Pharmacological Neuroenhancement, Perceived Stress and Resilience in Spine Surgeons - a Cross-Sectional Survey.

Abstract Background Spine surgeons are usually exposed to high work load and demanding work conditions. While the relationship between pharmacological neuroenhancement (PNE) and resilience, i.e. the ability to recover from stress, as well as perceived stress and resilience enhancing factors has been investigated in the general population, less is known about the impact of those factors in spine surgeons. The study aimed to close that gap by investigating the relationship between PNE use and resilience, perceived stress or resilience enhancing factors in spine surgeons. Methods We conducted a cross-sectional survey in a sample of N = 582 spine surgeons in German speaking countries (Austria, Germany, Switzerland). Potentially predictive variables as well as the use of PNE were assessed by self-report questionnaires. We conducted stepwise logistic regression with backward elimination to assess the relationship between PNE use, perceived stress, resilience and resilience enhancing factors. Results Lifetime prevalence for PNE use was 5,7%, with highest prevalence rates for antidepressants (2,6%). Each additional unit on the perceived stress scale increased the risk for PNE use (OR: 2.271, 95% CI: .1.363–3.785, p: .002). No statistically significant results were found for the individual ability to recover from stress or resilience enhancing factors. Conclusions Spine surgeons with higher levels of stress seem to be more prone to non-medical use of PNE. Tailored interventions may improve the ability to cope with high perceived stress and prevent the use of PNE. Further research should examine the efficacy of those interventions on the prevention of PNE in spine surgeons.