Objective <p>Paramedics are often exposed to challenging and potentially traumatic situations. Several studies have examined the prevalence of posttraumatic stress disorder (PTSD) among paramedics; however, controlled epidemiological studies comparing the risk of PTSD among paramedics with the risk of the general working population are lacking. This pilot study aims to contribute to the closure of this research gap.</p> Methods <p>This cross-sectional study included 125 paramedics and 103 white collar workers in Dresden and Heilbronn, Germany. The 1‑month prevalence of PTSD (with 95% Wilson confidence intervals, CI) according to DSM‑5 and DSM-IV was determined with the PCL-5/PCL‑C screening instrument. To estimate the risk of PTSD among emergency paramedics, odds ratios (OR) with 95% CI were calculated using logistic regression analysis, adjusted for age, sex and socioeconomic status.</p> Results <p>The 1‑month prevalence of PTSD among paramedics was 5.7% (95% CI 2.8–11.4%) based on DSM‑5 and 4.9% (95% CI 2.3–10.3%) based on DSM-IV. The corresponding PTSD prevalence among white collar workers was 2.3% (95% CI 0.6–8.0%) for both screening instruments. Dimensional analysis of DSM-IV substantially changed prevalence estimates. A&#xa0;statistically nonsignificant increased OR of&#xa0;2.9 (95% CI 0.3–26.6) was found based on DSM‑5 and&#xa0;4.4 (95% CI 0.5–42.2) based on DSM-IV. In a&#xa0;dimensional analysis according to DSM-IV, no increased PTSD risk was observed among paramedics (OR = 0.8; 95% CI 0.1–6.1). For the majority of both emergency and administrative personnel diagnosed with PTSD, a&#xa0;private event was reported as the most severe trauma they had experienced.</p> Conclusion <p>The prevalence of PTSD can vary considerably depending on the diagnostic instrument used. The increased PTSD risk found in our pilot study among paramedics compared to white collar workers cannot be statistically confirmed; however, the study power is limited. Further controlled studies are needed to investigate the risk of PTSD in paramedics. We are planning to considerably increase the power of the study by performing a&#xa0;pooled analysis with an ongoing study in the German state of Hesse and by conducting a&#xa0;follow-up survey.</p>

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Posttraumatische Belastungsstörung bei Beschäftigten im Rettungsdienst

  • Andreas Seidler,
  • Anna-Lena Höckel,
  • Tobias Büttner,
  • Daniel Kämpf,
  • David Reißig,
  • René Mauer,
  • Ulrich Bolm-Audorff,
  • Gabriela Petereit-Haack,
  • Albert Nienhaus,
  • Helge Höllmer,
  • Melanie Schubert

摘要

Objective

Paramedics are often exposed to challenging and potentially traumatic situations. Several studies have examined the prevalence of posttraumatic stress disorder (PTSD) among paramedics; however, controlled epidemiological studies comparing the risk of PTSD among paramedics with the risk of the general working population are lacking. This pilot study aims to contribute to the closure of this research gap.

Methods

This cross-sectional study included 125 paramedics and 103 white collar workers in Dresden and Heilbronn, Germany. The 1‑month prevalence of PTSD (with 95% Wilson confidence intervals, CI) according to DSM‑5 and DSM-IV was determined with the PCL-5/PCL‑C screening instrument. To estimate the risk of PTSD among emergency paramedics, odds ratios (OR) with 95% CI were calculated using logistic regression analysis, adjusted for age, sex and socioeconomic status.

Results

The 1‑month prevalence of PTSD among paramedics was 5.7% (95% CI 2.8–11.4%) based on DSM‑5 and 4.9% (95% CI 2.3–10.3%) based on DSM-IV. The corresponding PTSD prevalence among white collar workers was 2.3% (95% CI 0.6–8.0%) for both screening instruments. Dimensional analysis of DSM-IV substantially changed prevalence estimates. A statistically nonsignificant increased OR of 2.9 (95% CI 0.3–26.6) was found based on DSM‑5 and 4.4 (95% CI 0.5–42.2) based on DSM-IV. In a dimensional analysis according to DSM-IV, no increased PTSD risk was observed among paramedics (OR = 0.8; 95% CI 0.1–6.1). For the majority of both emergency and administrative personnel diagnosed with PTSD, a private event was reported as the most severe trauma they had experienced.

Conclusion

The prevalence of PTSD can vary considerably depending on the diagnostic instrument used. The increased PTSD risk found in our pilot study among paramedics compared to white collar workers cannot be statistically confirmed; however, the study power is limited. Further controlled studies are needed to investigate the risk of PTSD in paramedics. We are planning to considerably increase the power of the study by performing a pooled analysis with an ongoing study in the German state of Hesse and by conducting a follow-up survey.