# Preliminary Assessment of Post-traumatic Stress Disorder Symptoms Among Emergency Medicine Physicians During the COVID-19 Outbreak

## TL;DR

This study found that 92% of emergency medicine physicians in the U.S. experienced PTSD symptoms during the COVID-19 pandemic, with factors like prior mental health issues and rural work settings increasing symptom severity.

## Contribution

The study provides the first preliminary assessment of PTSD symptoms among U.S. emergency medicine physicians during the pandemic and identifies key contributing factors.

## Key findings

- 92% of participants reported PTSD symptoms, with 12% experiencing severe symptoms.
- Female sex, prior mental health diagnoses, and rural practice settings were linked to more severe PTSD symptoms.
- Most participants were from urban level 1 trauma centers and 40 U.S. states.

## Abstract

The COVID-19 pandemic has caused significant increases in work-related emotional stress and emergency department (ED) volumes. Our study aimed to provide a preliminary assessment of posttraumatic stress disorder (PTSD) symptoms among emergency medicine (EM) physicians in the United States following the COVID-19 pandemic and explore related factors and predictors of PTSD symptoms.

Participants were recruited using a convenience sampling approach via professional listservs from national and state EM societies. Eligible participants included board-certified or board-eligible EM physicians, EM residents, and non-EM physicians working in an EM setting during the pandemic. The survey was distributed online using Qualtrics, ensuring anonymity and data security, from September 2020 to April 2021, with active recruitment during 2 periods: September to October 2020 and March to April 2021. To optimize clarity, the survey was prepiloted and measures were included to prevent duplicate responses. Descriptive analyses were reported with percentages, means, and medians using RStudio, PBC.

A total of 362 surveys were distributed, of which 315 (87%) were completed and included in the analysis. Participants were predominantly aged 35 to 50 years (46%), White (86%), and board-certified in EM (70%), with most practicing in urban level 1 trauma centers (45%). Geographic representation included 40 states, with the largest proportions from the South (33%) and Midwest (29%). Overall, 92% of participants reported experiencing PTSD symptoms, with 41% classified as minimal, 22% mild, 18% moderate, 12% severe, and 7% very severe. The median PTSD Symptom Scale (PSS-I-5) score was 13 (IQR, 23). Factors associated with more severe PTSD symptoms included prior mental health diagnoses, female sex, and working in rural settings.

The study highlights the widespread occurrence of PTSD symptoms, with 92% of EM physicians reporting symptoms during the COVID-19 pandemic. Demographic and workplace factors, such as prior mental health diagnoses, female sex, and rural practice settings, contributed to greater symptom severity. These findings underscore the need for targeted mental health interventions and resources tailored to the specific needs of this at-risk group.