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The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis

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Lee, Brian En Chyi, Ling, Mathew, Boyd, Leanne, Olsson, Craig, Sheen, Jade·2023·Journal of Affective Disorders

DOI 10.1016/j.jad.2023.03.012PMC PMC10017178

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Abstract

OBJECTIVES: The mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19. METHODS: We searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17th February 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95 % prediction intervals. RESULTS: The meta-analysis included 401 studies, representing 458,754 participants across 58 countries. Pooled prevalence of depression was 28.5 % (95 % CI: 26.3-30.7), anxiety was 28.7 % (95 % CI: 26.5-31.0), PTSD was 25.5 % (95 % CI: 22.5-28.5), alcohol and substance use disorder was 25.3 % (95 % CI: 13.3-39.6) and insomnia was 24.4 % (95 % CI: 19.4-29.9). Prevalence rates were stratified by physicians, nurses, allied health, support staff and healthcare students, which varied considerably. There were significantly higher odds of probable mental health disorders in women, those working in high-risk units and those providing direct care. LIMITATIONS: Majority of studies used self-report measures which reflected probable mental health disorders rather than actual diagnosis. CONCLUSIONS: These updated findings have enhanced our understanding of at-risk groups working in hospitals. Targeted support and research towards these differences in mental health risks are recommended to mitigate any long-term consequences.

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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
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“The variability in prevalence estimates that was due to heterogeneity was assessed using standard χ2 to test for significant heterogeneity and I2 to determine low (<25 %), moderate (25 %–50 %), and high (>75 %) heterogeneity among studies (Higgins et al., 2003).”
Method
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Method
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Hua-chun, X., Qiu, L., Chen, Y., Zhang, M., Li, J., & Xiang, G. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1458167 · Cited by 3
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García-Vázquez, B., Muñoz‐Sanjosé, A., Fernández-López, A., Pérez-de-Ciriza, I., Nocete-Navarro, L., Almaraz-Garzón, E., Martín-Palacios, M. T., Novella, B., Bravo‐Ortiz, M. F., Ayuso‐Mateos, J. L., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1600059 · Cited by 4
A systematic review and meta-analysis of depressive symptoms and work-ralated psychoacial factors among healthcare workers
Habtu, Y., Kumie, A., Selamu, M., Hasen, H., Kusheta, S., Demelash, R., & Girma, E. (2026) · Discover Mental Health · doi:10.1007/s44192-026-00416-5 · Cited by 2
“The pooled prevalence in our review is higher than other meta-analyses [66] conducted on HCWs during the COVID-19 pandemic, but lower than the meta-analyses’ findings [67] involving studies from all over the world, and studies involving low-income countries [68].”
Work Characteristics, Workplace Support, and Mental Ill-Health in a Canadian Cohort of Healthcare Workers During the COVID-19 Pandemic
Cherry, N., Adisesh, A., Burstyn, I., Durand-Moreau, Q. V., Galarneau, J.-M. F., Labrèche, F., Ruzycki, S. M., & Zadunayski, T. (2024) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000003074 · Cited by 2
“There is little doubt that HCWs ’ mental health was impacted by work during the pandemic 15,16 and we have previously shown, using administrative health records, that HCWs in this cohort had an elevated risk of mental ill-health throughout the pandemic.”
Result
Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score
Júnior, C. J. D. S., Antunes, J. L. F., & Fischer, F. M. (2024) · Revista Brasileira de Saúde Ocupacional · doi:10.1590/2317-6369/09923pt2024v49e11 · Cited by 2
The effect of a collective competence intervention on collective efficacy, psychological wellbeing, and social wellbeing: a quasi-experimental study of a sample of healthcare workers during the COVID-19 crisis
Campos, M. L., Escorza, P. B., & Bascur, A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1369251 · Cited by 4
Mental health and well-being of healthcare workers in Central Asia
Seisembekov, T. Z., Bolatov, A., Brimkulov, N. N., Jarylkasynova, G., Taalaikanova, A., Yuldashova, R., Саломовна, К. Ш., & Smailova, D. S. (2024) · F1000Research · doi:10.12688/f1000research.153832.1 · Cited by 3
Predictors of dropout in cognitive behavior and interpersonal online brief psychotherapies for essential professionals during the COVID-19 pandemic
Martins, D. S., Bermúdez, M. B., Costa, M. D. A., Fleck, M. P., Salum, G. A., Dreher, C. B., & Manfro, G. G. (2024) · Scientific Reports · doi:10.1038/s41598-024-81327-9 · Cited by 3
Ability and utility of the Physician Well-Being Index to identify distress among Chinese physicians
Li, Z., Pu, P., Wu, M., Wang, X., Xu, H., Zhang, X., Deng, Q., Yang, W. F. Z., Liu, Y., Wang, Q., et al. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2476042 · Cited by 2
“Consistent with the prevalence of psychological distress reported in other countries [17–19], approximately one-third of Chinese physicians exhibit symptoms of depression and anxiety [10], with over half suffering from burnout [1].”
