{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:16:05Z","timestamp":1792181765077,"version":"4.4.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Physicians are a professional group at high risk of impaired quality of life (QoL) and mental health due to heavy workloads, exposure to suffering, and structural inequalities. In Brazil, rapid\u00a0feminisation\u00a0of the medical workforce has not eliminated gender and regional disparities, and nationwide evidence on physicians\u2019 QoL remains scarce.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a nationwide, cross-sectional, web-based survey of licensed physicians in Brazil between July and August 2024. Eligibility required active registration with a Regional Medical Council and prior use of a digital health platform. QoL was assessed using the WHOQOL-BREF, complemented by items on lifestyle, burnout, depression, and anxiety. Post-stratification weighting aligned the sample with the 2025 Brazilian Medical Census across sex and region. Weighted least squares regression models estimated unique contributions of sex, age, region, career stage, and mental disorders to QoL domains.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 2,005 physicians participated (56.1% women). Weighted WHOQOL-BREF scores post-stratification were 62.2 in the physical, 55.5 in the psychological, 56.5 in the social, and 63.6 in the environment domains, with a global score of QoL (defined as the mean of 0-100 four domains score)\u00a0of 59.5. Women reported significantly higher prevalence of mental disorders (46.8% vs. 33.5% in men), particularly depression (25.3% vs. 17.7%) and anxiety (39.9% vs. 25.1%). QoL displayed a U-shaped trajectory across the life course, with lower scores in early and mid-career and recovery at older ages. Mental disorders were strongly associated with lower scores across all domains (\u20139 to \u201310 points in psychological and QoL, p\u2009<\u20090.001, large effect sizes). Multivariable models identified mental disorder as the dominant predictor of psychological and QoL perception outcomes, while sex explained variance in social relations, and region and age modestly contributed to physical and environment domains.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Brazilian physicians report lower QoL than both the general Brazilian population and international physician cohorts, with particular vulnerability in psychological well-being. Gender disparities persist, with women experiencing greater psychiatric morbidity despite higher social relations scores. Structural inequalities, workload, and dissatisfaction with the health system emerged as key stressors. Interventions should combine structural reforms, gender equity policies, and lifestyle-promoting strategies to support physician well-being.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0338365","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T18:32:26Z","timestamp":1768242746000},"page":"e0338365","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impacts of gender disparities in mental health and quality of life: A cross-sectional study of Brazilian physicians"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7472-4464","authenticated-orcid":true,"given":"Marcelo","family":"Gobbo Jr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Silveira","family":"de Resende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1708-5659","authenticated-orcid":true,"given":"Eduardo Cardoso","family":"Moura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata de Almeida","family":"Pedro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1919-658X","authenticated-orcid":true,"given":"Isabelle Martins","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"pone.0338365.ref001","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1017\/S0033291798006667","article-title":"Development of the World Health Organization WHOQOL-BREF quality of life assessment","volume":"28","author":"The WHOQOL Group","year":"1998","journal-title":"Psychol Med"},{"issue":"2","key":"pone.0338365.ref002","first-page":"178","article-title":"Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref","volume":"34","author":"MP Fleck","year":"2000","journal-title":"Rev Saude Publica"},{"issue":"7","key":"pone.0338365.ref003","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s11136-011-9845-3","article-title":"Quality of life in Brazil: normative values for the WHOQOL-bref in a southern general population sample","volume":"20","author":"LN Cruz","year":"2011","journal-title":"Qual Life Res"},{"key":"pone.0338365.ref004","volume-title":"Demografia