Prevalence of Post-Traumatic Stress Disorder in Emergency Physicians in the United States

Abstract

There is increasing concern about the effects of occupational stressors on the wellness of healthcare providers. Given high patient acuity, circadian rhythm disruption, and other workplace stressors, emergency physicians (EP) would be predicted to have high rates of occupational stress. We conducted this study to assess the prevalence of post-traumatic stress disorder (PTSD) in attending EPs practicing in the United States. Methods: A link to an electronic questionnaire was distributed through the emergency medicinecentric publication Emergency Medicine News. We compared the prevalence of PTSD in EPs to the general population using a chi-square goodness of fit test, and performed logistic regression to assess for significance of risk factors. Results: We received survey responses from 526 persons. In this study, EPs had a PTSD point prevalence of 15.8%. Being a victim of a prior trauma or abuse is the primary predictor of PTSD (odds ratio [OR] [95% confidence interval {CI}, 2.16 (1.21-3.86)], p = 0.009) and PTSD severity score (OR [95% CI, 1.16 (1.07-1.26)], p <0.001). Conclusion: Emergency physicians have a substantial burden of PTSD, potentially jeopardizing their own health and career longevity. Future studies should focus on identifying subgroups at higher risk for PTSD and modifiable risk factors. Prevention and treatment strategies should be developed and tested in healthcare providers. [

Lifestyle Factors and Other Influences on Medical Students Choosing a Career in Emergency Medicine

“…However, students interested in EM may not be appropriately acknowledging the significance of the chronic and consistent stress that EM physicians are regularly exposed to and thus do not recognize that the potential stress and hardship of EM cannot be overcome by simply having more time off as a trade‐off. In fact, it has been suggested those working in EM could be suffering from posttraumatic stress disorder directly related to their acute and chronic exposure to their “front‐line” patient care responsibilities 10,11,12,13…”

“…In fact, it has been suggested those working in EM could be suffering from posttraumatic stress disorder directly related to their acute and chronic exposure to their "front-line" patient care responsibilities. [10][11][12][13] Medical school career planning activities may be one means by which these observations and findings could be discussed. Ensuring that messaging from career advisors, mentors, and others include a consideration about the effects of stress that is distinguishing of EM as a field would be helpful in improving this as a priority among trainees.…”

Post‐traumatic stress and stress disorders during the COVID‐19 pandemic: Survey of emergency physicians

“…Previous studies have reported that the incidence of high levels of stress in healthcare workers during an epidemic or pandemic range from 18.1% to 80.1%. 6 Sources of stress may include increased workload, fears of contagion for themselves and their families, working with new and frequently changing protocols and personal protective equipment (PPE), caring for critically ill patients, and caring for colleagues who have also fallen ill. 7 Several studies have identified high incidences of anxiety, depression, and stress among healthcare workers during this pandemic. 8,9 Among the findings in a 2020 study during the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City were that more than half had high levels of acute stress, nearly half had depression symptoms, one third had anxiety, and most had insomnia and loneliness.…”

PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic

“…Healthcare Workers (HCWs) in emergency care settings are particularly at risk for PTSD because of the highly stressful work-related situations they are exposed to, that include: management of critical medical situations, caring for severely traumatized people, frequent witnessing of death and trauma, operating in crowded settings, interrupted circadian rhythms due to shift work) ( Figley, 1995 ; Crabbe et al., 2004 ; Cieslak et al., 2014 ; Berger et al., 2012 ; Hegg-Deloye et al., 2013 ; Garbern et al., 2016 ). PTSD rates have been reported to range from 10 to about 20% ( Grevin, 1996 ; Clohessy and Ehlers, 1999 ; Robertson and Perry, 2010 ; DeLucia et al., 2019 ), with even higher PTSD rates (8% to 30%) among Intensive Care Unit (ICU) staff, ( Mealer et al., 2009 ; Karanikola et al., 2015 ; Machado et al., 2018 ).…”