Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States.
Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States.
Clin Psychol Rev. 2016 Mar;44:25-44. doi: 10.1016/j.cpr.2015.12.002. Epub 2015 Dec 12.
First responders-police officers, firefighters, emergency medical technicians (EMTs), and paramedics-experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities (e.g., posttraumatic stress disorder [PTSD], suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that may inoculate against the development or maintenance of psychiatric conditions. Several reviews of the literature have documented the prevalence and potency of PTSD among first responders; the value of these extant reviews is considerable. Nonetheless, the literature has not been systematically described with regard to suicidality. In this systematic review, we present 63 quantitative studies examining suicidal thoughts, behaviors, and/or fatalities among first responders; identify population-specific risk and protective factors; and pinpoint strengths and weaknesses of the existing literature. Findings reveal elevated risk for suicide among first responders; however, studies utilizing more rigorous methodologies (e.g., longitudinal designs, probability sampling strategies) are sorely needed. First responders have an armamentarium of resources to take care of others; it is the duty of researchers, clinicians, and the public to aid in taking care of their health as well, in part by reducing suicide risk.
急救人员——警察、消防员、急救医疗技术员（EMT）和护理人员——经历着重大的与工作相关的压力源和暴露，这可能会增加心理健康障碍（例如创伤后应激障碍 [PTSD]、自杀念头和行为）和加速死亡率（例如自杀）的风险。然而，这些职业中也存在一些因素（例如，同志情谊、入伍前筛查），这些因素可能预防或维持精神疾病的发展。一些文献综述记录了急救人员中 PTSD 的患病率和效力；这些现有综述的价值是相当大的。尽管如此，文献中并没有系统地描述自杀倾向。在本系统综述中，我们呈现了 63 项定量研究，这些研究检查了急救人员中的自杀念头、行为和/或死亡；确定了特定人群的风险和保护因素；并指出了现有文献的优缺点。研究结果显示急救人员自杀风险升高；然而，非常需要利用更严格的方法（例如，纵向设计、概率抽样策略）的研究。急救人员拥有一套照顾他人的资源；研究人员、临床医生和公众也有责任帮助照顾他们的健康，部分方法是降低自杀风险。