M\u00e9dica no Brasil 2025","author":"M Scheffer","year":"2025"},{"issue":"4","key":"pone.0338365.ref005","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023811","article-title":"What explains wage differences between male and female Brazilian physicians? A cross-sectional nationwide study","volume":"9","author":"GM Mainardi","year":"2019","journal-title":"BMJ Open"},{"key":"pone.0338365.ref006","doi-asserted-by":"crossref","first-page":"1537108","DOI":"10.3389\/fpubh.2025.1537108","article-title":"Prevalence and correlates of depression, anxiety, and burnout among physicians and postgraduate medical trainees: a scoping review of recent literature","volume":"13","author":"S Obeng Nkrumah","year":"2025","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0338365.ref007","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/bmb\/ldv007","article-title":"Women in medicine: historical perspectives and recent trends","volume":"114","author":"L Jefferson","year":"2015","journal-title":"Br Med Bull"},{"issue":"3","key":"pone.0338365.ref008","article-title":"Factors associated with medical students\u2019 quality of life in a Brazilian northeast countryside university","volume":"45","author":"HA dos Santos","year":"2021","journal-title":"Rev Bras Educ Med"},{"key":"pone.0338365.ref009","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.2147\/JMDH.S308076","article-title":"Factors Associated with Self-Esteem, Resilience, Mental Health, and Psychological Self-Care Among University Students in Northern Thailand","volume":"14","author":"N Auttama","year":"2021","journal-title":"J Multidiscip Healthc"},{"issue":"14","key":"pone.0338365.ref010","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/S0959-8049(01)00196-4","article-title":"Response shift in the perception of health for utility evaluation","volume":"37","author":"J Bernhard","year":"2001","journal-title":"European Journal of Cancer"},{"issue":"11","key":"pone.0338365.ref011","first-page":"2260","article-title":"Quality of life and risk factors that affect the quality of life of Thai female physicians","volume":"90","author":"T Vutyavanich","year":"2007","journal-title":"J Med Assoc Thai"},{"issue":"1","key":"pone.0338365.ref012","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1186\/s12913-023-09908-4","article-title":"Professional quality of life and its associated factors among Vietnamese doctors and nurses","volume":"23","author":"ANP Tran","year":"2023","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pone.0338365.ref013","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1023\/B:QURE.0000018486.91360.00","article-title":"The World Health Organization\u2019s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group","volume":"13","author":"WHOQOL Group","year":"2004","journal-title":"Qual Life Res"},{"issue":"12","key":"pone.0338365.ref014","doi-asserted-by":"crossref","first-page":"461","DOI":"10.47102\/annals-acadmedsg.V46N12p461","article-title":"Reliability and Validity of the English-, Chinese- and Malay-Language Versions of the World Health Organization Quality of Life (WHOQOL-BREF) Questionnaire in Singapore","volume":"46","author":"YB Cheung","year":"2017","journal-title":"Ann Acad Med Singap"},{"issue":"7","key":"pone.0338365.ref015","first-page":"809","article-title":"Application of WHOQOL-BREF in Measuring Quality of Life in Health-Care Staff","volume":"4","author":"A Gholami","year":"2013","journal-title":"Int J Prev Med"},{"issue":"7","key":"pone.0338365.ref016","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1590\/S0102-311X2013000700010","article-title":"Validade dimensional do instrumento de qualidade de vida WHOQOL-BREF aplicado a trabalhadores de sa\u00fade","volume":"29","author":"MML Castro","year":"2013","journal-title":"Cad Saude Publica"},{"key":"pone.0338365.ref017","article-title":"O WHOQOL-bref, um instrumento para avaliar qualidade de vida: uma revis\u00e3o sistem\u00e1tica","volume":"31","author":"ACGC Kluthcovsky","year":"2009","journal-title":"Rev psiquiatr Rio Gd Sul"},{"issue":"3","key":"pone.0338365.ref018","doi-asserted-by":"crossref","first-page":"375","DOI":"10.47626\/1679-4435-2021-730","article-title":"Quality of life of physicians in the state of Minas Gerais, Brazil","volume":"20","author":"A Moreira WC de","year":"2022","journal-title":"Rev Bras Med Trab"},{"key":"pone.0338365.ref019","doi-asserted-by":"crossref","first-page":"814109","DOI":"10.3389\/fpsyg.2022.814109","article-title":"Professional Quality of Life Among Physicians and Nurses Working in Portuguese Hospitals During the Third Wave