Doctors continue to be a population at high risk of depression and anxiety.
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Symptoms during COVID-19 are high, but not necessarily higher than pre-pandemic levels.
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Study design and variation in job demands may explain some of the heterogeneity.
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Multi-level interventions should be considered to support doctors’ mental health.
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Better research methodology is needed to improve confidence in outcomes.
Abstract
Background
This review provides an estimate of the global prevalence of depression and anxiety symptoms among doctors, based on analysis of evidence from the first year of the COVID-19 pandemic.
Methods
A systematic review was conducted to identify suitable studies. Final searches were conducted on 3rd March 2021. Papers were initially screened by title and abstract, based on pre-agreed inclusion criteria, followed by full-text review of eligible studies. Risk of bias was assessed using the Joanna Briggs Checklist for Prevalence Studies. Data from studies rated as low or medium risk of bias were pooled using a random-effects meta-analysis. Sensitivity and subgroup analyses were conducted to explore heterogeneity.
Results
Fifty-five studies were included after full-text review. Of these, thirty studies were assessed as low or medium risk of bias and were included in primary analyses. These comprised twenty-six studies of depression (31,447 participants) and thirty studies of anxiety (33,281 participants). Pooled prevalence of depression and anxiety was 20.5% (95% CI 16.0%-25.3%) and 25.8% (95% CI 20.4%-31.5%) respectively.
Interpretation
Evidence from the first year of the pandemic suggests that a significant proportion of doctors are experiencing high levels of symptoms of depression and anxiety, although not conclusively more so than pre-pandemic levels. Differences in study methodology and variation in job demands may account for some of the observed heterogeneity.
Limitations
Findings must be interpreted with caution due to the high heterogeneity and moderate risk of bias evident in the majority of included studies.
