Background: Emergency healthcare workers, including trainees and individuals in related occupations are at heightened risk of developing posttraumatic stress disorder (PTSD) and depression owing to work-related stressors. We aimed to investigate the type, frequency, and severity of direct trauma exposure, posttraumatic stress symptoms and other psychopathology amongst paramedic trainees. In order to create a risk profile for individuals who are at higher occupational risk of developing PTSD, we examined risk and resilience factors that possibly contributed to the presence and severity of posttraumatic symptomatology. Methods: Paramedic trainees (n = 131) were recruited from a local university. A logistic regression analysis was conducted using the explanatory variables age, gender, population group, trauma exposure, depression, alcohol abuse, alcohol dependence, resilience and social support. Results: 94% of paramedic trainees had directly experienced trauma, with 16% meeting PTSD criteria. A high rate of depression (28%), alcohol abuse (23%) and chronic perceived stress (7%) and low levels of social support was found. The number of previous trauma exposures, depression, resilience and social support significantly predicted PTSD status and depression had a mediating effect. Conclusion: There is a need for efficient, ongoing screening of depressive and PTSD symptomatology in trauma exposed high risk groups so that early psychological supportive interventions can be offered.

We determined the frequency and correlates of current common mental disorders (CMDs) in a consecutive series of 649 adult patients with human immunodeficiency virus (HIV), tuberculosis (TB) or both receiving treatment at 16 primary health care centres across Zambia. Data on socio-demographic variables, clinical disease features, anxiety and mood disorders were collected. The frequency of any anxiety disorder (AD) was 30.8% and major depressive disorder (MDD) 11.3%. Although differences by disease group did not reach statistical significance, rates of suicidality (34.8%) and panic disorder (4.1%) were highest for the TB–HIV group (n = 269), while rates of generalised AD (13.3%), obsessive compulsive disorder (7.6%), posttraumatic stress disorder (7.4%) and any AD (37.8%) were highest for the HIV group (n = 149). Female gender (p = 0.004) predicted any current AD as well as current suicidality (p = 0.009), while lower education status (p < 0.001) predicted current MDD. World Health Organisation (WHO) clinical staging and antiretroviral treatment status were not significantly associated with MDD or anxiety in the HIV and co-infected groups. This study indicates the importance of early identification of CMDs in TB, HIV and co-infected patients, especially women and uneducated patients, newly initiated on treatment in primary care settings.