Almost 1 in 5 Physicians Reported PTSD Symptoms During COVID-19 Pandemic

A systematic review and meta-analysis published in JAMA Network Open found that 18.3% of physicians who worked during the COVID-19 pandemic had symptoms consistent with post-traumatic stress disorder (PTSD).

Previous studies have demonstrated that physicians have a higher prevalence of PTSD than the general population. Given that the demands of the COVID-19 pandemic caused an unprecedented strain on the health care system, investigators hypothesized that physician PTSD was likely exacerbated during COVID-19 as health care workers likely experienced increased exposure to trauma during this time period.

To this aim, the investigators from McMaster University and The Ottawa Hospital in Canada conducted a systematic review and meta-analysis to evaluate the prevalence of PTSD symptoms among physicians during the COVID-19 pandemic. The investigators searched publication databases for studies published between December 2019 and November 2022 that assessed PTSD (using validated questionnaires) among health care workers.

A total of 57 studies were included in the present analysis, for a pooled study population of 28,965 clinicians. Most studies were conducted in Europe (n=17), Asia (n=16), and North America (n=14), followed by Africa (n=4), South America (n=3), Australia (n=2), and a global study with data from 101 countries (n=1). The studies were conducted in 2020 (80.7%), 2021 (10.5%), both 2020 and 2021 (7.0%), and both 2021 and 2022 (n=1). Most studies (75.4%) did not specify the medical specialty of the participants.

The outcome of PTSD was assessed by the Impact Events Scale-Revised (IES-R; 42.1%), PTSD Checklist (PCL) for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5; 40.3%), primary care-PTSD (PC-PTSD; 7%), and 1 study each used the Davidson Trauma Scale (DTS), Posttraumatic Diagnostic Scale for DSM-5 (PDS), PTSD Symptom Scale Self-Report version (PSS-SR5), National Stressful Events Survey for PTSD-Short Scale (NSESSS-PTSD), 8-item Treatment Outcome PTSD Scale (PTSD-8), and International Trauma Questionnaire (ITQ) instruments.

The investigators found that 5748 (18.3%) physicians reported symptoms consisted with PTSD (I², 97.3%). When stratified by the type of PTSD scale used, the proportion of PTSD cases ranged between 3% and 67% for IES-R, 2.3% to 41.9% for PCL, and 9.5% to 22.7% for PC-PTSD.

The results of the primary analysis were consistent when stratifying by study year and sample size.

A total of 14 studies reported gender-specific PTSD rates. Most studies (92.3%) reported a higher prevalence of PTSD among women than men, with a mean prevalence of 26.9% among women and 18.8% among men (mean difference [MD], 12.0%).

A total of 10 studies reported age-specific PTSD rates. Most studies (80.0%) reported a lower prevalence of PTSD among the youngest physicians than the oldest physicians (MD, 4.8%).

A total of 16 studies reported career stage-specific PTSD rates. The prevalence of PTSD among trainees ranged between 19.2% to 46.0% and among attending physicians between 12.2% to 42.5%.

A total of 13 studies reported specialty-specific PTSD rates. The mean prevalence of PTSD was highest for family medicine (31.2%), followed by emergency medicine (23.4%), otolaryngology (23.0%), surgery (22.4%), internal medicine (21.9%), anesthesiology (16.1%), and critical care (14.8%).

The likelihood of developing PTSD was significantly higher among women (odds ratio [OR], 1.93; 95% CI, 1.56-2.39; P <.001) and trainees (OR, 1.33; 95% CI, 1.12-1.57).

The review authors concluded, “The high prevalence of PTSD suggests that system level changes may be indicated to support physician health, which can include wellness supports and specific interventions to target and alleviate root causes.”

These study findings may be limited, as many studies lacked specialty-specific data and data about pre-pandemic PTSD levels.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Psychiatry Advisor