War and the long-term psychiatric health of journalists who cover it

Background Journalists covering war are exposed to grave risk which can cause mental health difficulties. Aims To determine the long-term psychiatric health of journalists who covered wars in Afghanistan and the Middle East between September 2001 (following 9/11) and 2013 (waning of the Arab Spring uprisings). Method Observational, qualitative study involving journalists from CNN, The New York Times , the Washington Post , the Associated Press and National Public Radio. Data collected via study website and Zoom interviews. Of 324 journalists identified, 202 (62.3%) were traceable. Of these, 16 (4.9%) were deceased, 156/186 (83.9%) consented and 30/186 (16.1%) declined participation. Of 156 journalists who provided psychometric data, 99 (63.4%) agreed to interview. Duration of exposure to and severity of risk were recorded. Psychometric data included the General Anxiety Disorder seven-item scale, the nine-item Patient Health Questionnaire, the PTSD Checklist for DSM-5 and the Structured Clinical Interview Schedule for DSM-5 to elicit 12-month and lifetime prevalence of psychiatric diagnoses. Results One hundred and twelve (71.8%) were male, mean age was 57.0 (s.d. = 9.75) years and 77/156 (49.4%) spent more than 3 years in war zones. Time in a war zone correlated with risk severity ( r = 0.476, p < 0.001). Lifetime and 12-month prevalence of post-traumatic stress disorder (PTSD) 27%/6%; major depression 34%/8%; any anxiety disorder 28%/11%; alcohol use disorder 34%/4%; acute stress disorder 6%/0%; dissociative disorder 2%/0%. Severity of risk predicted lifetime PTSD only (odds ratio 2.55, 95% CI: 1.27–5.14, p = 0.009). Counselling was available to 63/156 (40.4%) journalists while covering conflict. Conclusions Journalists who covered wars in Afghanistan, Iraq and elsewhere that began after 9/11 have a high lifetime prevalence of PTSD, major depression, any anxiety disorder and alcohol use disorder; 12-month prevalence for PTSD and any anxiety disorder remains elevated, albeit less so. War journalism is hazardous, and risk severity predicts PTSD, highlighting the importance of therapy availability.