Post-traumatic symptoms in the staff of a mental health inpatient unit after the suicide of a patient: a case report in Chile
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Resumen
BACKGROUND: Multiple studies have shown that the suicide of a patient can produce posttraumatic and depressive symptoms among the mental health care providers, who typically have high levels of baseline burnout. OBJECTIVES: To measure posttraumatic, depressive and burnout symptoms in the staff of an inpatient psychiatric unit after the suicide of a patient. METHODS: Two months after the suicide all the employees were invited to answer, anonymously, the Posttraumatic Check-List (PCL), the Beck Depression Inventory (BDI), and the Maslach Burnout Inventory (MBI), for measuring posttraumatic, depressive, and burnout symptoms, respectively. RESULTS: Over 80% of the staff participated. A total of 17.1% had probable PTSD, 19.5% probable major depression, 24.4% and 14.6% high levels of emotional exhaustion and depersonalization, respectively, and 24.4% low levels of professional accomplishment. The group consisting of nurses, paramedic technicians, and nursing assistants ("nursing staff") had PTSD significantly greater than other workers (p < .001). CONCLUSIONS: Suicide in a psychiatric ward can produce posttraumatic and depressive symptoms among the staff, as high as another kind of traumas. The impact may be greater on the nursing staff. It is essential that organizations involved in the provision or teaching of mental health care incorporate this reality into their agenda, to prevent, mitigate and respond better to this phenomenon.
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Derechos de autor 2017 Summa Psicológica
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Referencias
Aiken, L., Sermeus, W., Van den Heede, K., Sloane, D., Busse, R., McKee, M. & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. The British Medical Journal, 344, 1-14. doi:10.1136/bmj.e1717
Avendaño, C., Bustos, P., Espinoza, P., García, F. & Pierart, T. (2009). Burnout y apoyo social en personal del servicio de psiquiatría de un hospital público. Ciencia y Enfermería, 15(2), 55-68. doi:10.4067/S0717-95532009000200007
Beck, A., Rush, A., Shaw, B. & Emery, G. (1979). Cognitive therapy of depression (1st ed.). New York: The Guildford Press.
Blanchard, E., Jones-Alexander, J., Buckley, T. & Forneris, C. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34(8), 669-673. doi:10.1016/0005-7967(96)00033-2
Bonanno, G., Brewin, C., Kaniasty, K. & Greca, A. (2010). Weighing the costs of disaster consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest, 11(1), 1-49. doi:10.1177/1529100610387086
Brewin, C., Andrews, B. & Valentine, J. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748-766. doi:10.1037/0022-006X.68.5.748
Bromet, E. (2014). Emotional consequences of nuclear power plant disasters. Health Physics, 106(2), 206-210. doi:10.1097/HP.0000000000000012
Brown, H. (1987). The impact of suicide on therapists in training. Comprehensive Psychiatry, 28(2), 101-112. doi:10.1016/0010-440X(87)90075-7
Campbell, C. & Fahy, T. (2002). The role of the doctor when a patient commits suicide. Psychiatric Bulletin, 26(2), 44-49. doi:10.1192/pb.26.2.44
Cappelli, M., Clulow, M., Goodman, J., Davidson, S., Feder, S., Baron, P., … & McGrath, P. (1995). Identifying depressed and suicidal adolescents in a teen health clinic. Journal of Adolescent Health, 16(1), 64-70. doi:10.1016/1054-139X(94)00076-Q
