Therapeutic endoscopy has evolved significantly, with increasingly complex procedures carrying higher complication risks. While severe adverse events profoundly impact patients (first victims), their psychological effect on endoscopists (second victims) remains understudied in our setting. This research assessed the prevalence of post-traumatic stress symptoms (PTSS) and associated risk factors among advanced endoscopists in Spain.

A nationwide cross-sectional study was conducted among Spanish Society of Digestive Endoscopy (SEED) members. Using the validated PCL-5 questionnaire (DSM-5 criteria), we evaluated PTSS prevalence and severity. Data from 85 complete responses (out of 100 collected; 15 excluded for incompleteness) were analyzed using SPSS 31.

Participants' mean age was 46.34 years (SD 9.96), with 55.29% male representation. PTSD prevalence was 12.94% (n=11), while 31.76% (n=27) reported significant symptoms without meeting full diagnostic criteria. Among symptomatic participants, symptom severity distribution was: mild (18.17%; n=21), moderate (12.94%; n=11), and severe (8.23%; n=7). Univariate analysis identified performing ≥12 procedures per endoscopy list as a potential risk factor (p=0.04), though this association did not persist in multivariate analysis. No significant associations were found with age, sex, or years of experience.

A non-negligible prevalence of PTSD was identified among advanced endoscopists in our setting. These findings highlight the need to recognise the endoscopist as a potential second victim and to promote institutional strategies for psychological support and prevention. In a field where technical precision is essential, our results emphasise that the emotional wellbeing of the endoscopist is also a critical component of patient safety.