ArticlePLOS mental health2026
Disaster and distress: The double burden. Depression, anxiety, and post-traumatic stress disorder in doctors during the COVID-19 pandemic in Pakistan.
Article in PLOS mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Healthcare providers are at a high risk of occupational stress, psychological distress, and mental health issues due to unique job demands. The unprecedented negative impact of the COVID-19 pandemic on healthcare further amplified the risk. We aimed to find out the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in doctors during the COVID-19 pandemic, and explore various associated factors. 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. Doctors aged 20-60 years working at the public-sector hospitals of Lahore were included through non-probability convenience sampling. The non-parametric Mann-Whitney U and Chi-square test of independence were applied for inferential data analysis in SPSS version 26 at α = 0.05. Of 304 participants, the majority were males (54.6%), from medicine and allied departments (76.9%), junior staff (72%), and front-line 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 departments, and between front-line/second-line work. We found high levels of depression, anxiety, and PTSD in our physician sample, even during the 4th 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.
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