47 Post-Traumatic Stress Disorder Among Emergency Department Clinicians During the Pandemic

Abstract

Study Objective: The DSM-5 defines post-traumatic stress disorder (PTSD) as the development of certain characteristic symptoms after direct, witnessed, or secondhand "exposure to actual or threatened death, serious injury, or sexual violence." The COVID-19 pandemic has been compared to the 2003 SARS outbreak; health care workers (HCWs) during that crisis experienced increased levels of emotional distress. As of March 2021, there have been over 830,000 cases of COVID-19 and 24,000 mortalities in New Jersey (NJ). Our study aimed to identify the point prevalence of PTSD and sub-threshold PTSD in HCWs across NJ during the second wave of the pandemic.Methods: We conducted a prospective survey study that was distributed electronically to physicians (attendings, fellows, and residents) and mid-level practitioners (MLPs) working in emergency departments across NJ from December 2020 -March 2021 using a secure, online survey platform.Results: All collected participant demographics are shown by training level in Table 1. There are several provisional diagnostic determinations of PTSD currently in use (Table 2). For continuous total severity score, the mean score and standard deviation (SD) for attending physicians was 13.9 (12.6), for resident/fellow physicians it was 15.4 (18.2), and for MLPs it was 20.4 (14.9), causing a statistically significant difference between the groups (p¼0.01). Following the DSM-5 criteria, a total of 27 individuals were diagnosed with PTSD, where a significantly high proportion of those were MLPs (n (%) ¼ 20 (25); p¼0.02). DSM-5 criteria B-E (Table 2) is used to evaluate subthreshold PTSD. Regardless of whether two or three criteria were used for diagnosis, the proportion met was greatest for the MLPs, with criterion D being significantly associated with training level (p¼0.01).