Carpenter, L., Swerdlow, A. & Fear, N. (1997). Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants. Occupational and Environmental Medicine, 54(6), 388-395. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1128798/
Chemtob, C., Bauer, G., Hamada, R., Pelowski, S. & Muraoka, M. (1989). Patient suicide: Occupational hazard for psychologists and psychiatrists. Professional Psychology: Research and Practice, 20(5), 294-300. doi:10.1037/0735-7028.20.5.294
Chemtob, C., Hamada, R., Bauer, G., Kinney, B. & Torigoe, R. (1988). Patients’ suicides: frequency and impact on psychiatrists. The American Journal of Psychiatry, 145(2), 224-228. doi:10.1176/ajp.145.2.224
Cryan, M., Kelly, P. & McCaffrey, B. (1995). The experience of patient suicide among Irish psychiatrists. Psychiatric Bulletin, 19(1), 4-7. doi:10.1192/pb.19.1.4
David, A., Bedford, N., Wiffen, B. & Gilleen, J. (2012). Failures of metacognition and lack of insight in neuropsychiatric disorders. Philosophical Transactions B, 367(1594), 1379-1390. doi:10.1098/rstb.2012.0002
Dewar, I., Eagles, J., Klein, S., Gray, N. & Alexander, D. (2000). Psychiatric trainees’ experiences of, and reactions to patient suicide. Psychiatric Bulletin, 24(1), 20-23. doi:10.1192/pb.24.1.20
Edwards, B., Lambert, M., Moran, P., McCully, T., Smith, K. & Ellingson, A. (1984). A meta-analytic comparison of the Beck Depression Inventory and the Hamilton Rating Scale for Depression as measures of treatment outcome. British Journal of Clinical Psychology, 23(2), 93-99. doi:10.1111/j.2044-8260.1984.tb00632
Farberow, N. (2005). The mental health professional as suicide survivor. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 2(1), 13-20. Retrieved from http://www.clinicalneuropsychiatry.org/pdf/03_farberow.pdf
Grad, O. & Michel, K. (2005). Therapists as client suicide survivors. Therapeutic and Legal Issues for Therapists Who Have Survived a Client Suicide: Breaking the Silence. New York: Routledge.
Grad, O., Zavasnik, A. & Groleger, U. (1997). Suicide of a patient: gender differences in bereavement reactions of therapists. Suicide and Life-Threatening Behavior, 27(4), 379-386. doi:10.1111/j.1943-278X.1997.tb00517.x
Gulfi, A., Castelli Dransart, D., Heeb, J. & Gutjahr, E. (2010). The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis, 31(4), 202-210. doi:10.1027/0027-5910/a000027
Hawton, K., Clements, A., Sakarovitch, C., Simkin, S. & Deeks, J. (2001). Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995. Journal of Epidemiology & Community Health, 55(5), 296-300. doi:10.1136/jech.55.5.296
Hendin, H., Lipschitz, A., Maltsberger, J., Haas, A. & Wynecoop, S. (2000). Therapists’ reactions to patients’ suicides. The American Journal of Psychiatry, 157(12), 2022-2027. doi:10.1176/appi.ajp.157.12.2022
Henry, M., Séguin, M. & Drouin, S. (2008). L’impact du suicide d’un patient chez des professionnels en santé mentale. Frontières, 21(1), 53-63. doi:10.7202/037874ar
Hernández, J. (2003). Estrés y Burnout en profesionales de la salud de los niveles primario y secundario de atención. Revista Cubana de Salud Pública, 29(2), 103-110. Retrieved from http://ref.scielo.org/47mptm
Horn, P. (1994). Therapists’ psychological adaptation to client suicide. Psychotherapy: Theory, Research, Practice, Training, 31(1), 190-195. doi:10.1037/0033-3204.31.1.190
Horn, P. (1995). Therapists’ psychological adaptation to client suicidal behavior. Dissertation Abstracts International: Section B: The Sciences and Engineering, 56(5-B).
Howard, E. (2001). Incidence and impact of client suicide on health service providers in psychology. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61(9-B).
