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Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers

Abstract

Purpose  

We sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine
the variables implicated in the heterogeneity observed among the prevalences of individual studies.

Methods  

A systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential
steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference
list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate
meta-regression models were fitted to identify variables related to the prevalences heterogeneity.

Results  

A total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence
was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences
than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher
estimated PTSD prevalence than studies with firefighters and police officers.

Conclusions  

Rescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population.
Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving
pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures
for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.

  • Content Type Journal Article
  • Category Original Paper
  • Pages 1-11
  • DOI 10.1007/s00127-011-0408-2
  • Authors
    • William Berger, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rua Almirante Saddock de Sá, 290/402 Ipanema, Rio de Janeiro, RJ 22411-040, Brazil
    • Evandro Silva Freire Coutinho, Department of Epidemiology, Escola Nacional de Saúde Pública (ENSP-FIOCRUZ), Rio de Janeiro, RJ, Brazil
    • Ivan Figueira, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rua Almirante Saddock de Sá, 290/402 Ipanema, Rio de Janeiro, RJ 22411-040, Brazil
    • Carla Marques-Portella, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rua Almirante Saddock de Sá, 290/402 Ipanema, Rio de Janeiro, RJ 22411-040, Brazil
    • Mariana Pires Luz, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rua Almirante Saddock de Sá, 290/402 Ipanema, Rio de Janeiro, RJ 22411-040, Brazil
    • Thomas C. Neylan, Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
    • Charles R. Marmar, Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
    • Mauro Vitor Mendlowicz, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rua Almirante Saddock de Sá, 290/402 Ipanema, Rio de Janeiro, RJ 22411-040, Brazil
    • Journal Social Psychiatry and Psychiatric Epidemiology
    • Online ISSN 1433-9285
    • Print ISSN 0933-7954
Posted in: Meta-analyses - Systematic Reviews on 07/09/2011 | Link to this post on IFP |
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