Symptoms of depression, anxiety, and stress among physicians: a scoping review
DOI:
https://doi.org/10.11606/issn.2317-2770.v30i2e-242123Keywords:
Occupational Health, Physicians, Mental HealthAbstract
Introduction: Physicians’ mental health has received increasing attention, particularly following the COVID-19 pandemic, which intensified emotional and occupational demands. Identifying symptoms of depression, anxiety, and stress, as well as their associated risk and protective factors, is essential to inform preventive interventions. Objective: To review recent literature using the Depression, Anxiety, and Stress Scale – 21 items (DASS-21) to assess these symptoms among physicians, comparing prevalence across specialties, countries, and work settings. Methods: A literature review was conducted in the PubMed database between September and November 2024. The following search terms were used: (depression OR depressive disorder OR anxiety OR angst) AND (physician) AND (DASS), with a filter for publications from the past five years. Studies including physicians as participants and employing the DASS-21 were considered eligible. Of the 94 articles identified, 15 met the inclusion criteria. Results: The prevalence of moderate to severe depressive symptoms ranged from 9% to over 50%, with higher levels observed among resident physicians and professionals working in high-acuity settings, such as emergency departments and COVID-19 hospitals. Anxiety showed even higher prevalence rates, exceeding 60% in high-pressure environments. Stress, although presenting lower absolute values, demonstrated a more chronic pattern. Identified risk factors included female sex, younger age, high workload, low social support, and direct exposure to COVID-19 patients. Protective factors included male sex and greater professional experience. Conclusion: The findings indicate a high prevalence of emotional symptoms among physicians, reinforcing the need for preventive strategies, support measures, and continuous monitoring of mental health.Parte superior do formulário
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Boucher VG, Dahl M, Lee J, Faulkner G, Beauchamp MR, Puterman E. An umbrella review and meta-analysis of 87 meta-analyses examining healthcare workers' mental health during the COVID-19 pandemic. J Affect Disord. 2025;375:423-36. doi: 10.1016/j.jad.2025.01.109
Al Maqbali M, Alsayed A, Hughes C, Hacker E, Dickens GL. Stress, anxiety, depression and sleep disturbance among healthcare professional during the COVID-19 pandemic: An umbrella review of 72 meta-analyses. PLoS One. 2024;19(5):e0302597. doi: 10.1371/journal.pone.0302597
Guraya SS, Menezes P, Lawrence IN, Guraya SY, Rashid-Doubell F. Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review. Front Med (Lausanne). 2023;10:1071537. doi: 10.3389/fmed.2023.1071537
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u
Vignola RCB, Tucci AM. Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. J Affect Disord. 2014;155:104-9. doi: 10.1016/j.jad.2013.10.031
Sá e Camargo ML, Torres RV, Cotta KCG, Ezequiel ODS, Lucchetti G, Lucchetti ALG. Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians. Int J Soc Psychiatry. 2023;69(5):1260-7. doi: 10.1177/00207640231157258
Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954. doi: 10.1016/j.psychres.2020.112954
Akova İ, Kiliç E, Özdemir ME. Prevalence of burnout, depression, anxiety, stress, and hopelessness among healthcare workers in COVID-19 pandemic in Turkey. Inquiry. 2022;59:1-12. doi: 10.1177/00469580221079684
Baptista S, Teixeira A, Castro L, Cunha M, Serrão C, Rodrigues A, Duarte I. Physician burnout in primary care during the COVID-19 pandemic: A cross-sectional study in Portugal. J Prim Care Community Health. 2021;12:1-7. doi: 10.1177/21501327211008437
Cena L, Rota M, Calza S, Massardi B, Trainini A, Stefana A. Mental health states experienced by perinatal healthcare workers during COVID-19 pandemic in Italy. Int J Environ Res Public Health. 2021;18(12):6542. doi: 10.3390/ijerph18126542
Tiete J, Guatteri M, Lachaux A, Matossian A, Hougardy JM, Loas G, Rotsaert M. Mental health outcomes in healthcare workers in COVID-19 and non-COVID-19 care units: A cross-sectional survey in Belgium. Front Psychol. 2021;11:612241. doi: 10.3389/fpsyg.2020.612241
Martínez-Caballero CM, Matellán-Hernández MP, Polo-Portes CE, Reques-Marugán AM, Soto-Cámara R, Cardaba-García RM, et al. Exploring disparities in self-reported mental health symptoms across professional categories in Spain’s emergency medical services: A nationwide cross-sectional study. Disaster Med Public Health Prep. 2023;17(6):1-8. doi: 10.1017/dmp.2023.171
Arafa A, Mohammed Z, Mahmoud O, Elshazley M, Ewis A. Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic? J Affect Disord. 2021;278:365-71. doi: 10.1016/j.jad.2020.09.080
El-Gammal MA, Elgendy A, Heidler P, Owais TA, Eltewacy NK, Hamza N. The psychological impact of COVID-19 on healthcare work force in the Middle East region: C-S study. Front Psychiatry. 2023;14:1112501. doi: 10.3389/fpsyt.2023.1112501
Rahman A, Deeba F, Akhter S, Bashar F, Nomani D, Koot J, et al. Mental health condition of physicians working frontline with COVID-19 patients in Bangladesh. BMC Psychiatry. 2021;21(1):615. doi: 10.1186/s12888-021-03629-w
Mahat N, Zubaidi SA, Soe HHK, Nah SA. Paediatric surgical response to an 'adult' COVID-19 pandemic. Med J Malaysia. 2021;76(3):284-90.
Elsaie ML, Hasan MS, Zaky MS, Hussein SM, Kadah AS, Omar AM. Implication of COVID-19 on the mental health of Egyptian dermatologists: A cross-sectional study. J Cosmet Dermatol. 2021;20(10):3066-73. doi: 10.1111/jocd.14390
Zgliczyński WS, Rostkowska OM, Humeniuk E, Baska A, Bojar I, Raczkiewicz D. Burden of COVID-19 on mental health of resident doctors in Poland. Med Sci Monit. 2023;29:e940208. doi: 10.12659/MSM.940208
Javadekar A, Javadekar S, Chaudhury S, Saldanha D. Depression, anxiety, stress, and sleep disturbances in doctors and general population during COVID-19 pandemic. Ind Psychiatry J. 2021;30(3):20-5. doi: 10.4103/0972-6748.328783
Ayed M, Yazdani A, Esmaelili H, Alsaleh A, Sultan A, Alamad E, et al. COVID-19 pandemic and its effect on resident physicians’ mental well-being: A cross-sectional study in Kuwait. Cureus. 2023;15(3):e33606. doi: 10.7759/cureus.33606
Arenliu Qosaj F, Weine SM, Sejdiu P, Hasani F, Statovci S, Behluli V, et al. Prevalence of perceived stress, anxiety, and depression in healthcare workers in Kosovo during the COVID-19 pandemic: A cross-sectional survey. Int J Environ Res Public Health. 2022;19(24):16667. doi: 10.3390/ijerph192416667
Almhdawi KA, Alrabbaie H, Arabiat A, Alhammouri AT, Hamadneh M, Obeidat D, et al. Physicians’ health-related quality of life and its associated factors during COVID-19 pandemic in Jordan: A cross-sectional study. Eval Health Prof. 2022;45(1):76-85. doi: 10.1177/01632787211068899
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Copyright (c) 2025 Lara Vendramini Lucas de Freitas, Felipe Gabel, João Silvestre Silva-Junior
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