Jacobson, J., Ting, L., Sanders, S. & Harrington, D. (2004). Prevalence of and Reactions to Fatal and Nonfatal Client Suicidal Behavior: A National Study of Mental Health Social Workers. OMEGA - Journal of Death and Dying, 49(3), 237-248. doi:10.2190/HPKQ-T700-EPQL-58JQ
Kessler, R., Sonnega, A., Bromet, E., Hughes, M. & Nelson, C. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060. doi:10.1001/archpsyc.1995.03950240066012
Kleespies, P. (1993). Suicide in mental disorder. Suicide and Life-Threatening Behavior, 23(1), 67-73. doi:10.1111/j.1943-278X.1993.tb00281.x
Kumar, S. (2007). Burnout in psychiatrists. World Psychiatry, 6(3), 186-189. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2175073/
Kumar, S. (2011). Burnout and psychiatrists: what do we know and where to from here? Epidemiology and Psychiatric Sciences, 20(4), 295-301. doi:10.1017/S204579601100059X
Lafayette, J. & Stern, T. (2004). The impact of a patient’s suicide on psychiatric trainees: a case study and review of the literature. Harvard Review of Psychiatry, 12(1), 49-55. doi:10.1080/10673220490279152
Landsbergis, P. (1988). Occupational stress among health care workers: A test of the job demands-control model. Journal of Organizational Behavior, 9(3), 217-239. doi:10.1002/job.4030090303
Lasa, L., Ayuso-Mateos, J., Vázquez-Barquero, J., Díez-Manrique, F. & Dowrick, C. (2000). The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis. Journal of Affective Disorders, 57(1-3), 261-265. doi:10.1016/S0165-0327(99)00088-9
Leiter, M. P., Harvie, P. & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science & Medicine, 47(10), 1611-1617. doi:10.1016/S0277-9536(98)00207-X
Liu, Y., Xu, S. & Tourassi, G. (2015). Detecting Rumors Through Modeling Information Propagation Networks in a Social Media Environment. Social Computing, Behavioral-Cultural Modeling, and Prediction, 90(21), 121-130. doi:10.1007/978-3-319-16268-3_13
Luxton, D., June, J. & Fairall, J. (2012). Social media and suicide: a public health perspective. American Journal of Public Health, 102(Suppl. 2), S195-S200. doi:10.2105/AJPH.2011.300608
Marshall, G. (2004). Posttraumatic Stress Disorder Symptom Checklist: factor structure and English-Spanish measurement invariance. Journal of Traumatic Stress, 17(3), 223-230. doi:10.1023/B:JOTS.0000029265.56982.86
Martelli, C., Awad, H. & Hardy, P. (2010). [In-patients suicide: epidemiology and prevention]. Encephale, 36(Suppl. 2), D83-D91. doi:10.1016/j.encep.2009.06.011
Maslach, C. & Jackson, S. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99-113. doi:10.1002/job.4030020205
Melita-Rodríguez, A., Cruz-Pedreros, M. & Merino, J. (2008). Burnout en profesionales de enfermería que trabajan en centros asistenciales de la octava región, Chile. Ciencia y Enfermería, 14(2), 75-85. doi:10.4067/S0717-95532008000200010
Miles, J., Marshall, G. & Schell, T. (2008). Spanish and English versions of the PTSD Checklist-Civilian version (PCL-C): testing for differential item functioning. Journal of Traumatic Stress, 21(4), 369-376. doi:10.1002/jts.20349
Moreno-Jiménez, B., Oliver-Hernández, C. & Aragoneses, A. (1991). El “burnout”, una forma específica de estrés laboral. En G. Casal & V. Caballo (Eds.), Manual de psicología clínica aplicada (pp. 271-280). Madrid: Siglo Veintiuno de España.
