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Research ArticleRegular Articles

The Prevalence of Physicians Who Have Been Stalked: A Systematic Review

Andrea J. Nelsen, R. Scott Johnson, Britta Ostermeyer, Kristi A. Sikes and John H. Coverdale
Journal of the American Academy of Psychiatry and the Law Online June 2015, 43 (2) 177-182;
Andrea J. Nelsen
Dr. Nelsen is Psychiatrist of Forensic Programs at the Minnesota Security Hospital, St. Peter, MN. Drs. Johnson and Sikes are Residents and Dr. Coverdale is Professor of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX. Dr. Ostermeyer is The Paul and Ruth Jonas Chair and Professor, Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, October, 25–28, 2012, Montreal, Quebec, Canada.
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R. Scott Johnson
Dr. Nelsen is Psychiatrist of Forensic Programs at the Minnesota Security Hospital, St. Peter, MN. Drs. Johnson and Sikes are Residents and Dr. Coverdale is Professor of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX. Dr. Ostermeyer is The Paul and Ruth Jonas Chair and Professor, Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, October, 25–28, 2012, Montreal, Quebec, Canada.
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Britta Ostermeyer
Dr. Nelsen is Psychiatrist of Forensic Programs at the Minnesota Security Hospital, St. Peter, MN. Drs. Johnson and Sikes are Residents and Dr. Coverdale is Professor of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX. Dr. Ostermeyer is The Paul and Ruth Jonas Chair and Professor, Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, October, 25–28, 2012, Montreal, Quebec, Canada.
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Kristi A. Sikes
Dr. Nelsen is Psychiatrist of Forensic Programs at the Minnesota Security Hospital, St. Peter, MN. Drs. Johnson and Sikes are Residents and Dr. Coverdale is Professor of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX. Dr. Ostermeyer is The Paul and Ruth Jonas Chair and Professor, Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, October, 25–28, 2012, Montreal, Quebec, Canada.
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John H. Coverdale
Dr. Nelsen is Psychiatrist of Forensic Programs at the Minnesota Security Hospital, St. Peter, MN. Drs. Johnson and Sikes are Residents and Dr. Coverdale is Professor of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, TX. Dr. Ostermeyer is The Paul and Ruth Jonas Chair and Professor, Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK. A preliminary poster of this material was presented at the 43rd annual meeting of the American Academy of Psychiatry and the Law, October, 25–28, 2012, Montreal, Quebec, Canada.
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    Table 1

    Characteristics of Prevalence Studies

    StudyYearCountrySpecialtyLevel of TrainingNResponse Rate (%)Definition of StalkingPrevalence (%)Psychological Consequences Reported
    Morgan and Porter181999UKPsychiatryTrainee10085Not given4.7No
    Kowalenko et al.192005USAEmergency medicineAttending25070.8Unwanted or threatening contact by the patient or someone representing the patient in a persistent manner over time.3.5No
    Gale C et al.272006New ZealandGeneral practiceAttending230852.2Not given1.9No
    Hughes et al.202007New ZealandPsychiatryAttending55026.5Unwanted communications or repeated contacts (on more than 10 occasions) persisting for a period of more than 4 weeks and that created fear or anxiety for the clinician.68.5Yes
    McIvor et al.212008UKPsychiatryAttending, trainee32461Two or more episodes where a psychiatric patient initiated inappropriate contact outside the clinical setting that caused the psychiatrist concern.20.7Did not ask, but reported respondents' free text comments
    Allnut et al.222009Australia, New ZealandPlastic surgeryAttending19054.2A constellation of behaviors which one individual inflicts on another in the form of unwanted intrusions and/or communications … on two or more occasions to the extent that they felt fearful.4.5Yes
    Gale et al.242009New ZealandPsychiatryAttending30863.9Not given4.6No
    Behnam et al.232011USAEmergency medicineAttending, traineeN/ANot determinateNot given1.5No
    Abrams and Robinson252011*CanadaGP, IM, surgery, Psychiatry, EM, pediatrics, anesthesiology, nuclear medicine, OB/Gyn, otherAttending315937.6Willful, malicious, and repeated contacts; following; or harassing by a patient, ex-patient or patient's relative, partner, or ex-partner.14.9Yes31
    Abrams and Robinson, Part II312013*Same as Abrams and Robinson25
    Forrest et al.262011AustraliaGeneral PracticeAttending306326.3Not given3.6No
    Whyte et al.282011*UKPsychiatryAttending, trainee1042925At least 10 unwanted intrusions occurring over at least 2 weeks.2Yes28,29
    Maclean et al.292013*Same as Whyte et al.28
    Nwachukwu et al.302012IrelandPsychiatryAttending, trainee44262Repeated [unpleasantly intrusive] acts … which create apprehension.25.1Yes
    • ↵* There were two parts, published in separate articles, for the Abrams25,31 and Whyte.28,29 studies.

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    Table 2

    Quality Appraisal of Included Studies

    StudyNational SampleConstruct Validity/Defined by Piloting ExpertsStalking DefinedFormal Study Period UsedResponse Rate > 60%Score (out of 5)
    Kowalenko et al.19NoYesYesYesYes4
    Gale et al.24YesYesNoYesYes4
    Nwachukwu et al.30YesYesYesNoYes4
    Gale et al.27YesYesNoYesNo3
    McIvor et al.20NoYesYesNoYes3
    Allnut et al.22YesNoYesYes (past year)No3
    Behnam et al.23YesYesNoYesNot determined3
    Whyte et al.28 Maclean et al.29YesNoYesYesNo3
    Hughes et al.20YesNoYesNoNo2
    Abrams and Robinson25; Part II31NoYesYesNoNo2
    Forrest et al.26YesNoNoYesNo2
    Morgan and Porter18YesNoNoNoYes2
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Journal of the American Academy of Psychiatry and the Law Online: 43 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 43, Issue 2
1 Jun 2015
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The Prevalence of Physicians Who Have Been Stalked: A Systematic Review
Andrea J. Nelsen, R. Scott Johnson, Britta Ostermeyer, Kristi A. Sikes, John H. Coverdale
Journal of the American Academy of Psychiatry and the Law Online Jun 2015, 43 (2) 177-182;

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The Prevalence of Physicians Who Have Been Stalked: A Systematic Review
Andrea J. Nelsen, R. Scott Johnson, Britta Ostermeyer, Kristi A. Sikes, John H. Coverdale
Journal of the American Academy of Psychiatry and the Law Online Jun 2015, 43 (2) 177-182;
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