The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort.
Pietrzak-RH; Schechter-CB; Bromet-EJ; Katz-CL; Reissman-DB; Ozbay-F; Sharma-V; Crane-M; Harrison-D; Herbert-R; Levin-SM; Luft-BJ; Moline-JM; Stellman-JM; Udasin-IG; Landrigan-PJ; Southwick-SM
J Psychiatr Res 2012 Jul; 46(7):835-842
BACKGROUND: This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort. METHODS: A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001. RESULTS: The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs]=1.56-1.86), pre-9/11 stressors (ORs=1.30-1.50), family support (ORs=0.83-0.94), and union membership (ORs=0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR=1.36), performing search and rescue work (OR=1.29), and work support (OR=0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs=3.82-41.74), and somatic symptoms and functional difficulties (ORs=1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs=2.93-7.02; and ORs=1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls). CONCLUSIONS: These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.
Mental-health; Humans; Men; Women; Police-officers; Law-enforcement-workers; Injuries; Stress; Exposure-levels; Dusts; Workers; Worker-health; Work-environment; Work-areas; Statistical-analysis; Alcohols; Psychological-stress; Psychological-reactions; Emergency-responders;
Author Keywords: Posttraumatic stress disorder; Police; World Trade Center; Depression; Healthcare needs
Robert H. Pietrzak, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, Yale University School of Medicine, 950 Campbell Avenue 151E, West Haven, CT 06516
Contract; Cooperative Agreement
Cooperative-Agreement-Number-U10-OH-008232; Contract-200-2002-0038; B08292012
Journal of Psychiatric Research
Mount Sinai School of Medicine of New York