Norris, F., Murphy, A., Baker, C., Perilla, J., Rodriguez, F. & Rodriguez, J. (2003). Epidemiology of trauma and posttraumatic stress disorder in Mexico. Journal of Abnormal Psychology, 112(4), 646-656. doi:10.1037/0021-843X.112.4.646
Órdenes, D. (2004). Prevalencia de Burnout en trabajadores del hospital Roberto del Río. Revista Chilena de Pediatría, 75(5), 449-454. doi:10.4067/S0370-41062004000500006
Orlando, M. & Marshall, G. (2002). Differential item functioning in a Spanish translation of the PTSD checklist: detection and evaluation of impact. Psychological Assessment, 14(1), 50-59. doi:10.1037/1040-3590.14.1.50
Pieters, G., De Gucht, V., Joos, G. & De Heyn, E. (2003). Frequency and impact of patient suicide on psychiatric trainees. European Psychiatry, 18(7), 345-349. doi:10.1016/j.eurpsy.2003.02.003
Quass, C. (2006). Diagnóstico de burnout y técnicas de afrontamiento al estrés en profesores universitarios de la Quinta Región de Chile. Psicoperspectivas, 5(1), 65-75. Retrieved from http://www.psicoperspectivas.cl/index.php/psicoperspectivas/article/view/35
Robinson, J., Cox, G., Bailey, E., Hetrick, S., Rodrigues, M., Fisher, S. & Herrman, H. (2016). Social media and suicide prevention: a systematic review. Early Intervention in Psychiatry, 10(2), 103-121. doi:10.1111/eip.12229
Ruiz, A., Silva, H. & Miranda, E. (2001). Clinical and psychometric diagnosis of depression in patients in general medicine. Revista Médica de Chile, 129(6), 627-633. doi:10.4067/S0034-98872001000600005
Ruskin, R., Sakinofsky, I., Bagby, R., Dickens, S. & Sousa, G. (2004). Impact of patient suicide on psychiatrists and psychiatric trainees. Academic Psychiatry, 28(2), 104-110. doi:10.1176/appi.ap.28.2.104
Sahraian, A., Fazelzadeh, A., Mehdizadeh, A. & Toobaee, S. (2008). Burnout in hospital nurses: a comparison of internal, surgery, psychiatry and burns wards. International Nursing Review, 55(1), 62-67. doi:10.1111/j.1466-7657.2007.00582.x
Sanz, J. & Vázquez, C. (1998). Fiabilidad, validez y datos normativos del Inventario para la Depresión de Beck. Psicothema, 10(2), 303-318. Recuperado de http://www.psicothema.com/pdf/167.pdf
Scocco, P., Toffol, E., Pilotto, E. & Pertile, R. (2012). Psychiatrists’ emotional reactions to patient suicidal behavior. Journal of Psychiatric Practice, 18(2), 94-108. doi:10.1097/01.pra.0000413275.09305.d5
Takahashi, C., Chida, F., Nakamura, H., Akasaka, H., Yagi, J., Koeda, A. & Sakai, A. (2011). The impact of inpatient suicide on psychiatric nurses and their need for support. BMC Psychiatry, 11(38), 1-8. doi:10.1186/1471-244X-11-38
Tsai, A., Moran, S., Shoemaker, R. & Bradley, J. (2012). Patient suicides in psychiatric residencies and post-vention responses: a national survey of psychiatry chief residents and program directors. Academic Psychiatry, 36(1), 34-38. doi:10.1176/appi.ap.09100186
Vera-Villarroel, P., Zych, I., Celis-Atenas, K., Córdova-Rubio, N. & Buela-Casal, G. (2011). Chilean validation of the Posttraumatic Stress Disorder Checklist-Civilian version (PCL-C) after the earthquake on February 27, 2010. Psychological Reports, 109(1), 47-58. doi:10.2466/02.13.15.17.PR0.109.4.47-58
Vicente, B., Kohn, R., Rioseco, P., Saldivia, S., Levav, I. & Torres, S. (2006). Lifetime and 12-month prevalence of DSM-III-R disorders in the Chile psychiatric prevalence study. American Journal of Psychiatry, 163(8), 1362-1370. doi:10.1176/ajp.2006.163.8.1362
Virtanen, M., Vahtera, J., Batty, G., Tuisku, K., Oksanen, T., Elovainio, M. & Kivimäki, M. (2012). Health risk behaviors and morbidity among hospital staff-comparison across hospital ward medical specialties in a study of 21 Finnish hospitals. Scandinavian Journal of Work, Environment & Health, 38(3), 228-237. doi:10.5271/sjweh.3264
Warner, C., Appenzeller, G., Grieger, T., Belenkiy, S., Breitbach, J., Parker, J. & Hoge, C. (2011). Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Archives of General Psychiatry, 68(10), 1065-1071. doi:10.1001/archgenpsychiatry.2011.112
Witteveen, A., Bramsen, I., Twisk, J., Huizink, A., Slottje, P., Smid, T. & Van Der Ploeg, H. (2007). Psychological distress of rescue workers eight and one-half years after professional involvement in the Amsterdam air disaster. The Journal of Nervous and Mental Disease, 195(1), 31-40. doi:10.1097/01.nmd.0000252010.19753.19
