Evidence map›Paper›PMID 41993923›Full record

ArticleClinical practice and epidemiology in mental health : CP & EMH2026

Addressing Stress and Rhythm Dysregulation among Health Workers in the Post-Pandemic Context: An Italian Study and a Proposal for a Preventive Psychoeducational Intervention.

Elisa Cantone, Antonio Urban, Cesar Aviles Gonzales, Alessandra Perra, Stefano Lorrai, Michela Atzeni, Stocchino Serena, Rober Romero Ramírez, Adalberto Rangel Restrepo, Mauro Giovanni Carta and 1 more

Abstract read
In one paragraph

Article in Clinical practice and epidemiology in mental health : CP & EMH, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Elisa CantoneCapacities Building for Global Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0009-0001-5049-4614
Antonio UrbanCapacities Building for Global Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0009-0000-4948-8076
Cesar Aviles GonzalesAlumni Group of Nursing, Universidad Popular del Cesar, Valledupar 200002, Colombia.ORCID 0000-0002-1566-1974
Alessandra PerraDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0000-0001-5791-1655
Stefano LorraiDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.
Michela AtzeniDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0000-0002-0645-3006
Stocchino SerenaDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.
Rober Romero RamírezAlumni Group of Nursing, Universidad Popular del Cesar, Valledupar 200002, Colombia.
Adalberto Rangel RestrepoAlumni Group of Nursing, Universidad Popular del Cesar, Valledupar 200002, Colombia.
Mauro Giovanni CartaDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0000-0002-3745-3834
Giulia CossuDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.ORCID 0000-0002-1245-016X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: During the COVID-19 pandemic, healthcare workers (HCWs) faced intense and prolonged stress. This exposure increased their risk of burnout and mood disorders. The Methods: Ninety-seven HCWs from the University Hospital of Cagliari, Italy, participated in a cross-sectional study. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and rhythm regulation was evaluated through the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). Data were compared with published findings from mood disorders, psychotic disorders, and community samples. Results: A current depressive episode with PHQ-9 score was identified in 35.1% of HCWs participants, with significantly higher prevalence ( Discussion: The elevated rhythm dysregulation scores observed in healthcare workers support the hypothesis that chronic occupational stress may disrupt biological and social rhythms, potentially increasing vulnerability to mood disorders. Conclusion: HCWs displayed pronounced rhythm dysregulation and high rates of depressive symptoms, highlighting occupational stress as a potential major risk factor and further supporting the DYMERS hypothesis. From both clinical and research perspectives, it could be essential to promote psychoeducational programs that target rhythm regulation, such as adaptations of Interpersonal and Social Rhythm Therapy, which may offer effective preventive strategies to enhance resilience and mental well-being in this population. However, the cross-sectional design, convenience sampling, limited socio-demographic data, and reliance on self-reported measures constrain generalizability and causal inference, underscoring the need for larger longitudinal studies to validate and extend these findings.

Indexed as

COVID-19Depressive symptomsDYMERSHealthcare workersPreventionRhythm dysregulation

Identifiers

PMID41993923
PMCPMC13080392

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.