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      The impact of the Paris terrorist attacks on the mental health of resident physicians

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          Abstract

          Background

          On November 13, 2015, terrorist attacks took place in Paris. One hundred and twenty-nine people were immediately killed and 302 needed emergency care. Many resident physicians were on the front line of the medical response. Our aim was to report the frequency of symptoms of post-traumatic stress disorder (PTSD), anxiety and depression among resident physicians after the Paris terrorist attacks.

          Methods

          Anonymous questionnaires, including the Impact of Event Scale- Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), were emailed two months after the attacks to 2413 Parisian resident physicians. Exposure to the attacks was defined as having direct clinical contact with one of the victims up to one week after the attacks, being one of the victims, or having one among close relatives.

          Results

          The questionnaire was completed by 680 (28.2%) residents. Eighty-four (12.4%) reported symptoms of PTSD (IES-R ≥ 33), 76 (11.2%) reported symptoms of anxiety (HADS anxiety score > 10) and 16 (2.4%) reported symptoms of depression (HADS depression score > 10). Exposed residents had higher IES-R scores than non-exposed residents (18.8 ± 16.6 versus 14.2 ± 12.0, p = 0.001), and 40 (18.5%) of them reported symptoms of PTSD, compared to 44 (9.5%) of the non-exposed residents ( p = 0.001).

          Conclusions

          There was a high frequency of symptoms of mental distress among our respondents. Dedicated screening and care strategies must be considered in the event of new attacks.

          Electronic supplementary material

          The online version of this article (10.1186/s12888-019-2058-y) contains supplementary material, which is available to authorized users.

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          Most cited references46

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          The Hospital Anxiety and Depression Scale

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            Posttraumatic stress disorder in the National Comorbidity Survey.

            Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode. Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey. The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years. Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.
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              Impact of Event Scale: a measure of subjective stress.

              Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.
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                Author and article information

                Contributors
                jules.gregory@mail.mcgill.ca , juleslouisgregory@gmail.com
                j.delepinau@outlook.fr
                ariane.debuyer@neuf.fr
                nicolas.delanoy@gmail.com
                olivier.mir@gustaveroussy.fr
                raphael.gaillard@normalesup.org
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                21 February 2019
                21 February 2019
                2019
                : 19
                : 79
                Affiliations
                [1 ]ISNI 0000 0001 2175 4109, GRID grid.50550.35, Syndicat des Internes des Hôpitaux de Paris (SIHP), ; 17 rue du Fer à Moulin, 75005 Paris, France
                [2 ]ISNI 0000 0001 2284 9388, GRID grid.14925.3b, Department of Cancer Medicine, , Gustave Roussy Cancer Campus, Université Paris-Saclay, ; Villejuif, France
                [3 ]ISNI 0000 0001 2188 0914, GRID grid.10992.33, Department of Psychiatry, , Service Hospitalo-Universitaire, Centre Hospitalier Sainte Anne, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine Paris Descartes, ; Paris, France
                Author information
                http://orcid.org/0000-0001-6081-1663
                Article
                2058
                10.1186/s12888-019-2058-y
                6385411
                30791878
                5c3c2a2a-fb0f-4a30-8d0c-bb0967233ceb
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 June 2018
                : 13 February 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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