Zanarini, M., Frankenburg, F., Hennen, J. & Silk, K. (2004). Mental health service utilization by borderline personality disorder patients and Axis II comparison subjects followed prospectively for 6 years. Journal of Clinical Psychiatry, 65(1), 28-36. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14744165
Zlotnick, C., Johnson, J., Kohn, R., Vicente, B., Rioseco, P. & Saldivia, S. (2006). Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile. Psychological Medicine, 36(11), 1523-1533. doi:10.1017/S0033291706008282
Avendaño, C., Bustos, P., Espinoza, P., García, F. & Pierart, T. (2009). Burnout y apoyo social en personal del servicio de psiquiatría de un hospital público. Ciencia y Enfermería, 15(2), 55-68. doi:10.4067/S0717-95532009000200007
Beck, A., Rush, A., Shaw, B. & Emery, G. (1979). Cognitive therapy of depression (1st ed.). New York: The Guildford Press.
Blanchard, E., Jones-Alexander, J., Buckley, T. & Forneris, C. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34(8), 669-673. doi:10.1016/0005-7967(96)00033-2
Bonanno, G., Brewin, C., Kaniasty, K. & Greca, A. (2010). Weighing the costs of disaster consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest, 11(1), 1-49. doi:10.1177/1529100610387086
Brewin, C., Andrews, B. & Valentine, J. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748-766. doi:10.1037/0022-006X.68.5.748
Bromet, E. (2014). Emotional consequences of nuclear power plant disasters. Health Physics, 106(2), 206-210. doi:10.1097/HP.0000000000000012
Brown, H. (1987). The impact of suicide on therapists in training. Comprehensive Psychiatry, 28(2), 101-112. doi:10.1016/0010-440X(87)90075-7
Campbell, C. & Fahy, T. (2002). The role of the doctor when a patient commits suicide. Psychiatric Bulletin, 26(2), 44-49. doi:10.1192/pb.26.2.44
Cappelli, M., Clulow, M., Goodman, J., Davidson, S., Feder, S., Baron, P., … & McGrath, P. (1995). Identifying depressed and suicidal adolescents in a teen health clinic. Journal of Adolescent Health, 16(1), 64-70. doi:10.1016/1054-139X(94)00076-Q
Carpenter, L., Swerdlow, A. & Fear, N. (1997). Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants. Occupational and Environmental Medicine, 54(6), 388-395. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1128798/
Chemtob, C., Bauer, G., Hamada, R., Pelowski, S. & Muraoka, M. (1989). Patient suicide: Occupational hazard for psychologists and psychiatrists. Professional Psychology: Research and Practice, 20(5), 294-300. doi:10.1037/0735-7028.20.5.294
Chemtob, C., Hamada, R., Bauer, G., Kinney, B. & Torigoe, R. (1988). Patients’ suicides: frequency and impact on psychiatrists. The American Journal of Psychiatry, 145(2), 224-228. doi:10.1176/ajp.145.2.224
Cryan, M., Kelly, P. & McCaffrey, B. (1995). The experience of patient suicide among Irish psychiatrists. Psychiatric Bulletin, 19(1), 4-7. doi:10.1192/pb.19.1.4
David, A., Bedford, N., Wiffen, B. & Gilleen, J. (2012). Failures of metacognition and lack of insight in neuropsychiatric disorders. Philosophical Transactions B, 367(1594), 1379-1390. doi:10.1098/rstb.2012.0002
Dewar, I., Eagles, J., Klein, S., Gray, N. & Alexander, D. (2000). Psychiatric trainees’ experiences of, and reactions to patient suicide. Psychiatric Bulletin, 24(1), 20-23. doi:10.1192/pb.24.1.20
Edwards, B., Lambert, M., Moran, P., McCully, T., Smith, K. & Ellingson, A. (1984). A meta-analytic comparison of the Beck Depression Inventory and the Hamilton Rating Scale for Depression as measures of treatment outcome. British Journal of Clinical Psychology, 23(2), 93-99. doi:10.1111/j.2044-8260.1984.tb00632
Farberow, N. (2005). The mental health professional as suicide survivor. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 2(1), 13-20. Retrieved from http://www.clinicalneuropsychiatry.org/pdf/03_farberow.pdf
Grad, O. & Michel, K. (2005). Therapists as client suicide survivors. Therapeutic and Legal Issues for Therapists Who Have Survived a Client Suicide: Breaking the Silence. New York: Routledge.
