canton Vaud [60.7%], 262 specialists [64.4%], 245 non- psychiatrists [60.2%], 230 with more than ten years of clinical experience [56.5%], 309 employed in an institution/hospital [75.9%]). Multivariate analysis showed that (i) male physicians gave lower scores than female physicians, for both suicidal risk and hospitalization need, (ii) there was no difference between the scores given to female and male patients and (iii) clinicians of the same gender as the patient gave higher scores than clinicians of the opposite gender regarding the need for hospitalization.
CONCLUSION
Clinician’s gender has the most important effect when it comes to suicidal risk and hospitalization need assessment. The patient’s gender did not influence the clinician’s evaluation by itself, but it did in interaction with the clinician’s gender for the hospitalization need, a decision shared between the clinician and the patient.