Mental health of general practitioners and family medicine specialists two years after the beginning of the COVID-19 pandemic: results from a European survey

Marija Zafirovska, Aleksandar Zafirovski, Jelena Danilenko, Kristien Coteur, Heidrun Lingner, Nicola Buono, Christine Brütting, Aleksander Stepanović, Mumtaz M Mazicioglu, Mustafa Kursat Sahin, Milena Cojic, Miloranka Petrov Kiurski, Iliana-Carmen Busneag, Liljana Ramasaco, Zaim Jatic, Vanja Lazic, Lyubomir Kirov, Hristo Dimitrov, Monika Brovč, Fatbardha Skenderi, Manon Richter, Mustafa Fevzi Dikici, Daniel Atijas, Erjona Abazaj, Milena Kostic, Ljubin Sukriev

Keywords: mental health, general practice, family medicine, COVID-19

Background:

The mental health of physicians is greatly affected by work-related stress. This is significantly increased during pandemics due to poor coping and maladjustment. Currently, information on the mental health status of general practitioners (GPs) and family medicine specialists (FMSs) in Europe is missing. Part of achieving a global recovery from the COVID-19 pandemic is providing adequate attention and care to the mental health of GPs and FMSs as the pillars of primary healthcare.

Research questions:

What are the levels of anxiety, depression and fear of COVID-19 among GPs and FMSs in Europe, two years after the start of the COVID-19 pandemic, and what factors might influence them?

Method:

Thirteen countries participated in an online survey that included questions concerning the professional and personal experience of GPs and FMSs during the COVID-19 pandemic, as well as different scales for assessing mental health: PHQ-9, GAD-7 and Fear of COVID-19 scale. Descriptive statistics, linear regression and thematic analysis with inductive coding were used to analyse the data.

Results:

1724 respondents participated. More than 3/4 were female, the average age was 47±12.01 years and >70%, worked in an urban area. On average, respondents reported mild depression (6 on the PHQ-9), mild anxiety (5 on the GAD-7), and a mean score of 12.85±5.29 on the FCV-19 scale. Having had to close their practice during the pandemic had the biggest effect on increasing depression, whereas falling within an at-risk category for COVID-19 had the biggest effect on increased anxiety and fear. The most used coping mechanism was reaching out to friends and family. However, one in ten did nothing to cope with their stress or sadness.

Conclusions:

COVID-19 created specific significant stressors that negatively impact the mental health of GPs and FMSs two years after the start of the pandemic. Adapted interventions to support coping with mental health problems are needed.

Points for discussion:

How can we use the results of this research to help in creating better mental health support systems for physicians during pandemic outbreaks?

How can we reduce the negative impact and long-term effects of the COVID-19 pandemic on the mental health of GPs and FMSs?

How can we increase interest and improve response rates of GPs and FMSs in future research regarding mental health?