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Posttraumatic Stress Disorder, Depression, Anxiety, And Burnout Among ICU Healthcare Professionals In Conflict-Affected Cameroon

Siver Kibuh
Daystar University, Nairobi, Kenya
Prof. Alice Munene
Psy.D, Daystar University, Nairobi, Kenya
Dr Margret Sirima
Ph.D, Daystar University, Nairobi, Kenya
DOI Crossref DOI 10.37547/tajmspr/Volume07Issue09-07
tajmspr 2025
VOL. 7 / NO. 09 SEPTEMBER
FULL TEXT PP. 45-55
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VOLUME 7
ISSUE 09
YEAR 2025
PAGES 45-55
RESEARCH OVERVIEW

Abstract

Healthcare professionals in Intensive Care Units (ICUs) globally face a high risk of Posttraumatic Stress Disorder (PTSD) and comorbid psychological conditions, a crisis exacerbated in resource-constrained and conflict-affected settings. This study aimed to establish the comorbidities associated with PTSD among ICU healthcare professionals in high-stress hospitals in Kumbo, Cameroon. A quantitative, cross-sectional study was conducted with 134 ICU staff (nurses, physicians, auxiliary staff) from two general hospitals, including Saint Elizabeth General Hospital and Banso Baptist Hospital. Participants completed self-administered questionnaires, including the PTSD Checklist for DSM-5 (PCL-5), the Hospital Anxiety and Depression Scale (HADS), and the Maslach Burnout Inventory (MBI). Data were analyzed using descriptive statistics and chi-square tests of independence. The results revealed a near-universal prevalence of probable PTSD (94.8%), accompanied by high rates of probable depression (82.8%), probable anxiety (85.1%), and burnout risk or diagnosis (86.6%). However, statistical analyses found no significant associations between PTSD status and depression (χ²(1)=1.53, p=.216, φ=.11), anxiety (χ²(1)=1.08, p=.298, φ=.09), or burnout (χ²(2)=0.47, p=.791, Cramér's V=.06). The lack of significant association indicates that these conditions form a pervasive syndemic of distress affecting the entire workforce uniformly, rather than impacting a subset of individuals. The conclusion is that the extreme context creates a universal psychological burden, necessitating a paradigm shift from individual-focused interventions to systemic, organization-wide reforms to address the root causes of this occupational health crisis.