The burden of insomnia among public health sector nurses in KwaZulu-Natal, South Africa
Ntaba, P. P., Mashaphu, S., & Narsi, K. (2025) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v31i0.2433 · Cited by 2
Mental Health Consequences of the COVID‐19 Outbreak Among Emergency Department Healthcare Workers
Douplat, M., Subtil, F., Termoz, A., Jacquin, L., Verbois, F., Potinet, V., Hernu, R., Landel, V., Mazza, S., Berthiller, J., et al. (2024) · BioMed Research International · doi:10.1155/2024/8871959 · Cited by 3
“The mental health impacts of the COVID-19 pandemic had been studied worldwide demonstrating a strong impact for healthcare workers [8, 9].”
BackgroundInfluential
Alkoholkonsum und psychische Belastung im zweiten Lockdown der COVID-19-Pandemie bei medizinischem Personal und Personen aus anderen Bereichen
Georgiadou, E., Müller, A., Koopmann, A., Kiefer, F., & Hillemacher, T. (2023) · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · doi:10.1024/0939-5911/a000843 · Cited by 1
Salud mental de los trabajadores de la salud durante la pandemia por COVID-19: una revisión de revisiones
Osorio, L. M. C., Arango, L. M. L., Babativa, M. T. D., & Bernal, L. Á. R. (2024) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2024.04.006 · Cited by 1
Changes in Daily life due to the COVID-19 Pandemic and Mental Health Status in Korean Adolescents
Kang, T.-S., Kim, S., Kim, E., Kim, J., Yoon, J., Lee, D., Lee, J., & Han, M. A. (2024) · Psychiatric Quarterly · doi:10.1007/s11126-024-10084-9 · Cited by 1
What Mattered Most: Personal, Work-Related, and Psychopathological Characteristics Associated with Healthcare Workers’ Impairment of Functioning during COVID-19
Gesi, C., Cafaro, R., Cerioli, M., Achilli, F., Boscacci, M., Cirnigliaro, G., & Dell’Osso, B. M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13195821 · Cited by 1
“According to the most recent meta-analysis in the literature [14], which included 401 studies up to February 2022, the pooled prevalence of depression was 28.5%, while anxiety had a prevalence of 28.7%, followed by alcohol and substance use disorder (25.3%), and insomnia (24.4%).”
MethodResultInfluential
Non-Physician Healthcare Workers During COVID-19 Pandemic and Association Between Work-Related Factors, Perceived Stress, Depressive Symptoms, and Fatigue
Mahony, W. L., Ostovar-Kermani, T. G., González, S., Zoorob, R., Rupp, R. E., & Hirth, J. M. (2024) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2024.131 · Cited by 2
Prevalence and Factors Associated with Common Mental Disorders and Posttraumatic Stress Disorder Among Healthcare Workers in a Reference Center for Infectious Diseases During the COVID-19 Pandemic: A Survey-Based Cross-Sectional Study
Guimarães, P., de Oliveira, R. D. V. C., Amud, R., Bezerra, M. E., Rigolon, P. S., Milhomem, E., Lessa, J. L. M., Calvet, G. A., & Passos, S. R. L. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22020271 · Cited by 1
“Studies have indicated that young female HCWs are more prone to developing mental disorders [34,35].”