Grad, O., Zavasnik, A. & Groleger, U. (1997). Suicide of a patient: gender differences in bereavement reactions of therapists. Suicide and Life-Threatening Behavior, 27(4), 379-386. doi:10.1111/j.1943-278X.1997.tb00517.x
Gulfi, A., Castelli Dransart, D., Heeb, J. & Gutjahr, E. (2010). The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis, 31(4), 202-210. doi:10.1027/0027-5910/a000027
Hawton, K., Clements, A., Sakarovitch, C., Simkin, S. & Deeks, J. (2001). Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995. Journal of Epidemiology & Community Health, 55(5), 296-300. doi:10.1136/jech.55.5.296
Hendin, H., Lipschitz, A., Maltsberger, J., Haas, A. & Wynecoop, S. (2000). Therapists’ reactions to patients’ suicides. The American Journal of Psychiatry, 157(12), 2022-2027. doi:10.1176/appi.ajp.157.12.2022
Henry, M., Séguin, M. & Drouin, S. (2008). L’impact du suicide d’un patient chez des professionnels en santé mentale. Frontières, 21(1), 53-63. doi:10.7202/037874ar
Hernández, J. (2003). Estrés y Burnout en profesionales de la salud de los niveles primario y secundario de atención. Revista Cubana de Salud Pública, 29(2), 103-110. Retrieved from http://ref.scielo.org/47mptm
Horn, P. (1994). Therapists’ psychological adaptation to client suicide. Psychotherapy: Theory, Research, Practice, Training, 31(1), 190-195. doi:10.1037/0033-3204.31.1.190
Horn, P. (1995). Therapists’ psychological adaptation to client suicidal behavior. Dissertation Abstracts International: Section B: The Sciences and Engineering, 56(5-B).
Howard, E. (2001). Incidence and impact of client suicide on health service providers in psychology. Dissertation Abstracts International: Section B: The Sciences and Engineering, 61(9-B).
Jacobson, J., Ting, L., Sanders, S. & Harrington, D. (2004). Prevalence of and Reactions to Fatal and Nonfatal Client Suicidal Behavior: A National Study of Mental Health Social Workers. OMEGA - Journal of Death and Dying, 49(3), 237-248. doi:10.2190/HPKQ-T700-EPQL-58JQ
Kessler, R., Sonnega, A., Bromet, E., Hughes, M. & Nelson, C. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060. doi:10.1001/archpsyc.1995.03950240066012
Kleespies, P. (1993). Suicide in mental disorder. Suicide and Life-Threatening Behavior, 23(1), 67-73. doi:10.1111/j.1943-278X.1993.tb00281.x
Kumar, S. (2007). Burnout in psychiatrists. World Psychiatry, 6(3), 186-189. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2175073/
Kumar, S. (2011). Burnout and psychiatrists: what do we know and where to from here? Epidemiology and Psychiatric Sciences, 20(4), 295-301. doi:10.1017/S204579601100059X
Lafayette, J. & Stern, T. (2004). The impact of a patient’s suicide on psychiatric trainees: a case study and review of the literature. Harvard Review of Psychiatry, 12(1), 49-55. doi:10.1080/10673220490279152
Landsbergis, P. (1988). Occupational stress among health care workers: A test of the job demands-control model. Journal of Organizational Behavior, 9(3), 217-239. doi:10.1002/job.4030090303
Lasa, L., Ayuso-Mateos, J., Vázquez-Barquero, J., Díez-Manrique, F. & Dowrick, C. (2000). The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis. Journal of Affective Disorders, 57(1-3), 261-265. doi:10.1016/S0165-0327(99)00088-9