of the COVID-19 Pandemic","volume":"13","author":"C Serr\u00e3o","year":"2022","journal-title":"Front Psychol"},{"key":"pone.0338365.ref020","article-title":"Dataset of Impacts of gender disparities in mental health and quality of life: a cross-sectional study of Brazilian physicians","author":"M Gobbo","year":"2025","journal-title":"Zenodo"},{"issue":"5","key":"pone.0338365.ref021","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1590\/1806-9282.20220172","article-title":"Physicians\u2019 income in Brazil: a study on information sources","volume":"68","author":"M Scheffer","year":"2022","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"4","key":"pone.0338365.ref022","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.11591\/ijphs.v13i4.23946","article-title":"Quality of life among physicians in\u00a0Egypt\u00a0and its influencing factors: a cross-sectional study","volume":"13","author":"AI Abdelrahman","year":"2024","journal-title":"Int J Public Health Sci"},{"issue":"1","key":"pone.0338365.ref023","doi-asserted-by":"crossref","first-page":"78","DOI":"10.4300\/JGME-D-13-00117.1","article-title":"Ability of the physician well-being index to identify residents in distress","volume":"6","author":"LN Dyrbye","year":"2014","journal-title":"J Grad Med Educ"},{"issue":"2","key":"pone.0338365.ref024","doi-asserted-by":"crossref","first-page":"291","DOI":"10.5811\/westjem.2019.1.39666","article-title":"Assessment of Physician Well-being, Part Two: Beyond Burnout","volume":"20","author":"MD Lall","year":"2019","journal-title":"West J Emerg Med"},{"issue":"5","key":"pone.0338365.ref025","doi-asserted-by":"crossref","first-page":"3843","DOI":"10.1177\/15248380241265380","article-title":"Microaggression Interactions Among Healthcare Professionals, Trainees and Students in the Clinical Environment: A Mixed-Studies Review","volume":"25","author":"S Archuleta","year":"2024","journal-title":"Trauma Violence Abuse"},{"key":"pone.0338365.ref026","article-title":"Quality of life at work for health professionals during the COVID-19 pandemic","volume":"77","author":"S Oliveira MML da","year":"2024","journal-title":"Rev Bras Enferm"},{"key":"pone.0338365.ref027","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/1735-1995.196615","article-title":"A pilot study of quality of life in German prehospital emergency care physicians","volume":"21","author":"M Sand","year":"2016","journal-title":"J Res Med Sci"},{"issue":"1","key":"pone.0338365.ref028","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1186\/s12909-023-04596-4","article-title":"State of well-being among residents in a tertiary center in Riyadh, Saudi Arabia","volume":"23","author":"FS AlAhmari","year":"2023","journal-title":"BMC Med Educ"},{"issue":"12","key":"pone.0338365.ref029","article-title":"Quality of life in south-eastern Australia: normative values for the WHOQOL-BREF in a population-based sample of adults","volume":"13","author":"EC West","year":"2023","journal-title":"BMJ Open"},{"issue":"6","key":"pone.0338365.ref030","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-097917","article-title":"Impact of medical school on quality of life and mental health in Brazil: a cross-sectional comparative study","volume":"15","author":"M Silveira de Resende","year":"2025","journal-title":"BMJ Open"},{"issue":"4","key":"pone.0338365.ref031","doi-asserted-by":"crossref","first-page":"329","DOI":"10.31486\/toj.19.0019","article-title":"Sexual Harassment in the House of Medicine and Correlations to Burnout: A Cross-Sectional Survey","volume":"19","author":"E Mathews","year":"2019","journal-title":"Ochsner J"},{"issue":"12","key":"pone.0338365.ref032","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.3390\/ijerph21121583","article-title":"Occupational Risk Factors for Burnout Syndrome Among Healthcare Professionals: A Global Systematic Review and Meta-Analysis","volume":"21","author":"S Amiri","year":"2024","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"pone.0338365.ref033","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.34315","article-title":"Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic","volume":"4","author":"E Frank","year":"2021","journal-title":"JAMA Netw Open"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0338365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T18:32:31Z","timestamp":1768242751000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0338365"}},"subtitle":[],"editor":[{"given":"Md. Feroz","family":"Kabir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0338365","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]}}}