Prevalence and predictors of mental health outcomes in UK doctors and final year medical students during the COVID-19 pandemic
Open accessAbstract
BACKGROUND: The mental health of doctors is an ongoing concern, both prior to and during the COVID-19 pandemic. This study aimed to: i) assess the prevalence of symptoms of depression, anxiety, PTSD, and burnout in UK doctors and final year medical students during the pandemic, and ii) analyse the hypothesised relationships between psychological flexibility, intolerance of uncertainty and resilience with these mental health outcomes. METHODS: A cross-sectional online study of UK-based doctors and final year medical students was conducted between 27/09/2020 and 31/01/2021. Outcomes were measured using the PHQ9, GAD7, PCL-5, and aMBI. Independent variables included the CompACT-SF, IUS-12, and CD-RISC-10. Descriptive statistics, between-group analyses, and multiple regression were performed. RESULTS: Prevalence of anxiety symptoms was 26.3%, depression 21.9%, PTSD 11.8%, and burnout 10.8%. Psychological flexibility negatively predicted all outcomes, apart from low personal achievement. Intolerance of uncertainty positively predicted anxiety and PTSD scores. Resilience negatively predicted scores on burnout subscales. LIMITATIONS: Cross-sectional design and non-probability sampling method means that assumptions about causality cannot be made and may have implications for bias and generalisability of results. CONCLUSION: Doctors and medical students in the UK reported high levels of mental health symptoms during the pandemic, between September 2020 and January 2021. All three independent variables explained significant variance in mental health outcomes. Psychological flexibility was the most consistent predictor, over and above sociodemographic variables and other psychological predictors. These findings have implications for interventions to improve retention of our essential medical workforce, and for providing support at future times of national crisis.
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Recent research has identified a negative correlation between psychological flexibility and depression, anxiety, burnout, and post-traumatic stress disorder.
“Recent research has identified a negative correlation between psychological flexibility and depression, anxiety, burnout, and post-traumatic stress disorder [81]”
From Enhanced Stress-Resilience Training (ESRT) for graduate-entry medical students: a randomised-controlled, mixed-method investigation (2025) · cites this paper as [81]
Higher psychological flexibility predicts lower burnout among medical students and physicians during the pandemic.
“Conversely, higher psychological flexibility was recently found to predict lower burnout among medical students and physicians during the pandemic [58].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [58]
Low psychological flexibility is associated with burnout risk among medical students, physicians, and resident physicians.
“Low psychological flexibility is associated with burnout risk among medical students, physicians [58], and resident physicians [59].”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [58]
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- Authors
- Johns, G., Waddington, L., & Samuel, V.
- Affiliations
- Cardiff University (GB)
- Corresponding author
- Johns, G.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 311
- Pages
- 267-275
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC9098653
- OpenAlex
- W4280502708
- Cited by
- 25
- References
- 60
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 6 · 2023: 7
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Funders
- Public Health Wales NHS Trust
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- physician mental health, medical students, COVID-19 pandemic, depression, anxiety, post-traumatic stress disorder, burnout, psychological flexibility, intolerance of uncertainty, resilience, medical workforce retention
- MeSH terms
- COVID-19, SARS-CoV-2, Anxiety, Burnout, Professional, Cross-Sectional Studies, Depression, United Kingdom, Humans, Students, Medical, Prevalence, Outcome Assessment, Health Care, Pandemics
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