Post-traumatic stress disorder in major accidents: systematic review and meta-analysis

Major accidents are defined as accidents whose consequences spread spatially and temporally from acute events related to production activities. Exposure to these accidents has psychological impacts on individuals, including the development of mental disorders such as posttraumatic stress disorder. Thus, the aim of this study was to identify and analyze the evidence available in the literature on the relationship between exposure to major accidents and the development of posttraumatic stress disorder. To that end, a systematic literature review was conducted using the Web of Science and Google Scholar databases, followed by a meta-analysis based on the results of the selected studies. Twenty-six articles were selected, related to 14 major accidents, including 11 longitudinal and 15 cross-sectional studies. The studies were conducted from 2 months to 36 years after the major accident, comprising 24,276 participants. The methods, techniques and instruments used varied between studies. The meta-analysis indicated a prevalence of posttraumatic stress disorder of 18.57% (confidence interval 13.80-23.87; I² = 96.22%). Posttraumatic stress disorder symptoms persisted over the years after the accident. The prevalence of posttraumatic stress disorder after exposure to major accidents was found to be higher compared to that of the general population. Risk factors for posttraumatic stress disorder included intensity of exposure, occurrence of physical damage, lack of social support, and economic losses. The results indicate the need for planned, rapid start and long-term interventions.