Depression, Anxiety and Stress Symptoms among Afghan Healthcare Workers: A Cross-Sectional Analytical Study

Abstract

Background: Decades of conflict and cycles of disasters in Afghanistan have caused enormous impacts on health, the economy, and even national security. Objectives: We aimed to assess the levels of depression, anxiety, and stress symptoms and their determinants among Afghan healthcare workers. Methods: A cross-sectional study of 830 Afghan healthcare workers working in public and private hospitals was conducted between May and July 2021. We employed a non-probability sampling method to select our subjects. The questionnaire was composed of sections on sociodemographic information, working conditions, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Multivariable linear regression models were fitted using SPSS 21 to identify determinants of mental health symptoms among Afghan healthcare workers at a 5% significance level. Results: Of all participants, 52.3% (435) had symptoms of depression, 48.8% (405) anxiety, and 46.9% (389) stress. The likelihood of mental health symptoms was higher among those who worked in an urban setting (P = 0.001), were physically inactive (P = <0.001), had a decrease in income or an unpaid salary in the past six months (P = <0.001), thinking of leaving Afghanistan (P = <0.001), had medical comorbidity (P = <0.001), and being single (P = 0.048)]. Conclusion: This study highlights the important findings about the psychological health of healthcare workers in Afghanistan. These findings suggest rapid, actionable, and locally relevant interventions to assure potential improvements in working and living conditions for the health staff.