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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
Open accessAbstract
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.
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“International estimates of mental disorders among PSP range from 10% to 35%,1,9–13”
From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]
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“similarly, police officers and firefighters appeared to have the lowest estimates for current PTSD prevalence across PSP categories assessed in a recent international meta-analysis.9”
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“Differences may also be based on populations being served, such as for correctional workers who engage with incarcerated persons in extraordinary environments that can reasonably be hypothesized to increase risk for developing a mental disorder.9”
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“Similarly, paramedics report experiencing very high rates of exposure to human suffering9 for which they often feel responsible,55 potentiating substantial emotional stress.55,56”
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“The same meta-analysis did not identify substantial differences in rates when comparing self-report assessments and interview assessments.”
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“however, the association appears less consistent among PSP, with some research finding a relationship68 and other research not.9”
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Metadata
- Authors
- Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T. C., Marmar, C. R., & Mendlowicz, M. V.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Escola Nacional de Saúde Pública Sergio Arouca (BR)
- San Francisco VA Medical Center (US)
- Corresponding author
- Berger, William
- ORCID
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2011-06-18
- Volume
- 47
- Issue
- 6
- Pages
- 1001-1011
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC3974968
- OpenAlex
- W2057489037
- Cited by
- 712
- References
- 78
- Citations by year
- 2026: 47 · 2025: 69 · 2024: 57 · 2023: 69 · 2022: 76 · 2021: 69 · 2020: 87 · 2019: 68 · 2018: 46 · 2017: 40 · 2016: 28 · 2015: 27 · 2014: 12 · 2013: 11 · 2012: 5
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 – MH056350-06, R29MH057157, MH057157, MH73978, R01MH073978, R01MH056350)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- post-traumatic stress disorder, rescue workers, PTSD prevalence, ambulance personnel, firefighters, police officers, occupational injuries, PTSD prevention
- MeSH terms
- Asia, Europe, Humans, North America, Occupational Diseases, Population Surveillance, Stress Disorders, Post-Traumatic, Prevalence, Rescue Work, Emergency Responders
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