{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:11:51Z","timestamp":1790806311074,"version":"4.1.0"},"reference-count":60,"publisher":"Cambridge University Press (CUP)","issue":"5-6","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1935789319000028_as1\"><jats:title>Objective:<\/jats:title><jats:p>To assess the psychological impact of a mass casualty incident (MCI) in a subset of personnel in a level I hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000028_as2\"><jats:title>Methods:<\/jats:title><jats:p>Emergency department staff responded to an MCI in June 2017 in Turin, Italy by an unexpected sudden surge of casualties following a stampede (mass escape). Participants completed the Psychological Simple Triage and Rapid Treatment Responder Self-Triage System (PsySTART-R), which classified the potential risk of psychological distress in \u201cno risk\u201d versus \u201cat risk\u201d categorization and identified a range of impacts aggregated for the population of medical responders. Participants were administered a questionnaire on the perceived effectiveness of management of the MCI. Two months later, the participants were evaluated using the Hospital Anxiety and Depression Scale (HADS), the Kessler Psychological Distress Scale (K6), and the Posttraumatic Stress Disorder Checklist (PCL-5).<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000028_as3\"><jats:title>Results:<\/jats:title><jats:p>The majority of the responders were classified as \u201cno risk\u201d by the PsySTART-R; no significant differences on HADS, K6, and PCL-5 were found in the participants grouped by the PsySTART-R categories. The personnel acquainted to work in emergency contexts (emergency department and intensive care unit) scored significantly lower in the HADS than the personnel usually working in other wards. The number of positive PsySTART-R criteria correlated with the HADS depression score.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000028_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Most of the adverse psychological implications of the MCI were well handled and averted by the responders. A possible explanation could be related to factors such as the clinical condition of the victims (most were not severely injured, no fatalities), the small number of casualties (87) brought to the hospital, the event not being considered life-threatening, and its brief duration, among others. Responders had mainly to cope with a sudden surge in casualties and with organizational issues.<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2019.2","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T03:28:33Z","timestamp":1561001313000},"page":"880-888","source":"Crossref","is-referenced-by-count":14,"title":["The Mass Casualty Incident in Turin, 2017: A Case Study of Disaster Responders\u2019 Mental Health in an Italian Level I Hospital"],"prefix":"10.1017","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6106-0432","authenticated-orcid":false,"given":"Valeria","family":"Caramello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Bertuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Ricceri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Albert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Boccuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Della Corte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merritt C","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"S1935789319000028_ref18","first-page":"w13070","article-title":"Trend in burnout among Swiss doctors","volume":"140","author":"Arigoni","year":"2010","journal-title":"Swiss Med Wkly"},{"key":"S1935789319000028_ref16","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/SLA.0b013e3181bfdab3","article-title":"Burnout and medical errors among American surgeons","volume":"251","author":"Shanafelt","year":"2010","journal-title":"Ann Surg"},{"key":"S1935789319000028_ref12","doi-asserted-by":"crossref","first-page":"e61526","DOI":"10.1371\/journal.pone.0061526","article-title":"Empathy in clinical practice: how individual dispositions, gender and experience moderate empathic concern, burnout and emotional distress in physicians","volume":"8","author":"Gleichgerrcht","year":"2013","journal-title":"PLoS One"},{"key":"S1935789319000028_ref11","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2015.9.27945"},{"key":"S1935789319000028_ref4","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection","volume":"146","author":"Kroenke","year":"2007","journal-title":"Ann Intern Med"},{"key":"S1935789319000028_ref2","first-page":"22","volume-title":"Understanding Doctors\u2019 Performance","author":"Firth-Cozens","year":"2006"},{"key":"S1935789319000028_ref6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.3399\/bjgp08X319486","article-title":"Doctors as patients: a systematic review of doctors\u2019 health access and the barriers they experience","volume":"58","author":"Kay","year":"2008","journal-title":"Br J Gen Pract"},{"key":"S1935789319000028_ref46","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s12888-015-0602-y","article-title":"Problem Management Plus (PM+) for common mental disorders in a humanitarian setting in Pakistan: study protocol for a randomised controlled trial (RCT)","volume":"15","author":"Sijbrandij","year":"2015","journal-title":"BMC Psychiatry"},{"key":"S1935789319000028_ref38","unstructured":"38. 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