Psychological reactions of drivers to railway suicide.

Around 90 London Underground train drivers experience a person jumping or falling in front of their train each year. The majority of these incidents are suicides or attempted suicides. 76 drivers were interviewed in order to assess the range of responses to these incidents. The following psychometric instruments were used: Present State Examination (PSE9); Post-Traumatic Stress Disorder (PTSD) Interview; General Health Questionnaire (GHQ-28); Impact of Events Scale (IES); Post-Traumatic Symptom Scale; Recent Difficulties/Events scale; Perceived Stress Scale and Eysenck Personality Questionnaire (EPQ). When interviewed 1 month after the incident 13 (17.11%) drivers presented with PTSD. Diagnoses other than PTSD e.g. neurotic depression and phobic state were present in 24 (31.58%) drivers (including 12 of the 13 PTSD cases who had one additional diagnosis). On the basis of diagnoses three groups were identified: Group 1 drivers had PTSD and in most cases an additional PSE9 diagnosis; Group 2 drivers had a PSE9 diagnosis only; Group 3 drivers were not cases. 56 drivers were again interviewed 6 months after the incident to assess duration of caseness and/or symptoms and to identify any cases of delayed onset. Two drivers were still cases at 6 months (neurotic depression and phobic state), no driver presented with PTSD at 6 months. At 6 months there was a significant drop in symptom scores compared with measures taken at 1 month. These results suggest that although approximately one-third of drivers suffered a severe psychological reaction following a railway suicide, when interviewed again 6 months after the incident most drivers reported a marked reduction in symptoms.