Moral Injury, Mental Disorders, and Suicidal Behavior Among Health Professionals During the COVID-19 Pandemic: A Network Analysis.

During extreme conditions such as the COVID-19 pandemic, health professionals were susceptible to mental health issues. A series of network analyses were performed to explore the relationship between moral injury and depressive symptoms, anxiety symptom, PTSD symptom, and suicidal behaviors in 14,993 health professionals. Depressive symptoms were identified as the main pathway through which moral injury led to suicidal behavior, and betrayal was the most significant bridge symptom for moral injury with PTSD, anxiety, and depressive symptoms. The symptom profiles of MI associated with the common mental outcomes included betrayal, self-condemnation, and feeling punished by God. The most central mental symptoms of health professionals were irritability, nervousness, and feeling afraid. It is crucial to implement targeted measures addressing the bridge symptoms of moral injury and the core symptoms of anxiety to prevent and treat mental health consequences among health professionals.