Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers

• Published in: The American journal of psychiatry Vol. 161; no. 8; pp. 1370 - 1376
• Main Authors: Fullerton, Carol S., Ursano, Robert J., Wang, Leming
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.08.2004; American Psychiatric Association
• Subjects: Accidents, Aviation - psychology; Acute stress disorder; Adult; Adult and adolescent clinical studies; Age Factors; Anxiety disorders. Neuroses; Biological and medical sciences; Community Mental Health Services - utilization; Depression; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Disaster Planning - methods; Disasters; Disasters - statistics & numerical data; Dissociative disorders; Dissociative Disorders - diagnosis; Dissociative Disorders - epidemiology; Emergency services; Employees; Female; Follow-Up Studies; Followup studies; Humans; Longitudinal Studies; Male; Marital Status; Medical sciences; Mental depression; Mental health care; Patient Acceptance of Health Care - statistics & numerical data; Post traumatic stress disorder; Posttraumatic stress disorder; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Rescue Work - statistics & numerical data; Rescue workers; Risk Factors; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Traumatic, Acute - diagnosis; Stress Disorders, Traumatic, Acute - epidemiology; Terrorism; United States - epidemiology; Workers; United States; Mood disorder; Human; Professional experience; Posttraumatic syndrome; Prevalence; Rescuer; Dissociative disorder; Use; Anxiety disorder; Disaster; Traffic accident; Depression; Exposure; Health service; Stress; Symptomatology; Marital status; Follow up study; Sociodemographic factor; Air traffic; Predictive factor; Age; Antecedent; Comparative study
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.161.8.1370

OBJECTIVE: The events of Sept. 11, 2001, highlighted the importance of understanding the effects of trauma on disaster workers. To better plan for the health care of disaster workers, this study examined acute stress disorder, posttraumatic stress disorder (PTSD), early dissociative symptoms, depression, and health care utilization in disaster workers. METHOD: Exposed disaster workers (N=207) and unexposed comparison subjects (N=421) were examined at 2, 7, and 13 months after an airplane crash. RESULTS: Exposed disaster workers had significantly higher rates of acute stress disorder, PTSD at 13 months, depression at 7 months, and depression at 13 months than comparison subjects. Those who were younger and single were more likely to develop acute stress disorder. Exposed disaster workers with acute stress disorder were 3.93 times more likely to be depressed at 7 months. Those with high exposure and previous disaster experience or who had acute stress disorder were more likely to develop PTSD. Similarly, those who were depressed at 7 months were 9.5 times more likely to have PTSD. Those who were depressed at 13 months were 7.96 times more likely to also meet PTSD criteria. More exposed disaster workers than comparison subjects obtained medical care for emotional problems at 2, 7, and 13 months. Overall, 40.5% of exposed disaster workers versus 20.4% of comparison subjects had acute stress disorder, depression at 13 months, or PTSD. CONCLUSIONS: Exposed disaster workers are at increased risk of acute stress disorder, depression, or PTSD and seek care for emotional problems at an increased rate.