ICD-11 Posttraumatic Stress Disorder and Complex PTSD Among Hospital Medical Workers in China: Impacts of Wenchuan Earthquake Exposure, Workplaces, and Sociodemographic Factors.

Sijian Li,Chunlan Guo,Sunshine S S Chan

doi:10.3389/fpsyt.2021.735861

Abstract

BackgroundPrevious studies address posttraumatic stress disorder (PTSD) following disasters as a public health issue. However, few studies investigate the long-term effect of disaster exposure on PTSD among hospital medical workers (HMWs).ObjectivesThis study aimed to study the prevalence of ICD-11 PTSD and complex PTSD (CPTSD) among exposed and non-exposed HMWs 11 years after the Wenchuan earthquake in China, to identify the factors associated with PTSD and CPTSD scores, and to examine the factor structures of PTSD and CPTSD models.MethodsA cross-sectional study was conducted using a self-administered online questionnaire. Two thousand fifty-nine valid samples were collected from four hospitals in 2019. Descriptive statistical analysis, multivariate regression models, and confirmatory factor analysis (CFA) were performed.ResultsThe prevalence of PTSD and CPTSD was 0.58 and 0.34%, respectively. The unexposed group reported higher PTSD and CPTSD scores than the exposed group. The type of workplace and marital status were significantly associated with the PTSD and CPTSD scores of HMWs. The CFA results indicate that both the correlated first-order model and the correlated two-layer model were a good fit to explain the structure of PTSD and CPTSD.ConclusionThese findings suggest that few HMWs who were exposed to the Wenchuan earthquake suffered from PTSD or CPTSD 11 years following the disaster. However, psychological support was still necessary for all HMWs, especially for unmarried HMWs who were Working in smaller hospitals. Further research is required to analyze mental health status using ICD-11 PTSD and CPTSD to provide ongoing evidence to help HWMs cope effectively with the challenges of future disasters.

Highlights

Posttraumatic stress disorder (PTSD) is one of the most common types of psychopathologies experienced after a mass traumatic incident caused by a disaster [1]
Of the 2,059 hospital medical workers (HMWs) in the study, 9.9% experienced the Wenchuan earthquake as survivors (204 out of 2,059), 15.4% experienced the earthquake as disaster relief workers
The factors that had a significant and positive association with HMWs’ PTSD and complex PTSD (CPTSD) scores were not being exposed to the earthquake and working in a hospital that was distant from the epicenter (i.e., Hospital A). These findings confirm that geographical location has a significant role in an individual’s adaptation following a disaster as previously reported [38]. Another possible explanation for these findings is that we only examined the effect of Wenchuan earthquake exposure on PTSD and did not evaluate the effects of other natural disasters on HMWs’ mental health

Summary

Introduction

Posttraumatic stress disorder (PTSD) is one of the most common types of psychopathologies experienced after a mass traumatic incident caused by a disaster [1]. The disorder involves substantial functional impairment and often coexists with other mental health conditions, such as depression, generalized anxiety disorder, and substance abuse. As the largest component of the medical care workforce, healthcare professionals often play a vital role in providing emergency medical relief when a disaster strikes [5, 9, 10]. They are vulnerable to developing PTSD [11] because they may witness mass causalities, deaths, and severe injuries, which may cause psychological shock or intense fear. Few studies investigate the long-term effect of disaster exposure on PTSD among hospital medical workers (HMWs)

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