The medical profession is associated with high demands and occupational stressors – including confrontation with illness and death, extended work hours, and high workload – which may increase the risk of traumatization and posttraumatic stress disorder (PTSD). This systematic review aimed to synthesize evidence on prevalence of PTSD among physicians and examine potential moderators, including the COVID-19 pandemic, specialties, and geographic regions.

A systematic search was conducted in PubMed, Web of Science, PsychINFO, and PubPsych up to April 2025. Included studies were English-language, peer-reviewed, observational studies, reporting PTSD prevalence in physicians, using validated instruments. Studies focusing on preselected PTSD cases or mixed healthcare samples were excluded. Data extraction included study methodology, measurement tools, geographic region, specialty, and survey timing (pre-/“post”-COVID). Risk of bias was assessed using the JBI critical appraisal checklist for prevalence studies. Quantitative synthesis and moderator analyses were performed. The review was registered with PROSPERO (ID CRD42023401984).

Based on 81 studies (N = 41,051), the pooled PTSD prevalence using a random-effects model was 14.9% (95% CI [0.132–0.168]). Prevalence estimates were lower in high-income (13.6%) compared to middle-income countries (21.1%) (p < 0.036). Studies employing brief screening tools (≤10 items) yielded significantly lower prevalence estimates (10.2%) than those using longer instruments (16.4%) (p < 0.027). No other significant moderators were identified.

PTSD prevalence among physicians is elevated relative to the general population, with notable variation across regions and measurement approaches. Future research should address gaps in representativeness and geographic coverage to improve prevalence estimates and guide prevention strategies.

The study was conducted to assess the psychological resilience and stress symptoms in health care workers following the 2023 Kahramanmaraş earthquake.

The study was completed with a sample size of 313 health care workers who experienced the earthquake and was carried out in a descriptive and correlational design. The Sociodemographic Data Form, Brief Psychological Resilience Scale (BPRS), and Traumatic Stress Symptom Scale-5 (TSSS-5) were used.

The study found that 39.6% of health care workers were diagnosed with post-traumatic stress disorder, 41.2% of participants considered leaving their jobs after the earthquake, and 79.9% reported a decrease in job motivation (slight or a lot). It was determined that there was a negative correlation between the participants’ BPRS scores and TSSS-5 scores (r:-0.523, P = 0.00).

In accordance with the findings of our study, it can be posited that traumatic stress symptoms diminished as the level of psychological resilience increased in health care workers who experienced the earthquake.

The purpose of this study is to determine the effects of the perceived trauma levels of women at reproductive age after earthquakes on their menstruation cycle.

This descriptive and correlational study was conducted between March 17, 2023, and April 17, 2023, after the earthquakes that happened in Turkey on February 6, 2023 and affected 11 cities. The study was conducted with 355 women. Data were collected using an online questionnaire form prepared via Google Forms. Data collection was performed using a Participant Information Form and the Post-Earthquake Trauma Level Determination Scale.

According to the multiple regression analysis results, the significant predictors of perceived trauma levels after the earthquakes included the severity of dysmenorrhea (β-coefficient = 0.164, P = .007), characteristics of vaginal discharge (β-coefficient = 0.136, P = .027), and itching in the perineum (β-coefficient = −0.220, P = .001). These variables explained 12.4% of the total variance in the perceived trauma levels of the participants.

The perceived trauma levels of women after the earthquakes had significant effects on the severity of dysmenorrhea, characteristics of vaginal discharge, and itching in the perineum. Health professionals should not overlook the effects of women’s perceived trauma levels on their menstruation cycles after earthquakes and evaluate the issue considering these aspects.

Robust research has established that preexisting physical and mental health conditions increase risk for adverse psychiatric outcomes after disasters. However, it is unclear if increased risk is independent of disaster exposure, and most studies have relied on retrospective reports of pre-disaster functioning.

In a pre-post sample of high-risk Puerto Rican adults (N = 361) who experienced Hurricanes Irma and Maria, we assessed: 1) whether indicators of pre-disaster depression and physical health conditions were associated with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) symptoms; and 2) whether the effects of pre-disaster depression and physical health conditions on PTSD and MDD symptoms were indirect via disaster exposure or had exacerbated the effects of disaster exposure on PTSD and MDD symptoms.

Pre-disaster depression and physical health problems were significantly associated with higher post-disaster MDD symptoms (B = 1.50, SE = 0.36, p < .001, and B = 0.21; SE = 0.09, P = 0.016), but not PTSD symptoms. Indirect effects of pre-disaster depression and physical health symptoms via disaster exposure were non-significant, and neither moderated the association of disaster exposure on PTSD and MDD symptoms.