Influential
Pandemic Concerns, Occupational Stressors, Burnout, and Psychological Distress Among U.S. Air Force Remotely Piloted Aircraft Personnel: A Multidimensional Mediation Model
Tett, R. P., Devlin, N., Galloway, K., Rigby, E., Ounpraseuth, S., & Martínez, R. N. (2025) · Stress and Health · doi:10.1002/smi.70027 · Cited by 1
Emotional distress during the first year of the COVID-19 pandemic-large sample serbian study
Dunjić-Kostić, B., Mitković-Vončina, M., Jović, J., Erić, E., Gostiljac, M., Jerotić, S., Lalović, N., Latas, M. B., & Pantović-Stefanović, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-96452-2 · Cited by 1
“Mental health burden and overall functioning among HCPcontinues to attract attention 10,29 .”
Chain mediating effect of fatigue, anxiety symptoms on the relationship between perceived stress and insomnia in Chinese researchers
Wang, L., Zhou, S., Gao, L., Qi, M., Li, H., Li, J., Tan, Y., & Chen, J. (2025) · BMC Public Health · doi:10.1186/s12889-025-24800-y · Cited by 1
“Previous studies have found that the incidence of insomnia symptoms among college students is 31.4%, which is higher than that of the general population [50, 51].”
Influential
Predicting burnout, anxiety and depression among Canadian healthcare professionals during the COVID-19 pandemic: a cross-sectional secondary analysis study
Balakrishnar, K., Long, B.-Z. S., Premji, R., Choi, C., Sathananthan, A., Choppella, M., Mazur, M., & Nowrouzi‐Kia, B. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-104892 · Cited by 1
Anxiety-depression symptom networks across emotion regulation profiles in Chinese nurses: a latent profile and network analysis
Lin, P., Wang, X., Lin, Y., Lin, Y., Chen, L., & Wu, B. (2026) · BMC Nursing · doi:10.1186/s12912-026-04903-6 · Cited by 1
“A comprehensive meta-analysis encompassing 401 studies and 458,754 participants from 58 countries established the pooled prevalence of anxiety and depression among nurses at 31.5% and 28.0%, respectively [8].”
Influential
Diagnóstico situacional por COVID-19 e impacto en la salud de los médicos del Antiguo Hospital Civil de Guadalajara (AHCGFAA)
Barrios, Z. M. V., León-Garnica, G., Uribe, M. C. M., García‐Benavides, L., Reyes, G. Y., Flores-Tinajero, M. Á., Villa-Villagrana, F., Rodríguez-Méndez, L. M., Hernández-Mora, F. J., & Delgado-Franco, B. (2023) · Salud Jalisco · doi:10.35366/111180 · Cited by 1
Fluctuations of stress and resilience in healthcare workers during the COVID-19 pandemic: Insights and recommendations
de Bles, N. J., Giltay, E. J., Boeschoten, M. A., van der Wee, N. J. A., Janssen, V. R., van Hemert, A. M., Vermetten, E. H. G. J. M., & Ottenheim, N. R. (2024) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2024.100767 · Cited by 1
Staff Opinions on the Most Positive and Negative Changes in Mental Health Services During the 2 Years of the Pandemic Emergency in Italy
Magliano, L., Papa, C., Maio, G., & Bonavigo, T. (2024) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-024-00406-2 · Cited by 1
“As reported by other authors (Bommersbach et al., 2021; Lee et al., 2023), staff have reported increased stress due to intensified work-loads and a greater burden of responsibilities, as well as a perceived lack of support from managers.”