Leiter, M. P., Harvie, P. & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science & Medicine, 47(10), 1611-1617. doi:10.1016/S0277-9536(98)00207-X
Liu, Y., Xu, S. & Tourassi, G. (2015). Detecting Rumors Through Modeling Information Propagation Networks in a Social Media Environment. Social Computing, Behavioral-Cultural Modeling, and Prediction, 90(21), 121-130. doi:10.1007/978-3-319-16268-3_13
Luxton, D., June, J. & Fairall, J. (2012). Social media and suicide: a public health perspective. American Journal of Public Health, 102(Suppl. 2), S195-S200. doi:10.2105/AJPH.2011.300608
Marshall, G. (2004). Posttraumatic Stress Disorder Symptom Checklist: factor structure and English-Spanish measurement invariance. Journal of Traumatic Stress, 17(3), 223-230. doi:10.1023/B:JOTS.0000029265.56982.86
Martelli, C., Awad, H. & Hardy, P. (2010). [In-patients suicide: epidemiology and prevention]. Encephale, 36(Suppl. 2), D83-D91. doi:10.1016/j.encep.2009.06.011
Maslach, C. & Jackson, S. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99-113. doi:10.1002/job.4030020205
Melita-Rodríguez, A., Cruz-Pedreros, M. & Merino, J. (2008). Burnout en profesionales de enfermería que trabajan en centros asistenciales de la octava región, Chile. Ciencia y Enfermería, 14(2), 75-85. doi:10.4067/S0717-95532008000200010
Miles, J., Marshall, G. & Schell, T. (2008). Spanish and English versions of the PTSD Checklist-Civilian version (PCL-C): testing for differential item functioning. Journal of Traumatic Stress, 21(4), 369-376. doi:10.1002/jts.20349
Moreno-Jiménez, B., Oliver-Hernández, C. & Aragoneses, A. (1991). El “burnout”, una forma específica de estrés laboral. En G. Casal & V. Caballo (Eds.), Manual de psicología clínica aplicada (pp. 271-280). Madrid: Siglo Veintiuno de España.
Norris, F., Murphy, A., Baker, C., Perilla, J., Rodriguez, F. & Rodriguez, J. (2003). Epidemiology of trauma and posttraumatic stress disorder in Mexico. Journal of Abnormal Psychology, 112(4), 646-656. doi:10.1037/0021-843X.112.4.646
Órdenes, D. (2004). Prevalencia de Burnout en trabajadores del hospital Roberto del Río. Revista Chilena de Pediatría, 75(5), 449-454. doi:10.4067/S0370-41062004000500006
Orlando, M. & Marshall, G. (2002). Differential item functioning in a Spanish translation of the PTSD checklist: detection and evaluation of impact. Psychological Assessment, 14(1), 50-59. doi:10.1037/1040-3590.14.1.50
Pieters, G., De Gucht, V., Joos, G. & De Heyn, E. (2003). Frequency and impact of patient suicide on psychiatric trainees. European Psychiatry, 18(7), 345-349. doi:10.1016/j.eurpsy.2003.02.003
Quass, C. (2006). Diagnóstico de burnout y técnicas de afrontamiento al estrés en profesores universitarios de la Quinta Región de Chile. Psicoperspectivas, 5(1), 65-75. Retrieved from http://www.psicoperspectivas.cl/index.php/psicoperspectivas/article/view/35
Robinson, J., Cox, G., Bailey, E., Hetrick, S., Rodrigues, M., Fisher, S. & Herrman, H. (2016). Social media and suicide prevention: a systematic review. Early Intervention in Psychiatry, 10(2), 103-121. doi:10.1111/eip.12229
Ruiz, A., Silva, H. & Miranda, E. (2001). Clinical and psychometric diagnosis of depression in patients in general medicine. Revista Médica de Chile, 129(6), 627-633. doi:10.4067/S0034-98872001000600005