RESEARCH TOPICS

Keywords

Posttraumatic Stress Disorder comorbidities healthcare workers

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References

  1. Abdelbaky, A. M., & Eldelpshany, M. S. (2024). Intensive Care Unit (ICU)-Related Posttraumatic Stress Disorder: A Literature Review. Curēus, 16(3). https://doi.org/10.7759/cureus.57049
  2. Agresti, A. (2007). An introduction to categorical data analysis (2nd ed.). Wiley.
  3. American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code/
  4. Andhavarapu, S., Yardi, I., Bzhilyanskaya, V., Lurie, T., Bhinder, M., Patel, P., Pourmand, A., & Tran, Q. K. (2022). Posttraumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry research, 317, 114890. https://doi.org/10.1016/j.psychres.2022.114890
  5. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. Journal of Traumatic Stress, 28(6), 489–498.
  6. Carmassi, C., Dell'Oste, V., Bui, E., Foghi, C., Bertelloni, C. A., Atti, A. R., Buselli, R., Di Paolo, M., Goracci, A., Malacarne, P., Nanni, M. G., Gesi, C., Cerveri, G., & Dell'Osso, L. (2022). The interplay between acute posttraumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. Journal of affective disorders, 298(Pt A), 209–216.
  7. Cochran, W. G. (1977). Sampling Techniques (3rd ed.). Wiley.
  8. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
  9. Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.
  10. Deltour, V., Poujol, A. & Laurent, A. (2023). Posttraumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Annals of Intensive Care, 13(1). https://doi.org/10.1186/s13613-023-01145-6
  11. Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
  12. Hamed, R.A., Abd Elaziz, S.Y. & Ahmed, A.S. (2020). Prevalence and predictors of burnout syndrome, post-traumatic stress disorder, depression, and anxiety in nursing staff in various departments. Middle East Current Psychiatry 27, 36. https://doi.org/10.1186/s43045-020-00044-x
  13. Harriss, D. J., Macsween, A., & Atkinson, G. (2019). Standards for ethics in sport and exercise science research: 2020 update. International Journal of Sports Medicine, 40(13), 813–817.
  14. Hovland, I. S., Skogstad, L., Stafseth, S., Hem, E., Diep, L. M., Ræder, J., Ekeberg, Ø., & Lie, I. (2023). Prevalence of psychological distress in nurses, physicians and leaders working in intensive care units during the COVID-19 pandemic: A National One-year follow-up study. BMJ Open, 13(12). https://doi.org/10.1136/bmjopen-2023-075190
  15. Human, A. K., Vahed, N., & Marais, B. (2023). Posttraumatic stress symptoms in mental healthcare workers in the context during the COVID-19 outbreak. South African Journal of Psychiatry, 29(0), a2098. https://doi.org/10.4102/sajpsychiatry.v29i0.2098
  16. Israel, G. D. (1992). Determining Sample Size. University of Florida Cooperative Extension Service.
  17. Jorm, A. F., Kelly, C. M., & Morgan, A. J. (2007). Participant distress in psychiatric research: A systematic review. Psychological Medicine, 37(7), 917–926.
  18. Laurent, A., Fournier, A., Lheureux, F., Louis, G., Nseir, S., Jacq, G., Goulenok, C., Muller, G., Badie, J., Bouhemad, B., Georges, M., Mertes, P.-M., Merdji, H., Castelain, V., Abdulmalak, C., Lesieur, O., Plantefeve, G., Lacherade, J.-C., Rigaud, J.-P., & Sedillot, N. (2021). Mental health and stress among ICU healthcare professionals in France according to intensity of the COVID-19 epidemic. Annals of Intensive Care, 11(1). https://doi.org/10.1186/s13613-021-00880-y
  19. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
  20. Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout Inventory Manual (3rd ed.). Consulting Psychologists Press.
  21. Mbazzi, F. B., Dewailly, A., Admasu, K., Duagani, Y., Wamala, K., Vera, A., Bwesigye, D., & Roth, G. (2021). Cultural Adaptations of the Standard EMDR Protocol in Five African Countries. Journal of EMDR Practice and Research, 15(1), 29–43.
  22. McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3 (1), 131–149.
  23. Mertens, D. M., & Ginsberg, P. E. (2009). The handbook of social research ethics. SAGE Publications.
  24. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research.
  25. National Institutes of Health. (2003). Protecting personal health information in research: Understanding the HIPAA Privacy Rule.
  26. Niba, J. O., Ngasa, S. N., Chang, N., Sanji, E., Awa, A.-M., Dingana, T. N., Sama, C. B., Tchouda, L., & Julius, M. E. (2022). Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon. PLOS Global Public Health, 2 (11), e0001145. https://doi.org/10.1371/journal.pgph.0001145
  27. Ntlantsana, V., Molebatsi, K., Mashaphu, S., Chiliza, B., & Akena, D. (2021). Posttraumatic stress disorder psychological interventions in sub-Saharan Africa: protocol for a systematic review of the literature. BMJ Open, 12(2), e052903. https://doi.org/10.1136/bmjopen-2021-052903
  28. Parcesepe, A. M., Filiatreau, L. M., Ebasone, P. V., Dzudie, A., Pence, B. W., Wainberg, M., Yotebieng, M., Anastos, K., Pefura-Yone, E., Nsame, D., Ajeh, R., & Nash, D. (2022). Psychiatric comorbidity and psychosocial stressors among people initiating HIV care in Cameroon. PLOS ONE, 17(6), e0270042. https://doi.org/10.1371/journal.pone.0270042
  29. Pool M, Sorsdahl K, Myers B, van der Westhuizen C (2024) The prevalence of and factors associated with depressive and anxiety symptoms during the COVID-19 pandemic among healthcare workers in South Africa. PLoS ONE 19(3): e0299584. https://doi.org/10.1371/journal.pone.0299584
  30. Resnik, D. B. (2020). Research ethics timeline (1932–present). National Institute of Environmental Health Sciences.
  31. Roger, C., Ling, L., Petrier, M., Elotmani, L., Atchade, E., Allaouchiche, B., ... & Robin, S. (2024). Occurrences of posttraumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study. Annals of General Psychiatry, 23(1), 3. https://doi.org/10.1186/s12991-023-00488-5
  32. Sahebi, A., Yousefi, A., Abdi, K., Jamshidbeigi, Y., Moayedi, S., Torres, M., Wesemann, U., Sheikhbardsiri, H., & Golitaleb, M. (2021). The Prevalence of Posttraumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis. Frontiers in psychiatry, 12, 764738.
  33. Serrano-Ripoll, M. J., Meneses-Echavez, J. F., Ricci-Cabello, I., Fraile-Navarro, D., Fiol-deRoque, M. A., Pastor-Moreno, G., Castro, A., Ruiz-Pérez, I., Zamanillo Campos, R., & Gonçalves-Bradley, D. C. (2020). Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. Journal of Affective Disorders, 277, 347–357. https://doi.org/10.1016/j.jad.2020.08.034
  34. Shapiro, F. (2014). EMDR therapy: An overview of the method. Springer Publishing Company.
  35. Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
  36. Sieber, J. E. (1992). Planning ethically responsible research: A guide for students and internal review boards. SAGE Publications.
  37. Taherdoost, H. (2016). Sampling methods in research methodology: How to choose a sampling technique for research. International Journal of Academic Research in Management, 5(2), 18–27.
  38. Tesfaye, A., Sendekie, A., Kabito, G., Engdaw, G., Argaw, G., Desye, B., Angelo, A., Aragaw, F., & Abere, G. (2024). Posttraumatic stress disorder and associated factors among internally displaced persons in Africa: A systematic review and meta-analysis. PloS One, 19(4), e0300894. https://doi.org/10.1371/journal.pone.0300894
  39. United Nations Office for the Coordination of Humanitarian Affairs. (2024, March 21). Cameroon: Situation Report, 21 March 2024. UNOCHA. https://www.unocha.org/publications/report/cameroon/cameroon-situation-report-21-march-2024
  40. van Mol, M., Kompanje, E., Benoit, D., Bakker, J. & Nijkamp, M. (2015). The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review. PLoS ONE, 10(8): e0136955. https://doi.org/10.1371/journal.pone.0136955
  41. Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD.
  42. World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194.
  43. Zhang, Y., Wu, C., Ma, J., Liu, F., Shen, C., Sun, J., Ma, Z., Hu, W., & Lang, H. (2024). Relationship between depression and burnout among nurses in intensive care units at the late stage of COVID-19: A network analysis. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01867-3
  44. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.