PTSD and Burnout are Related to Lifetime Mood Spectrum in Emergency Healthcare Operator

Claudia Carmassi1, Carlo Antonio Bertelloni1, *, Maria Teresa Avella1, Ivan Cremone1, Enrico Massimetti2, Martina Corsi1, Liliana Dell’Osso1
1 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
2 ASST, Bergamo Ovest, SSD Servizio Psichiatrico diagnosi e cura, Treviglio, Italy

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© 2020 Carmassi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy; Tel: +39-050-2219760; Fax: +39-050-2219787; E-mail:



PTSD and burnout are frequent conditions among emergency healthcare personnel because exposed to repeated traumatic working experiences. Increasing evidence suggests high comorbidity between PTSD and mood symptoms, particularly depression, although the real nature of this relationship still remains unclear. The purpose of this study was to investigate the relationship between PTSD, burnout and lifetime mood spectrum, assessed by a specific scale, among health-care professionals of a major University Hospital in Italy.


N=110 Emergency Unit workers of the Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy) were assessed by the TALS-SR, MOODS-SR lifetime version and the ProQOL R-IV.


Approximately 60% of participants met at least one PTSD symptom criterion (criterion B, 63.4%; criterion C, 40.2%; criterion D 29.3%; criterion E, 26.8%), according to DSM-5 diagnosis. Almost sixteen percent of the sample reported a full symptomatic DSM-5 PTSD (work-related) diagnosis, and these showed significantly higher scores in all MOODS-SR depressive domains, as well as in the rhythmicity domain, compared with workers without PTSD. Further, mood-depressive and cognition-depressive MOODS-SR domains resulted to be predictive for PTSD. Significant correlations emerged between either PTSD diagnosis and criteria or ProQOL subscales and all the MOOD-SR domains.


A significant association emerged among PTSD, burnout and lifetime MOOD Spectrum, particularly the depressive component, in emergency health care operators, suggesting this population should be considered at-risk and undergo regular screenings for depression and PTSD.

Keywords: Trauma, Emergency, Health operators, Nurse, PTSD, Burnout, Depression, Mood.