Research is needed to understand other pathways through which pre-disaster health conditions predict post-disaster mental health.

Terrorism and trauma survivors often experience changes in biomarkers of autonomic, inflammatory and hypothalamic-pituitary-adrenal (HPA) axis assessed at various times. Research suggests interactions of these systems in chronic stress.

This unprecedented retrospective study explores long-term stress biomarkers in three systems in terrorism survivors.

Sixty healthy, direct terrorism survivors were compared to non-exposed community members for cardiovascular reactivity to a trauma script, morning salivary cortisol, interleukin 1-β (IL-1β), and interleukin 2-R (IL-2R). Survivors’ biomarkers were correlated with psychiatric symptoms and diagnoses and reported functioning and well-being seven years after the Oklahoma City (OKC) bombing.

Main outcome measures were the Diagnostic Interview Schedule (DIS) Disaster Supplement for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnoses, Impact of Events Scale-Revised (IES-R), Beck Depression Inventory-II (BDI-II), Distress and Functioning Scale (DAF), and General Physical Well-Being Scale.

Survivors had higher inflammatory IL-1β, lower anti-inflammatory IL-2R, lower cortisol, higher resting diastolic blood pressure (BP), and less cardiovascular reactivity to a trauma script than comparisons. Survivors’ mean posttraumatic stress (PTS) symptom levels did not differ from comparisons, but survivors reported worse well-being. None of survivors’ biomarkers correlated with PTS or depressive symptoms or diagnoses or reported functioning.

Alterations of biological stress measures in cardiovascular, inflammatory, and cortisol systems coexisted as an apparent generalized long-term response to terrorism rather than related to specific gauges of mental health. Potential interactions of biomarkers long after trauma exposure is discussed considering relevant research. Longer-term follow-up could determine whether biomarkers continue to differ or correlate with subjective measures, or if they accompany health problems over time. Given recent international terrorism, understanding long-term sequelae among direct survivors is increasingly relevant.

It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye.

Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaraş region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder–Short Scale.

A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression.

It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.

Adolescent substance use, externalizing and attention problems, and early life stress (ELS) commonly co-occur. These psychopathologies show overlapping neural dysfunction in the form of reduced recruitment of reward processing neuro-circuitries. However, it is unclear to what extent these psychopathologies show common v. different neural dysfunctions as a function of symptom profiles, as no studies have directly compared neural dysfunctions associated with each of these psychopathologies to each other.

In study 1, a latent profile analysis (LPA) was conducted in a sample of 266 adolescents (aged 13–18, 41.7% female, 58.3% male) from a residential youth care facility and the surrounding community to investigate substance use, externalizing and attention problems, and ELS psychopathologies and their co-presentation. In study 2, we examined a subsample of 174 participants who completed the Passive Avoidance learning task during functional magnetic resonance imaging to examine differential and/or common reward processing neuro-circuitry dysfunctions associated with symptom profiles based on these co-presentations.

In study 1, LPA identified profiles of substance use plus rule-breaking behaviors, attention-deficit hyperactivity disorder, and ELS. In study 2, the substance use/rule-breaking profile was associated with reduced recruitment of reward processing and attentional neuro-circuitries during the Passive Avoidance task (p < 0.05, corrected for multiple comparisons).

Findings indicate that there is reduced responsivity of striato-cortical regions when receiving outcomes on an instrumental learning task within a profile of adolescents with substance use and rule-breaking behaviors. Mitigating reward processing dysfunction specifically may represent a potential intervention target for substance-use psychopathologies accompanied by rule-breaking behaviors.

Identification of genetic risk factors may inform the prevention and treatment of posttraumatic stress disorder (PTSD). This study evaluates the associations of polygenic risk scores (PRS) with patterns of posttraumatic stress symptoms following combat deployment.

US Army soldiers of European ancestry (n = 4900) provided genomic data and ratings of posttraumatic stress symptoms before and after deployment to Afghanistan in 2012. Latent growth mixture modeling was used to model posttraumatic stress symptom trajectories among participants who provided post-deployment data (n = 4353). Multinomial logistic regression models tested independent associations between trajectory membership and PRS for PTSD, major depressive disorder (MDD), schizophrenia, neuroticism, alcohol use disorder, and suicide attempt, controlling for age, sex, ancestry, and exposure to potentially traumatic events, and weighted to account for uncertainty in trajectory classification and missing data.

