Early Screening Can Spot Emergency Workers at Greater Risk for Depression

A team of researchers from the University of Oxford and King’s College London wanted to find out if they could identify the risk factors which made people more likely to suffer post-traumatic stress disorder (PTSD) or major depression (MD) when working with emergency services.

The Study

Dr. Jennifer Wild, of the University of Oxford explained “Emergency workers are regularly exposed to stressful and traumatic situations and some of them will experience periods of mental illness. Some of the factors that make that more likely can be changed through resilience training, reducing the risk of PTSD and depression. We wanted to test whether we could identify such risk factors, making it possible to spot people at higher risk in their early training and to develop interventions that target these risk factors to strengthen their resilience.”

The team studied a group of 400 new ambulance workers through the first two years of their three-year training period. During the initial 6-week classroom phase of the training, the students received a number of assessments to establish their thinking style, coping behavior, psychiatric history and personality type.

The team then carried out follow up sessions every four months for the next two years to see if any of the participant experienced PTSD or depression. After two years, a final assessment was given to look at quality of life, as well as drinking and smoking use, weight changes, insomnia and burnout.
Professor Anke Ehlers stated, “While just under one in five experienced PTSD or depression in the two years, most got better by the next four-month follow-up.”

He further said, “However, there were still lasting effects. Those who had reported mental ill health were more likely to have sleep problems at 2 years. They were also more likely to have days off work. Paramedics developed an episode of PTSD were also more likely to report weight gain and smoking.”
The team discovered that even after accounting for past psychiatric history, individuals were more likely to experience depression or PTSD if they had lowered perceived resilience to trauma or if they dwelled on stressful past events, prior to beginning their training. Significantly, the number of traumatic incidents they experienced could not be used to predict PTSD, but was relevant to predicting major depression, which suggests a cumulative risk of different exposures to trauma for depression.

Conclusion:

Dr. Wild stated in closing, “This is not about screening out particular people in training. Early assessment means that those who are at risk can be offered training to improve their resilience to stressful and traumatic experiences. That has the potential to reduce episodes of PTSD and major depression and improve the long-term health of a valued and essential workforce.”