Nearly one in five physicians reported pandemic PTSD: study

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Nearly one in five physicians reported symptoms of PTSD during the COVID-19 pandemic, and women were twice as likely as men to be affected, according to a newly published study by Ottawa researchers.

The research, the largest of its kind, was based on a systematic review of 57 studies from around the world involving slightly less than 28,000 participants. It was published in the journal JAMA Network Open.

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Lead researcher Dr. Manish Sood, a physician and senior scientist at the Ottawa Hospital Research Institute with a research chair in physician health and wellness, said the findings surprised researchers.

The study found that about 18 per cent of physicians reported symptoms consistent with post-traumatic stress disorder between December 2019 and November 2022. The rate of reported PTSD was higher than before the pandemic and higher than in the general population.

“It was higher than any of us anticipated. Sometimes in research, when you see numbers that are high, you double-, triple- and quadruple-check. We checked and checked and this is what it is,” Sood said.

The findings, he said, constitute a call for action to do more to address physician mental health.

“It is giving you a signal, like a canary in the coal mine, that something is wrong. You can’t ignore something like this.”

Especially concerning, Sood said, was the finding that female physicians had significantly higher rates of PTSD than male colleagues, as did trainees.

Additional research is needed to better understand why female physicians have higher rates of PTSD and whether female physicians have an added risk of PTSD compared to females who are not physicians, he said.

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The authors proposed that the increased rates of PTSD among female physicians could be related to the fact that women likely have higher rates of social supports to manage stress than their male counterparts, but that was limited during the pandemic.

Medical trainees also had higher rates of PTSD than most physicians, as did older physicians.

Sood said the severity of cases, concerns about bringing COVID-19 home to their families and the moral distress associated with seeing patients unable to get timely help for their health needs were likely all among the factors contributing to stress for physicians during the pandemic.

“There is the stress of seeing a mass-casualty event, including young people, often with very severe illness and dying in front of you. What if you catch it and bring it home to your family and get others around you sick? This is very scary and stressful,” he said.

Sood said it was significant that the research spanned nearly three years of the pandemic and not just its early months. It suggests the factors that contributed to PTSD continued throughout the pandemic.

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The research comes at a time when there is a growing focus on physician wellbeing, especially during a period of widespread physician shortages, something that Sood says is not always given the attention it deserves. Traditionally, he says, there has been a “don’t ask don’t tell” attitude toward illness for physicians, especially for mental health issues.

That is changing and physician wellbeing has become an emerging area of study and policies. Sood believes that is, in part, due to the growing number of women physicians.

“I think they are demanding change in a good way,” he said.

Physician mental health visits spiked in the months after COVID-19 in Ontario, according to previous research. Sood said the newest study was a means of taking a closer look into what was behind those visits.

Sood was the senior researcher on the study, which was originally part of a fourth-year student research project by Mihir Kamra. Kamra is listed first among authors of the paper, many of them also students completing their undergraduate degrees. Kamra is set to begin medical school in the fall, Sood said.

Sood hopes the research will be used by physician-wellness programs that are being developed to focus on physician health and wellbeing.

“I think we can now take this (information) and develop programs for early screening, early detection and intervention,” he said.

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