Participants were classified into low-severity (77.2%), increasing-severity (10.5%), decreasing-severity (8.0%), and high-severity (4.3%) posttraumatic stress symptom trajectories. Standardized PTSD-PRS and MDD-PRS were associated with greater odds of membership in the high-severity v. low-severity trajectory [adjusted odds ratios and 95% confidence intervals, 1.23 (1.06–1.43) and 1.18 (1.02–1.37), respectively] and the increasing-severity v. low-severity trajectory [1.12 (1.01–1.25) and 1.16 (1.04–1.28), respectively]. Additionally, MDD-PRS was associated with greater odds of membership in the decreasing-severity v. low-severity trajectory [1.16 (1.03–1.31)]. No other associations were statistically significant.

Higher polygenic risk for PTSD or MDD is associated with more severe posttraumatic stress symptom trajectories following combat deployment. PRS may help stratify at-risk individuals, enabling more precise targeting of treatment and prevention programs.

Post-intensive care syndrome, which includes symptoms of anxiety, depression, and posttraumatic stress, afflicts one-third of critical illness survivors. Symptoms persist and significantly degrade quality of life. No intervention has earned clear evidence of reducing these adverse psychological sequelae. Building on earlier pilot data, psychological support based on positive suggestions (PSBPS), is being investigated in an ongoing, randomized, controlled prospective trial across multiple intensive care unit (ICU) settings in a large, tertiary medical center.

Recognizing that even sedated patients perceive and internalize communication, we share lessons learned thus far in the art of engaging with sedated, often unresponsive patients.

Our presentation describes this NIH-funded PSBPS study, including the preparatory training and subsequent implementation of a structured script delivered daily to ICU patients, regardless of cognitive status or ability to respond. To interfere with the initial process of fear conditioning/negative memory formation, we introduce mitigating information about potentially traumatic events during the temporal window when initial memory consolidation occurs, reframing the alien, often frightening ICU environment while providing positive suggestions of safety and healing.

Psychiatrists characteristically engage alert, communicative patients. Unfortunately, when meaningful cognitive exchange is impossible, further effort is often limited. By contrast, choosing to engage ventilated, sedated patients with active re-interpretation is a novel enterprise. We share technique and lessons learned from the first two years.

Consultation psychiatrists are uniquely situated to explore with our critical care colleagues how best to mitigate the corrosive psychological consequences of intensive care and improve the future of ICU survivors.

No significant relationships.

Persistent psychological distress associated with the coronavirus disease 2019 (COVID-19) pandemic has been well documented. This study aimed to identify pre-COVID brain functional connectome that predicts pandemic-related distress symptoms among young adults.

Baseline neuroimaging studies and assessment of general distress using the Depression, Anxiety and Stress Scale were performed with 100 healthy individuals prior to wide recognition of the health risks associated with the emergence of COVID-19. They were recontacted for the Impact of Event Scale-Revised and the Posttraumatic Stress Disorder Checklist in the period of community-level outbreaks, and for follow-up distress evaluation again 1 year later. We employed the network-based statistic approach to identify connectome that predicted the increase of distress based on 136-region-parcellation with assigned network membership. Predictive performance of connectome features and causal relations were examined by cross-validation and mediation analyses.

The connectome features that predicted emergence of distress after COVID contained 70 neural connections. Most within-network connections were located in the default mode network (DMN), and affective network-DMN and dorsal attention network-DMN links largely constituted between-network pairs. The hippocampus emerged as the most critical hub region. Predictive models of the connectome remained robust in cross-validation. Mediation analyses demonstrated that COVID-related posttraumatic stress partially explained the correlation of connectome to the development of general distress.

Brain functional connectome may fingerprint individuals with vulnerability to psychological distress associated with the COVID pandemic. Individuals with brain neuromarkers may benefit from the corresponding interventions to reduce the risk or severity of distress related to fear of COVID-related challenges.

Refugees report a diverse array of psychological responses following persecution and displacement. Little is known, however, regarding the mechanisms that underlie differential psychological reactions in refugees. This study investigated the longitudinal impact of negative moral appraisals about one's own actions [i.e. moral injury-self (MI-self) appraisals] and others' actions [i.e. moral injury-other (MI-others) appraisals] on a variety of psychological symptoms over a period of 6 months.

Participants were 1085 Arabic, Farsi, Tamil, or English-speaking refugees who completed a survey at baseline and 6 months later either on-line or via pen-and-paper. The survey indexed demographic factors, exposure to potentially traumatic events (PTEs), exposure to ongoing stressors, MI-other appraisals, MI-self appraisals, re-experiencing and arousal symptoms, and feelings of sadness, anger and shame.

