Researchers tried to establish the prevalence and nature of psychiatric conditions among doctors with the use of several methods such as literature review, review of policy documents from the Department of Health and the General Medical Council, review of evidence, and attendance at conferences on physician health.

The British group found that health problems ranged from anxiety through emotional exhaustion to clinical depression, substance misuse, and suicide. Depression, alcoholism, and anxiety disorders were the most common conditions among physicians.

Although some of the findings in the study reflect the type of organizational structure in the United Kingdom (namely, a national health system), an inadequacy within organized medicine to identify or aid physicians in trouble is probably widespread.

Studies by the Nuffield Trust identified the major factors for psychological disturbance in junior to senior grades of medicine as the long hours required to practice, the high workload, the pressure of work, and the effect of such stressors on doctors' personal lives --- factors that are not specific to Britain.

A mental health needs assessment should be conducted urgently across the profession, not just those doctors who are already seeking help, wrote the authors. A health impact assessment should also be undertaken to build an evidence base for acceptable, responsive, and effective services.

"We owe a duty of care to our colleagues. At present we are letting them down," they concluded.