{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:42:20Z","timestamp":1789580540284,"version":"build-2803163510"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"unspecified","delay-in-days":275,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010221","name":"Higher Education Commision, Pakistan","doi-asserted-by":"publisher","award":["16055-NRPU-HEC."],"award-info":[{"award-number":["16055-NRPU-HEC."]}],"id":[{"id":"10.13039\/501100010221","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1935789325102103_sec1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence and severity of anxiety and depression among health care professionals in Khyber Pakhtunkhwa and the impact of gender and professional roles on mental health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102103_sec2\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted between March and November 2023 using stratified random sampling among health care professionals, including doctors, nurses, paramedics, and emergency staff, across multiple hospitals. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression. Data were analyzed using R\/RStudio, employing descriptive statistics, chi-square tests, independent t-tests, Mann-Whitney U tests, and Pearson\u2019s correlation coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102103_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 651 participants, 65% were male. Anxiety prevalence was significant, with 42% experiencing minimal anxiety, 35% mild, 16% moderate, and 7.7% severe. Depression prevalence included 10% with no depression with 7.8% moderately severe and 5.9% severe depression. Nurses (40%) and doctors (34%) had the highest depression rates. Females exhibited significantly higher anxiety and depression scores. Anxiety prevalence varied across hospitals (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.024). A strong positive correlation was observed between GAD-7 and PHQ-9 scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102103_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mental health challenges among frontline health care workers in Khyber Pakhtunkhwa are substantial, with anxiety and depression particularly prevalent among nurses and doctors. Female workers experience greater psychological distress. We recommend implementation of hospital-based mental health support systems, prioritizing interventions for female staff and high-burden departments. Policies ensuring regular psychological screening and peer support mechanisms are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2025.10210","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T10:52:49Z","timestamp":1759488769000},"source":"Crossref","is-referenced-by-count":1,"title":["Emergency Related Mental Health Challenges Among Frontline Health Workers in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study"],"prefix":"10.1017","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6133-3349","authenticated-orcid":false,"given":"Asif","family":"Rehman","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5933-270X","authenticated-orcid":false,"given":"Farhad Ali","family":"Khattak","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8813-4801","authenticated-orcid":false,"given":"Khalid","family":"Rehman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urooj","family":"Ashfaq","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihtesham Ul","family":"Haq","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohaib","family":"Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Irfan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02t2qwf81","id-type":"ROR","asserted-by":"publisher"}],"name":"Peshawar Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalil","family":"Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00nv6q035","id-type":"ROR","asserted-by":"publisher"}],"name":"Khyber Medical 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