{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:18:34Z","timestamp":1769768314156,"version":"3.49.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosmentalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Ment Health"],"abstract":"<jats:p>Healthcare providers are at a high risk of occupational stress, psychological distress, and mental health issues due to unique job demands. The unprecedented negative impact of the COVID-19 pandemic on healthcare further amplified the risk. We aimed to find out the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in doctors during the COVID-19 pandemic, and explore various associated factors. We conducted a cross-sectional survey among clinicians across tertiary care hospitals in Lahore, Pakistan through online forms\/ paper-based questionnaires, using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) Scale, and The Impact of Events Scale-Revised (IES-R) from July-November 2021. Doctors aged 20\u201360 years working at the public-sector hospitals of Lahore were included through non-probability convenience sampling. The non-parametric Mann-Whitney U and Chi-square test of independence were applied for inferential data analysis in SPSS version 26 at \u03b1\u2009=\u20090.05. Of 304 participants, the majority were males (54.6%), from medicine and allied departments (76.9%), junior staff (72%), and\u00a0front-line\u00a0workers (75%). 9.5% had a history of psychiatric illness. The prevalence of depression was 25%, anxiety 31.9%, PTSD 15.8%, severe depression 13.8%, and severe anxiety 7.2%. The total median (IQR) scores of depression, anxiety, and PTSD were 5(2-9.5), 4(0\u20137), and 10(1\u201323), respectively. Females and junior staff had comparatively severe symptoms of anxiety and depression. Psychiatric history was linked to severe depression (p\u2009=\u20090.003) and PTSD (p=&lt;0.001) but not anxiety (p\u2009=\u20090.136). There were no statistically significant differences in the anxiety and PTSD severity across departments, and between\u00a0front-line\/second-line work. We found high levels of depression, anxiety, and PTSD in our physician sample, even during the 4th COVID-19 wave. This has implications for emphasizing the significance of the mental well-being of healthcare providers and identifying effective interventions to prioritize it even after the pandemic.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000421","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T18:28:51Z","timestamp":1769711331000},"page":"e0000421","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disaster and distress: The double burden. Depression, anxiety, and post-traumatic stress disorder in doctors during the COVID-19 pandemic in Pakistan"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2844-9654","authenticated-orcid":true,"given":"Madah","family":"Fatima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazish","family":"Imran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irum","family":"Aamer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-9355","authenticated-orcid":true,"given":"Somia","family":"Iqtadar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilquis","family":"Shabbir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"issue":"3","key":"pmen.0000421.ref001","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.bpa.2020.11.009","article-title":"Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives","volume":"35","author":"AD Kaye","year":"2021","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"pmen.0000421.ref002","volume-title":"The impact of COVID-19 on health and care workers: a closer look at deaths. 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