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Psychological impact of managing COVID-19 patients among doctors: A pre- and post-survey study

Amber Tahir, MBBS, FCPS-I (Psychiatry), Anaam Bugti, MBBS, FCPS-I (Psychiatry), Ayesha Sarwat, MBBS, MCPS (Psychiatry), FCPS (Psychiatry), Azizullah Khan Dhiloo, MBBS, FCPS (Medicine), FCPS (Infectious Diseases), Mahnoor Yousif Shaikh, MBBS


Objective: In any struggling healthcare system, it is always the frontline workers—doctors, nurses, and paramedical staff – that are affected first. This study aimed to assess the psychological impact—anxiety, stress, depression, and post-traumatic stress disorder (PTSD) —among doctors working in COVID-19 wards and the underlying triggers in a public hospital in Karachi.

Methods: Pre- and post-survey methodologies were adopted. Post-graduate trainees working in COVID-19 isolation facilities from April till September 2020 were interviewed before starting their one-month rotation and after completing it. The psychological impact was assessed using two standard instruments—Depression Anxiety and Stress 21 (DASS-21) and the Impact of Event Scale-Revised (IES-R). Data were entered and analyzed through SPSS version 22.0.

Results: For 100 doctors, the mean score for stress, anxiety, stress, and depression on DASS-21 and PTSD on IES-R significantly increased after the rotation (p < 0.01). The mean score of depression and IES-R was higher in younger (<28 years) doctors (p ≤ 0.05). Married doctors scored higher on anxiety and IES-R (p ≤ 0.05). Doctors who were not willfully performing their duties scored worse on all measures of DASS-21 and IES-R (p < 0.01). Doctors facing family resist­ance scored significantly higher on stress, anxiety, and IES-R (p < 0.01).

Conclusion: Working in COVID-19 facilities is imparting a negative impact on the psychological health of doctors. Healthcare administration should be aware of this psychological distress and should introduce mental health aid at administrative levels to prevent a mental health epidemic among care providers.


anxiety, COVID-19 pandemic, depres¬sion, healthcare providers, severe acute respiratory syndrome coronavirus 2, stress, post-traumatic stress

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