Physician Posttraumatic Stress Disorder During COVID-19

Author:

Kamra Mihir1,Dhaliwal Shan2,Li Wenshan3,Acharya Shrey1,Wong Adrian1,Zhu Andy1,Vemulakonda Jaydev1,Wilson Janet2,Gibb Maya3,Maskerine Courtney3,Spilg Edward34,Tanuseputro Peter3456,Myran Daniel T.56789,Solmi Marco3791011,Sood Manish M.34

Affiliation:

1. McMaster University, Hamilton, Ontario, Canada

2. Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

3. The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

4. Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada

5. ICES, Ontario, Canada

6. Bruyere Research Institute, Ottawa, Ontario, Canada

7. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

8. Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada

9. School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada

10. Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada

11. Deptartment of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada

Abstract

ImportanceThe COVID-19 pandemic placed many physicians in situations of increased stress and challenging resource allocation decisions. Insight into the prevalence of posttraumatic stress disorder in physicians and its risk factors during the COVID-19 pandemic will guide interventions to prevent its development.ObjectiveTo determine the prevalence of posttraumatic stress disorder (PTSD) among physicians during the COVID-19 pandemic and examine variations based on factors, such as sex, age, medical specialty, and career stage.Data SourcesA Preferred Reporting Items for Systematic Reviews and Meta-analyses–compliant systematic review was conducted, searching MEDLINE, Embase, and PsychInfo, from December 2019 to November 2022. Search terms included MeSH (medical subject heading) terms and keywords associated with physicians as the population and PTSD.Study SelectionPeer-reviewed published studies reporting on PTSD as a probable diagnosis via validated questionnaires or clinician diagnosis were included. The studies were reviewed by 6 reviewers.Data Extraction and SynthesisA random-effects meta-analysis was used to pool estimates of PTSD prevalence and calculate odds ratios (ORs) for relevant physician characteristics.Main Outcomes and MeasuresThe primary outcome of interest was the prevalence of PTSD in physicians, identified by standardized questionnaires.ResultsFifty-seven studies with a total of 28 965 participants and 25 countries were included (of those that reported sex: 5917 of 11 239 [52.6%] were male and 5322 of 11 239 [47.4%] were female; of those that reported career stage: 4148 of 11 186 [37.1%] were medical trainees and 7038 of 11 186 [62.9%] were attending physicians). The estimated pooled prevalence of PTSD was 18.3% (95% CI, 15.2%-22.8%; I2 = 97%). Fourteen studies (22.8%) reported sex, and it was found that female physicians were more likely to develop PTSD (OR, 1.93; 95% CI, 1.56-2.39). Of the 10 studies (17.5%) reporting age, younger physicians reported less PTSD. Among the 13 studies (22.8%) reporting specialty, PTSD was most common among emergency department doctors. Among the 16 studies (28.1%) reporting career stage, trainees were more prone to developing PTSD than attendings (OR, 1.33; 95% CI, 1.12-1.57).Conclusions and RelevanceIn this meta-analysis examining PTSD during COVID-19, 18.3% of physicians reported symptoms consistent with PTSD, with a higher risk in female physicians, older physiciansy, and trainees, and with variation by specialty. Targeted interventions to support physician well-being during traumatic events like pandemics are required.

Publisher

American Medical Association (AMA)

Reference89 articles.

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