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Posttraumatic Stress Disorder Among Hospital Surgical Physicians Exposed to Victims of Terror: A Prospective, Controlled Questionnaire Survey

J Clin Psychiatry 2006;67:890-896

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 disciplines.

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 counterparts.