ArticleBMJ open2026
Prevalence and factors associated with symptoms of common mental disorders, anxiety, depression, burnout, insomnia and stress among primary healthcare workers in Brazil: protocol for a systematic review and prevalence meta-analysis.
Article in BMJ open, 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
introductionThe mental health of primary healthcare (PHC) workers is a determinant of service quality and sustainability in the Brazilian Unified Health System (SUS). Brazilian observational studies report symptoms of common mental disorders, anxiety, depression, burnout, insomnia and stress among PHC workers, but the evidence is fragmented across settings, occupational categories, instruments and time periods. This protocol describes a systematic review and prevalence meta-analysis to consolidate prevalence estimates and synthesise associated sociodemographic, occupational and organisational factors among PHC workers in Brazil. METHODS AND ANALYSIS: We will conduct a systematic review and prevalence meta-analysis in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and report the completed review following PRISMA 2020. We searched MEDLINE (via PubMed), Embase, PsycINFO, CINAHL and BVS/LILACS from inception to 16 September 2025, complemented by grey literature searches (Google Scholar and CAPES Theses and Dissertations) and reference-list screening. Eligible studies will be quantitative observational studies conducted in Brazil with workers linked to PHC within the SUS, including health professionals and other occupational groups (eg, community health workers and administrative/operational staff). Studies must report prevalence based on validated instruments for use in Brazilian populations and an explicit case definition/cut-off for common mental disorders, anxiety symptoms, depression, burnout, insomnia and stress. Two independent reviewers will screen records and full texts in Rayyan; disagreements will be resolved by consensus or a third reviewer. Risk of bias will be assessed using the Joanna Briggs Institute checklist for prevalence studies. We will pool prevalence estimates by outcome using random-effects models (primary approach: binomial models), quantify heterogeneity (I², τ², Q) and estimate prediction intervals. Prespecified subgroup/sensitivity analyses will explore geographic region, occupational category, instrument/cut-off, sampling approach, risk of bias and data collection period, classified as prepandemic, pandemic/postpandemic or mixed. Associated factors will be synthesised as a structured narrative by domain; meta-analysis of associations will be considered only when exposure definitions and effect measures are sufficiently comparable. ETHICS AND DISSEMINATION: Ethics approval is not required because this study uses secondary data from published reports. For queries related to research integrity, please contact the Research Ethics Committee of the Federal University of Espírito Santo (cep.ufes@hotmail.com). Findings will be disseminated through publication in a peer-reviewed journal and presentations at scientific meetings.
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