Distribution of psychological instability among surgeons

in World Neurosurgery (2023)

Background High emotional instability, i.e. neuroticism, is associated with poor mental health. Conversely, traumatic experiences may increase neuroticism. Stressful experiences such as complications are ... [more ▼]

Background High emotional instability, i.e. neuroticism, is associated with poor mental health. Conversely, traumatic experiences may increase neuroticism. Stressful experiences such as complications are common in the surgical profession, with neurosurgeons being particularly affected. We compared the personality trait neuroticism between physicians in a prospective cross-sectional study. Methods 5,148). Multivariate linear regression was used to model differences between surgeons, non-surgeons and specialties with occasional surgical interventions with respect to neuroticism, adjusting for gender, age, age squared and their interactions, then testing equality of parameters of adjusted predictions separately and jointly using Wald tests. Results With an expected variability within disciplines, average levels of neuroticism are lower in surgeons than non-surgeons, especially in the first part of their career. However, the course of neuroticism across age follows a quadratic pattern, i.e., an increase after the initial decrease. The acceleration of neuroticism with age is specifically significant in surgeons. Levels of neuroticism are lowest towards mid-career, but exhibit a strong secondary increase towards the end of the surgeons’ career. This pattern seems driven by neurosurgeons. Conclusion Despite initially lower levels of neuroticism, surgeons suffer a stronger increase of neuroticism together with age. Since, beyond well-being, neuroticism influences professional performance and healthcare systems costs, explanatory studies are mandatory to enlighten causes of this burden. [less ▲]

Sexual Dysfunction After Good-Grade Aneurysmal Subarachnoid Hemorrhage

in World Neurosurgery (2018)

OBJECTIVE: To assess the consequences of aneurysmal subarachnoid hemorrhage (aSAH) on sexual pleasure in patients with an otherwise favorable neurologic outcome. METHODS: Anonymous, standardized ... [more ▼]

OBJECTIVE: To assess the consequences of aneurysmal subarachnoid hemorrhage (aSAH) on sexual pleasure in patients with an otherwise favorable neurologic outcome. METHODS: Anonymous, standardized questionnaires concerning sexual function, including the International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), and a statement on subjective change in sexual pleasure after aSAH, were completed by 33 patients treated at the Cantonal Hospital St Gallen between 2005 and 2013. All had favorable neurologic outcomes (Glasgow Outcome Scale score 4 or 5). RESULTS: Ten patients (31.3%) reported a subjective worsening of sexual pleasure after aSAH. Sexual dysfunction according to FSFI criteria affected 9 of the 19 female patients (47.4%). All 19 women had a hypoactive sexual desire disorder. Erectile dysfunction was present in 7 of the 14 male patients (50%). Patients with World Federation of Neurosurgical Societies (WFNS) grade 2 aSAH were significantly more likely to report a subjective worsening of sexual experience after hemorrhage than those with WFNS grade 1. CONCLUSIONS: This is the first known evaluation of sexual health following aSAH with otherwise favorable neurological outcomes, and confirms that sexual dysfunction is common in this population. Sexual health should be explored during follow-up with these patients [less ▲]