Comparison of the Psychological Impact of COVID-19 on Healthcare Workers between 2022 and 2023 in a Romanian COVID-19 Hub Hospital
Muntean, M. I., Colcear, D., Briciu, V. T., Lupșe, M. S., Crișan, C. A., Sidea, M., & Rădulescu, A. L. (2024) · COVID · doi:10.3390/covid4070074 · Cited by 1
Comparison of psychopathology, purpose in life and moral courage between nursing home and hospital healthcare workers during the COVID-19 pandemic
Echeverria, I., Bonet, L., Benito, A., López, J., Almodóvar-Fernández, I., Peraire, M., & Haro, G. (2024) · Scientific Reports · doi:10.1038/s41598-024-68983-7 · Cited by 1
One Year After Mild COVID-19: Emotional Distress but Preserved Cognition in Healthcare Workers
Peláez, I., Martínez‐Íñigo, D., Fernandes-Magalhaes, R., Lahoz, M. E. D., del Pino, A. B., Pérez-Aranda, S., García-Romero, A., Soldic, D., & Mercado, F. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14176007 · Cited by 1
Comparing the Effects of Existential Therapy and Acceptance and Commitment Therapy on the Death Anxiety of Nurses in the Corona Wards
Aghaee, V., Kazemi, R., Taklavi, S., & Nazari, V. (2025) · Qom Univ Med Sci · doi:10.32598/qums.19.3027.1
WER HILFT DEN HELFERINNEN: GESUNDHEITS – UND PFLEGEPERSONAL IN DER PANDEMIE WHO HELPS THE HELPERS: HEALTH AND CARE PERSONNEL IN THE PANDEMIC
Institut für Psychologie, U. I., Kreh, A., Juen, B. H., Institut für Psychologie, U. I., Riedel, P.-L., Institut für Psychologie, U. I., Kulcar, V., & Institut für Psychologie, U. I. (2023) · Psychiatria Danubina · doi:10.24869/psyd.2023.628
Spirituality and anxiety in pastoral care workers and physicians in the first wave of the COVID-19 pandemic
Culmann, A. C., Baranowski, A., Matthias, J.-K., Tüttenberg, S. C., Belschner, W., Erim, Y., Morawa, E., Beschoner, P., Jerg‐Bretzke, L., Albus, C., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1354044 · Cited by 1
Posttraumatic Stress, Loneliness, and Perceived Pandemic Consequences in a Military Intelligence CommunityPreprint
Tett, R. P., Goodman, T. M., Devlin, N., Rigby, E., & Martínez, R. N. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4768560
Estresse ocupacional: vivência de enfermeiros intensivistas que atuaram na pandemia de COVID-19
Severino, K. C. F. (2023) · doi:10.31744/pg2023.109489
Acupuntura e acutone para redução de estresse em profissionais de enfermagem: ensaio clínico randomizado piloto
da Silva, V. A., & Turrini, R. N. T. (2024) · Caderno Pedagógico · doi:10.54033/cadpedv21n7-204
The Role of Personality Traits, Cognitive Performances, and Perceived Social Support on Job Satisfaction Among Individuals with Chronic Psychiatric Disorders
Azizi, S., & Bagheri, M. (2024) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-144246
Assessing the Psychological Well-being of Healthcare Workers During the COVID-19 Pandemic
Bermagambetova, S., Shayakhmetova, K. N., Karashova, G., Сакебаева, Л. Д., Rabayeva, F. A., Satybaldieva, U., Zinalieva, A., & Mamyrbayev, А. (2024) · Медицинский журнал Западного Казахстана · doi:10.18502/wkmj.v66i3.16087
“Another meta-analysis [24], incorporating 401 studies with 458,754 participants from 58 countries, revealed depression prevalence at 28.5%, anxiety at 28.7%, post-traumatic stress disorder at 25.5%, and insomnia at 24.4%.”
