McMaster University, Hamilton, Ontario, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
JAMA Netw Open. 2024 Jul 1;7(7):e2423316. doi: 10.1001/jamanetworkopen.2024.23316.
The 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.
To 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.
A 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.
Peer-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.
A random-effects meta-analysis was used to pool estimates of PTSD prevalence and calculate odds ratios (ORs) for relevant physician characteristics.
The primary outcome of interest was the prevalence of PTSD in physicians, identified by standardized questionnaires.
Fifty-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).
In 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.
COVID-19 大流行使许多医生处于压力增加和面临具有挑战性的资源分配决策的情况。了解 COVID-19 大流行期间医生中创伤后应激障碍的患病率及其危险因素，将指导预防其发展的干预措施。
确定 COVID-19 大流行期间医生中创伤后应激障碍 (PTSD) 的患病率，并根据性别、年龄、医学专业和职业阶段等因素考察其差异。
进行了一项符合系统评价和荟萃分析首选报告项目的系统评价，检索了 2019 年 12 月至 2022 年 11 月的 MEDLINE、Embase 和 PsychInfo。搜索词包括与医生作为人群相关的医学主题词 (MeSH) 术语和关键词以及 PTSD。
纳入了通过经过验证的问卷或临床医生诊断报告 PTSD 作为可能诊断的同行评审已发表研究。由 6 名评审员对这些研究进行了审查。
使用随机效应荟萃分析汇总 PTSD 患病率的估计值，并计算相关医生特征的优势比 (OR)。
主要结局是通过标准化问卷确定的医生 PTSD 的患病率。
共纳入了 57 项研究，总计 28965 名参与者和 25 个国家（其中报告性别：11239 名中的 5917 名 [52.6%] 为男性，11239 名中的 5322 名 [47.4%] 为女性；报告职业阶段：11186 名中的 4148 名 [37.1%] 为医学实习生，11186 名中的 7038 名 [62.9%] 为主治医生）。估计的 PTSD 总体患病率为 18.3%（95% CI，15.2%-22.8%；I2=97%）。14 项研究（22.8%）报告了性别，发现女性医生更有可能患上 PTSD（OR，1.93；95% CI，1.56-2.39）。在报告年龄的 10 项研究（17.5%）中，年轻医生报告的 PTSD 较少。在报告专业的 13 项研究（22.8%）中，急诊科医生 PTSD 最常见。在报告职业阶段的 16 项研究（28.1%）中，实习生比主治医生更容易患上 PTSD（OR，1.33；95% CI，1.12-1.57）。
在这项针对 COVID-19 期间 PTSD 的荟萃分析中，18.3%的医生报告了符合 PTSD 的症状，女性医生、年龄较大的医生和实习生的风险更高，并且专业也存在差异。需要针对大流行等创伤性事件对医生进行幸福感的有针对性的干预。