Ruskin, R., Sakinofsky, I., Bagby, R., Dickens, S. & Sousa, G. (2004). Impact of patient suicide on psychiatrists and psychiatric trainees. Academic Psychiatry, 28(2), 104-110. doi:10.1176/appi.ap.28.2.104
Sahraian, A., Fazelzadeh, A., Mehdizadeh, A. & Toobaee, S. (2008). Burnout in hospital nurses: a comparison of internal, surgery, psychiatry and burns wards. International Nursing Review, 55(1), 62-67. doi:10.1111/j.1466-7657.2007.00582.x
Sanz, J. & Vázquez, C. (1998). Fiabilidad, validez y datos normativos del Inventario para la Depresión de Beck. Psicothema, 10(2), 303-318. Recuperado de http://www.psicothema.com/pdf/167.pdf
Scocco, P., Toffol, E., Pilotto, E. & Pertile, R. (2012). Psychiatrists’ emotional reactions to patient suicidal behavior. Journal of Psychiatric Practice, 18(2), 94-108. doi:10.1097/01.pra.0000413275.09305.d5
Takahashi, C., Chida, F., Nakamura, H., Akasaka, H., Yagi, J., Koeda, A. & Sakai, A. (2011). The impact of inpatient suicide on psychiatric nurses and their need for support. BMC Psychiatry, 11(38), 1-8. doi:10.1186/1471-244X-11-38
Tsai, A., Moran, S., Shoemaker, R. & Bradley, J. (2012). Patient suicides in psychiatric residencies and post-vention responses: a national survey of psychiatry chief residents and program directors. Academic Psychiatry, 36(1), 34-38. doi:10.1176/appi.ap.09100186
Vera-Villarroel, P., Zych, I., Celis-Atenas, K., Córdova-Rubio, N. & Buela-Casal, G. (2011). Chilean validation of the Posttraumatic Stress Disorder Checklist-Civilian version (PCL-C) after the earthquake on February 27, 2010. Psychological Reports, 109(1), 47-58. doi:10.2466/02.13.15.17.PR0.109.4.47-58
Vicente, B., Kohn, R., Rioseco, P., Saldivia, S., Levav, I. & Torres, S. (2006). Lifetime and 12-month prevalence of DSM-III-R disorders in the Chile psychiatric prevalence study. American Journal of Psychiatry, 163(8), 1362-1370. doi:10.1176/ajp.2006.163.8.1362
Virtanen, M., Vahtera, J., Batty, G., Tuisku, K., Oksanen, T., Elovainio, M. & Kivimäki, M. (2012). Health risk behaviors and morbidity among hospital staff-comparison across hospital ward medical specialties in a study of 21 Finnish hospitals. Scandinavian Journal of Work, Environment & Health, 38(3), 228-237. doi:10.5271/sjweh.3264
Warner, C., Appenzeller, G., Grieger, T., Belenkiy, S., Breitbach, J., Parker, J. & Hoge, C. (2011). Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Archives of General Psychiatry, 68(10), 1065-1071. doi:10.1001/archgenpsychiatry.2011.112
Witteveen, A., Bramsen, I., Twisk, J., Huizink, A., Slottje, P., Smid, T. & Van Der Ploeg, H. (2007). Psychological distress of rescue workers eight and one-half years after professional involvement in the Amsterdam air disaster. The Journal of Nervous and Mental Disease, 195(1), 31-40. doi:10.1097/01.nmd.0000252010.19753.19
Zanarini, M., Frankenburg, F., Hennen, J. & Silk, K. (2004). Mental health service utilization by borderline personality disorder patients and Axis II comparison subjects followed prospectively for 6 years. Journal of Clinical Psychiatry, 65(1), 28-36. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14744165
Zlotnick, C., Johnson, J., Kohn, R., Vicente, B., Rioseco, P. & Saldivia, S. (2006). Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile. Psychological Medicine, 36(11), 1523-1533. doi:10.1017/S0033291706008282