Mental health risk factors for shift work disorder in paramedics: A longitudinal study

Objectives: Depression and anxiety are prominent in paramedics, as is the prevalence of shift work disorder (SWD), a circadian sleep condition comorbid with mental health disorders. However, the role of mental health risk factors for SWD is largely unknown. This study investigated whether mental health levels in recruit paramedics before shift work predicted greater risk of SWD at 6-months into their career and explored whether shift and sleep factors mediated this relationship.Design: A longitudinal study. Setting: Victoria, Australia. Participants: Recruit paramedics were assessed at baseline (n = 101; ie, pre-shift work) and after 6-months (n = 93) of shift and emergency work. Measurements: At both time points, participants completed self-reported measures of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Questionnaire-7), and SWD (SWD-Screening Questionnaire). Participants also filled a sleep and work diary for 14-days at each timepoint.Results: After 6-months of emergency work 21.5% of paramedics had a high SWD risk. Logistic regression models showed baseline depression predicted 1.24-times greater odds for SWD at 6-months. Through Lavaan path analysis we found shift and sleep variables did not mediate the relationship between baseline mental health and SWD risk. Baseline depression was associated with increased sleepiness levels following paramedics' major sleep periods at 6-months. Pre-existing depression levels also predicted greater perceived nightshift workload.Conclusions: Our results highlight depression symptoms before emergency work are a risk factor for SWD within 6-months of work. Depression represents a modifiable risk factor amenable to early interventions to reduce paramedics' risk of SWD. (c) 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Automated summary

This study investigated whether the mental health levels of recruit paramedics before shift work predicted a greater risk of shift work disorder (SWD) at 6 months into their career and whether shift and sleep factors mediated this relationship. The results showed that baseline depression predicted a higher risk of SWD at 6 months, and baseline depression levels also predicted a greater perceived nightshift workload.