Early screening spots emergency workers at greater risk of mental illness


Study offers new direction for preventative interventions to increase mental resilience to stress and trauma

Emergency services workers who are more likely to suffer episodes of mental ill health later in their careers can be spotted in the first week of training. That’s the conclusion of a Wellcome Trust funded study carried out with trainee paramedics.

Researchers from the University of Oxford and King’s College London wanted to see if they could identify risk factors that made people more likely to suffer post-traumatic stress (PTSD) or major depression (MD) when working in emergency services. Their results are published in the journal Psychological Medicine.

Dr Jennifer Wild from 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 early in their training and to develop interventions that target these risk factors to strengthen their resilience.’

The researchers followed a group of around 400 new ambulance staff through the first two years of their three-year training period. During the initial six-week classroom phase of the training, the students were given a number of assessments to establish their thinking styles, coping behaviour, psychiatric history and personality traits.

Follow up sessions were carried out every four months for the next two years to see if any of the participants had had PTSD or depression. After two years, a final assessment looked at quality of life, as well as smoking, alcohol and drug use, days off work, weight change, burnout and insomnia.

Professor Anke Ehlers said: ‘While just under one in five experienced PTSD or depression in the two years, most got better by the next four-month follow-up.

‘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 who developed an episode of PTSD were also more likely to report gaining weight and smoking.’

The team found that even accounting for past psychiatric history, people were more likely to experience PTSD and depression if they had lower perceived resilience to trauma, or if they dwelled on stressful events from the past before they started their training.   Significantly, the number of traumatic incidents they experienced could not be used to predict PTSD but was relevant to predicting MD, suggesting a cumulative risk of different exposures to trauma for depression.

Dr Wild said: ‘This is not about screening out particular people in training. Early assessment means that those who are more 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.’

The full paper has been published Open Access in Psychological Medicine, ‘A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression’ by  J. Wild et al. can be viewed here free of charge.

Source: Early screening spots emergency workers at greater risk of mental illness- University of Oxford/News


Canadian Journal of Emergency Medicine joins the Cambridge Journals list

CJEM cover 1606.indd
A new partnership between Cambridge University Press and the Canadian Association of Emergency Physicians (CAEP).

From January 2015 the Canadian Journal of Emergency Medicine (CJEM) will join the Cambridge Journals list.

CJEM is a scholarly, peer-reviewed journal, produced specifically for emergency medicine care providers in rural, urban, community, and academic settings. The journal focuses on emergency medicine content relevant to clinical practice, emergency medical services, research, medical education, administration, and continuing professional development and knowledge exchange.

A key development will be the move to an online-only format, and CJEM’s readers and authors will benefit from the additional features available on Cambridge’s electronic platform, Cambridge Journals Online. These include increased usability via mobile and web-optimized sites and state-of-the-art functionality. CJEM will be available in a wide range of different article formats for devices including pdf, html, Kindle, and epub to enhance and optimise article usage. These developments will enhance CJEM’s discoverability, whilst CJEM will continue to adhere to the same high level of peer review and editorial excellence.

Speaking about the decision to partner with Cambridge University Press, Vera Klein, Executive Director, Canadian Association of Emergency Physicians, said “CAEP is very excited to be partnering with Cambridge University Press. It will help take CJEM to new heights as a completely digital publication, but it will also allow the journal to continue its focus on Canadian emergency medicine.”


Katy Christomanou, Publishing Director for STM Journals, Cambridge University Press, commented, “There is a strong fit between the CAEP’s aims and our strength in emergency medicine within both our books and journals programmes. Our focus will be on expanding the journal’s reach and impact across the community, realising the journal’s potential to attract a worldwide audience.”


View the new journal homepage here.


Leadership and Management in the operating department

Blog Post by Paul Wicker, Head of Perioperative Studies, Faculty of Health, Edge Hill University, Ormskirk, UK

Ugh! I can hear you now, after all, who on earth would be interested in a droll subject like leadership and management, let alone buy a book about it!

Well, I think that there are three main reasons why you might want to read Operating Department Practice, Leadership and Management. Firstly there are 234 million surgical procedures carried out in the world annually. Somebody has to manage that mess. Secondly, if you work in an operating department, you might be the manager taking the buck for it all. Thirdly, you might be at the receiving end of all of this. Wouldn’t you want your operation to go smoothly?

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