• Andrea Chmitorz, Malte Ottenhausen, Darius Kalasauskas, Irene Irene, Klaus Lieb, and Florian Ringel.
• Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany. Electronic address: andrea.chmitorz@hs-esslingen.de.
• World Neurosurg. 2022 Feb 1; 158: e265-e276.

BackgroundSpine surgeons are usually exposed to high workload and demanding work conditions. Although 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. This study aimed to close that gap by investigating the relationship between PNE use and resilience, perceived stress, or resilience-enhancing factors in spine surgeons.MethodsWe conducted a cross-sectional survey in a sample of 582 spine surgeons in German-speaking countries (Austria, Germany, and 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 among PNE use, perceived stress, resilience, and resilience-enhancing factors.ResultsLifetime 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 (odds ratio, 2.271; 95% confidence interval, 0.1.363-3.785; P = 0.002). No statistically significant results were found for the individual ability to recover from stress or resilience-enhancing factors.ConclusionsSpine surgeons with higher levels of stress seem to be more prone to nonmedical 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.Copyright © 2021 Elsevier Inc. All rights reserved.

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