Disaster and Distress: The Double Burden. Depression, Anxiety, and Post-traumatic Stress Disorder in Healthcare Providers during the COVID-19 Pandemic in Pakistan

Introduction Healthcare providers are at a high risk of occupational stress, psychological distress, and mental health problems due to unique job demands. The unprecedented negative impact of the COVID-19 pandemic on healthcare further intensified the risk. Objectives To find out the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in healthcare providers during the COVID-19 pandemic, and explore various associated factors. Methods We conducted a cross-sectional survey among clinicians across tertiary care hospitals in Lahore, Pakistan through online forms/ paper-based questionnaires, using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) Scale, and The Impact of Events Scale-Revised (IES-R) from July-November 2021. Physicians aged 20-60 years working at the public-sector hospitals of Lahore were included through non-probability convenient sampling. The non-parametric Mann-Whitney U, Kruskal-Wallis, and Chi-square test of independence were applied for inferential data analysis in SPSS version 26 at α=0.05. Results Of 302 participants, the majority were males (54.6%), from medicine and allied departments (76.9%), junior staff (72%), and frontline workers (75%). 9.5% had a history of psychiatric illness. The prevalence of depression was 25%, anxiety 31.9%, PTSD 15.8%, severe depression 13.8%, and severe anxiety 7.2%. The total median (IQR) scores of depression, anxiety, and PTSD were 5(2-9.5), 4(0-7), and 10(1-23) respectively. Females and junior staff had comparatively severe symptoms of anxiety and depression. Psychiatric history was linked to severe depression (p=0.003) and PTSD (p=0.001) but not anxiety (p=0.136). There were no statistically significant differences in the anxiety and PTSD severity across genders, departments, and frontline/second-line work. Conclusions We found high levels of depression, anxiety, and PTSD in our physician sample even during the 4 th COVID-19 wave. This has implications for emphasizing the significance of the mental well-being of healthcare providers and identifying effective interventions to prioritize it even after the pandemic. Disclosure of Interest None Declared