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Symptoms of post-traumatic stress disorder among emergency medicine residents

  • Lisa D. Mills
    Correspondence
    Reprint Address: Lisa D. Mills, md, Charity Hospital/LSUHSC, Department of Medicine, Section of Emergency Medicine, 1532 Tulane Ave., Room 1351, New Orleans, LA 70112
    Affiliations
    Department of Medicine, Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana (at time of study: University of Texas Southwestern, Dallas, TX)
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  • Trevor J. Mills
    Affiliations
    Department of Medicine, Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana (at time of study: University of Texas Southwestern, Dallas, TX)
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      Abstract

      There have been anecdotal reports of post-traumatic stress disorder (PTSD) in physicians responding to mass casualty events. No formal, prospective study has addressed the presence of PTSD symptoms as a result of the work of Emergency Medicine residents in non-mass casualty settings. The purpose of this study is to evaluate the presence of symptoms of PTSD among Emergency Medicine residents (EMR). The study was a survey of EMR, administered in an anonymous, voluntary format in late June 2001. The survey was conducted at an Emergency Medicine residency program that serves a large, urban, county hospital. Four groups, incoming interns and three EM resident classes were surveyed. PTSD symptoms were divided into three categories according to the DSM IV. The Jonckheere-Terpstra test for trends was applied to each of the three categories of symptoms. Sixty-three surveys were administered, with a 93.6% response rate. All respondents reported experience with patient death or dying. Seven residents reported sufficient symptoms to meet the DSM IV criteria for PTSD. Each of the three symptom categories showed a statistically significant increase in the proportion of positive responses as the resident time in training increased (p < 0.01). In conclusion, many EM residents reported symptoms of PTSD. Symptoms of PTSD significantly increased as resident level of training increased.

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      References

      1. Diagnostic and statistical manual of mental disorders. 4th edn. American Psychiatric Association, Washington1994
      2. Kessler RC. PTSD: the burden to the individual and to society. J Clin Psychiatry 61:4–12.

        • Zimmerman M.
        • Mattia J.I.
        Is posttraumatic stress disorder underdiagnosed in routine clinical settings?.
        J Nerv Ment Dis. 1999; 187: 420-428
        • Firth-Cozens J.
        • Midgley S.J.
        • Burges C.
        Questionnaire survey of post-traumatic stress disorder in doctors involved in the Omagh bombing.
        BMJ. 1999; 319: 1609
        • Friedman S.A.
        • Brandes D.
        • Peri T.
        • Shaley A.
        Predictors of chronic post-traumatic stress disorder.
        Br J Psychiatry. 1999; 174: 353-359
      3. Psychiatr Ann. 1991; 21: 2
        • Birch D.
        • Ashton H.
        • Kamali F.
        Alcohol, drinking, illicit drug use, and stress in junior house officers in north-east England.
        Lancet. 1998; 352: 785-786
        • Summerfield D.
        Post-traumatic stress disorder in doctors involved in the Omagh bombing.
        BMJ. 2000; 320: 1276
        • Tyssen R.
        • Vaglum P.
        • Gronvold N.T.
        • Ekeberg O.
        The impact of job stress and working conditions on mental health problems among junior house officer.
        Med Educ. 2000; 34: 374-384
        • Kapur N.
        • Borrill C.
        • Stride C.
        Psychological morbidity and job satisfaction in hospital consultants and junior house officers.
        BMJ. 1998; 317: 511-512
        • Horowitz M.
        • Wilner N.
        • Alvarez W.
        Impact of event scale.
        Psychosom Med. 1979; 41: 209-218
        • Blake D.D.
        • Weathers F.W.
        • Nagy L.M.
        • et al.
        The development of a clinician-administered PTSD scale.
        J Traum Stress. 1995; 8: 75-90
        • Blanchard E.B.
        • Jones-Alexander J.
        • Buckley T.C.
        • Fomeris C.A.
        Psychometric properties of the PTSD checklist.
        Behav Res Ther. 1996; 34: 669-673
        • Hollander M.
        • Wolfe E.D.
        Nonparametric statistical methods.
        John Wiley, New York1999
      4. Model Curriculum Task Force. Model curriculum and guidelines. Available at: www.saem.org/inform/modelins.htm. Accessed August 2002.

        • Fischer J.E.
        • Calame A.
        • Dettling A.C.
        • Zeier H.
        • Fanconi S.
        Experience and endocrine stress responses in neonatal and pediactric critical care nurses and physicians.
        Crit Care Med. 2000; 28: 3281-3288
        • Gitlin M.J.
        A psychiatrist’s reaction to a patient’s suicide.
        Am J Psychiatry. 1999; 156: 1630-1634
        • Zisook S.
        • Chentsova-Dutton
        • Shuchter S.R.
        PTSD following bereavement.
        Ann Clin Psychiatry. 1998; 10: 157-163
        • Jefferson T.
        Primary care physicians and posttraumatic stress disorder.
        JAMA. 1999; 282: 1710-1711
        • Klain E.
        • Pavic L.
        Countertransference and empathic problems in therapists/helpers working with psychotraumatized persons.
        Croat Med J. 1999; 40: 466-472