Findings indicated that, after controlling for demographics, PTE exposure and ongoing stressors, MI-other appraisals predicted increased re-experiencing and hyperarousal symptoms, and feelings of sadness and shame. MI-self appraisals predicted decreased feelings of shame, and decreased re-experiencing symptoms. In contrast, psychological symptoms at baseline did not as strongly influence MI appraisals 6 months later.

These findings highlight the important role that cognitive appraisals of adverse events play in the longitudinal course of psychological symptoms. These results thus have important implications for the development of tailored psychological interventions to alleviate the mental health burden held by refugees.

The objective of this study was to examine associations between media contact and posttraumatic stress in a sample with a large number of individuals who were directly exposed to the September 11, 2001 (9/11) attacks and to compare outcomes in exposed and unexposed participants.

Structured interviews and questionnaires were administered to a volunteer sample of 254 employees of New York City businesses 35 months after the attacks to document disaster trauma exposures, posttraumatic stress outcomes, and media contact and reactions.

Media variables were not associated with psychopathological outcomes in exposed participants, but media contact in the first week after the attacks and feeling moderately/extremely bothered by graphic 9/11 media images were associated with re-experiencing symptoms in both the exposed and unexposed participants. Feeling moderately/extremely bothered by graphic media images was associated with hyperarousal symptoms in exposed participants.

The findings suggest that media contact did not lead to psychopathology in exposed individuals, although it was associated with normative distress in both exposure groups. Because of the potential for adverse effects associated with media contact, clinicians and public health professionals are encouraged to discuss concerns about mass trauma media contact with their patients and the public at large.

Visual and auditory signs of patient functioning have long been used for clinical diagnosis, treatment selection, and prognosis. Direct measurement and quantification of these signals can aim to improve the consistency, sensitivity, and scalability of clinical assessment. Currently, we investigate if machine learning-based computer vision (CV), semantic, and acoustic analysis can capture clinical features from free speech responses to a brief interview 1 month post-trauma that accurately classify major depressive disorder (MDD) and posttraumatic stress disorder (PTSD).

N = 81 patients admitted to an emergency department (ED) of a Level-1 Trauma Unit following a life-threatening traumatic event participated in an open-ended qualitative interview with a para-professional about their experience 1 month following admission. A deep neural network was utilized to extract facial features of emotion and their intensity, movement parameters, speech prosody, and natural language content. These features were utilized as inputs to classify PTSD and MDD cross-sectionally.

Both video- and audio-based markers contributed to good discriminatory classification accuracy. The algorithm discriminates PTSD status at 1 month after ED admission with an AUC of 0.90 (weighted average precision = 0.83, recall = 0.84, and f1-score = 0.83) as well as depression status at 1 month after ED admission with an AUC of 0.86 (weighted average precision = 0.83, recall = 0.82, and f1-score = 0.82).

Direct clinical observation during post-trauma free speech using deep learning identifies digital markers that can be utilized to classify MDD and PTSD status.

As self-injurious thoughts and behaviors (SITB) remain a pressing public health concern, research continues to focus on risk factors, such as posttraumatic stress disorder (PTSD). Network analysis provides a novel approach to examining the PTSD-SITB relationship. This study utilized the network approach to elucidate how individual PTSD symptoms may drive and maintain SITB.

We estimated cross-sectional networks in two samples of trauma-exposed adults (Sample 1: N = 349 adults; Sample 2: N = 1307 Veterans) to identify PTSD symptoms that may act as bridges to SITB. Additionally, we conducted a cross-lagged panel network in Sample 2 to further clarify the temporal relationship between PTSD symptoms and SITB during a 2-year follow-up. Finally, in both samples, we conducted logistic regressions to examine the utility of PTSD symptoms in prospectively predicting SITB, over a 15-day period (Sample 1) and over a 2-year period (Sample 2), allowing us to examine both short- and long-term prediction.

Two PTSD symptoms (i.e. negative beliefs and risky behaviors) emerged as highly influential on SITB in both cross-sectional networks. In the cross-lagged panel network, distorted blame emerged as highly influential on SITB over time. Finally, risky behaviors, unwanted memories, and psychological distress served as the strongest predictors of SITB across the two samples.

Overall, our results suggest that treatments targeting negative beliefs and risky behaviors may prevent SITB in community and Veteran populations, whereas treatments targeting distorted blame and unwanted memories may help reduce SITB for individuals with a history of combat trauma.