Posttraumatic Stress Disorder Among Hospital Surgical Physicians Exposed to Victims of Terror: A Prospective, Controlled Questionnaire Survey
J Clin Psychiatry 2006;67:890-896
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background and Objective: Surgical
physicians often treat victims of terror-related
multiple-casualty incidents. This may cause secondary posttraumatic stress disorder
(PTSD), impairing their ability to care for patients.
The objective of this study was to determine
whether professional exposure to victims of terror
caused PTSD in Israeli physicians from surgical
Method: This was a validated
questionnaire survey of physicians (November 2002
through March 2003) from 2 Jerusalem hospitals (a
tertiary trauma center and a secondary regional
hospital) divided into study (physicians from
surgical disciplines regularly exposed to victims of
terror) and control (physicians not regularly
exposed) groups. Questionnaires included the PTSD
Symptom Scale-Self-Report to diagnose PTSD (DSM-IV criteria) and allowed exclusion of other
causes of similar symptoms. The main outcome
measure was the difference in the prevalence of
PTSD between groups.
Results: Included were 212 (102 study,
110 control) participants. The study group experienced a significantly higher level of exposure
to terror victims at work, validating prospective group definitions. The prevalence of PTSD
was similar in both groups (study group = 16%,
control group = 15%; p = 1.00). The study and control groups were similar in all predicting
variables except for number of years in medical
practice, occupational status, and workplace. The
groups had similar levels of exposure to terror
outside work (p = .24). The probability that a
physician would have PTSD was related to use of
nonadaptive coping strategies (OR = 5.1; p = .009) and a higher level of exposure to terror out of
work (OR = 3.5; p = .013).
Conclusion: Hospital physicians from
surgical disciplines who were professionally exposed
to victims of terror did not demonstrate a higher incidence of PTSD than their less exposed