[Gender aspects in female and male physicians : Occupational and psychosocial stress]. / Gender-Aspekte bei Ärztinnen und Ärzten : Berufsleben und psychosoziale Belastungen.

BACKGROUND: International studies have shown that physicians have an elevated risk of developing depression or burnout syndrome. Gender aspects with regard to occupation are discussed in German politics and society. Currently, there is little data comparing female and male physicians with regard to stress at work, depression, and burnout. OBJECTIVES: Are there differences between male and female physicians with respect to psychosocial strain, emotional exhaustion, and depression? METHODS: In different cross-sectional studies, anaesthetists, psychiatrists and dentists filled out a questionnaire containing questions on personal data, occupation, past medical history and medication intake. Additional standardized questionnaires (Beck Depression Inventory (BDI) and Maslach Burnout Inventory (MBI)) were performed. RESULTS: The return rate was 51.8 % (n = 3782). Male and female physicians vary significantly in social data, participation in the job, and health status. Female physicians are on average not married (p < 0.001) and have significantly fewer children (p < 0.05). Leading positions are mostly held by male physicians (p < 0.001); female physicians more often work in part-time jobs (p < 0.001). Female physicians reached higher scores of emotional exhaustion (MBI) (p < 0.01) and depression (BDI) (p < 0.001). DISCUSSION: The study shows big differences between male and female physicians with respect to their occupation, personal life, and psychosocial wellbeing. Female physicians more often report burnout and depression. Causes might be family and job strain, gender aspects in hierarchy, as well as different recognition and interpretation of symptoms.

CYP2D6 in the brain: genotype effects on resting brain perfusion.

The cytochrome P450 2D6 (CYP2D6) is a genetically polymorphic enzyme involved in the metabolism of several psychoactive drugs. Beside its expression in the liver, CYP2D6 is highly expressed in several regions of the brain, such as the hippocampus, thalamus, hypothalamus and the cortex, but its function in the brain is not well understood. The CYP2D6 enzyme may also have a physiological role due to its involvement in neurotransmitter biotransformation. In this study, CYP2D6 genotyping was performed in N=188 healthy individuals and compared with brain perfusion levels at rest, which may reflect an ongoing biological process regulating the reactivity of the individual to emotional stimuli and the detection of signals evoking fear. Relative to N=42 matched extensive metabolizers, N=14 poor metabolizers were associated with 15% higher perfusion levels in the thalamus (P=0.03 and 0.003). Effects were also present in the whole (N=188) sample divided into metabolizer groups, or finely graded into seven CYP2D6 activity levels. A weaker effect was observed in the right hippocampus (P=0.05). An exploratory analysis, extended to the whole brain, suggested the involvement of CYP2D6 in regions associated with alertness or serotonergic function. These findings support the hypothesis of a functional role of CYP2D6 in the brain.