MethodInfluential
Child and Adolescent Mental Health in a Period of Fewer COVID-19-Related Restrictions in an Urban Population in Germany
Konopka, A., Führer, A., Binder, M., Diexer, S., Frese, T., Gekle, M., Girndt, M., Gottschick, C., Hoell, J. I., Klee, B., et al. (2024) · Psychiatry International · doi:10.3390/psychiatryint5040050
Investigating the Effectiveness of the Health-promoting Lifestyle Educational Program on Suicidal Thoughts in Healthcare Workers
Abiri, E., Raesi, R., & Kashani, M. H. G. (2024) · The Open Public Health Journal · doi:10.2174/0118749445356241241111092936
Knowledge of COVID-19 and the psychological status of parents: a retrospective survey in Wuhan, Hubei
Wang, L., Gan, H., Zhang, Y., Xiong, C., Wang, G., Mei, C., Chen, L., Xu, Y., He, L., Lv, L., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2023-083653
Acute stress exposure in healthy oil and gas field workers and early post-traumatic stress disorder symptoms: A lesson from the COVID-19 crisis
Fitriani, D. Y., Mansyur, M., Raharjanti, N. W., Adi, N. P., Isbayuputra, M., Ramadianto, A. S., Nugrahadi, N. R., Yo, E. C., Pujo, J. M., & Kallel, H. (2025) · Australasian Psychiatry · doi:10.1177/10398562251320529
Burnout and Depression Among UK-Based Healthcare Professionals
Collett, G., Kotecha, A., & Gupta, A. K. (2025) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000003364
Acupuntura auricular para fadiga de compaixão em profissionais de enfermagem: protocolo de ensaio clínico randomizado
Maia, M. C. W., Kogien, M., Santos, V. H. M., Leite, V. F., & Bittencourt, M. N. (2025) · Revista gaúcha de enfermagem · doi:10.1590/1983-1447.2025.20240063.pt
Auricular acupuncture for compassion fatigue in nursing professionals: a randomized clinical trial protocol
Maia, M. C. W., Kogien, M., Santos, V. H. M., Leite, V. F., & Bittencourt, M. N. (2025) · Revista gaúcha de enfermagem · doi:10.1590/1983-1447.2025.20240063.en
The Role of Leisure Activities in Mitigating Mental Health Disorders Among Healthcare Workers During the (COVID)-19 Pandemic in Taiwan
Chang, P.-Y., Li, C.-Y., Kuo, C.-W., Chang, Y.-K., & Lin, C.-F. (2025) · American Journal of Health Behavior · doi:10.5993/ajhb.49.2.6
Effects of a combined nature-based and audio-based virtual mindfulness intervention on stress and wellbeing of COVID-19 healthcare workers: a randomized controlled trial
Bagereka, P., Ameli, R., Sinaii, N., Vocci, M. C., Coulter, A. M., Neustedter, M., & Berger, A. M. (2025) · PeerJ · doi:10.7717/peerj.19109
Factors influencing the implementation of interventions for symptoms of posttraumatic stress disorder among hospital-based nurses and physicians during the COVID-19 pandemic: a scoping review
Katzmarzyk, D., Holle, D., & Roes, M. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13005-z
“…the inclusion criteria; [3] planning the systematic literature searches and selection approach; [4] conducting the systematic literature search; [5] performing the evidence screening and selection; [6] conducting the data extraction; [7] performing the data analysis; and [8] presenting the results.”
Psychological Burden of the COVID-19 Pandemic on Healthcare Workers: A Comparative Study Across Sectors and Clinical Roles
Subramanian, J. V., Venkatakrishnan, R. T., Cattamanchi, S., Kumar, K., Pugazhendhi, S., & Dharuman, K. K. (2025) · Cureus · doi:10.7759/cureus.91426
“The psychological impact of these frontline professionals extends beyond immediate stress and anxiety associated with crisis management [1].”
Stress management strategies and controlling emotion among Polish nurses and midwives who suffer COVID: cross-sectional study
Zych, B., Kremska, A., Lewandowska, A., & Nagórska, M. (2025) · PeerJ · doi:10.7717/peerj.19816
Implementing PTSD interventions for hospital nurses and physicians during COVID-19: A scoping review
Katzmarzyk, D., Holle, D., & Roes, M. (2025) · Archives of Public Health · doi:10.1186/s13690-025-01706-0 · Cited by 1
Effects of a smartphone-based stress management program on work performance, sick leave, and intention to leave among nurses during COVID-19 in Vietnam and Thailand: an analysis of secondary outcomes of a randomized controlled trial
Sakuraya, A., Tran, T. T. T., Sripo, N., Watanabe, K., Imamura, K., Boonyamalik, P., Sasaki, N., Tienthong, T., Asaoka, H., Iida, M., et al. (2025) · Journal of Occupational Health · doi:10.1093/joccuh/uiaf061
Additional file 1 of Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study
Skaffari, E., Iirola, T., & Nordquist, H. (2024) · Figshare · doi:10.6084/m9.figshare.26692696

Authors: Lee, B. E. C., Ling, M., Boyd, L., Olsson, C., & Sheen, J.
Affiliations: Deakin University (AU)
Eastern Health (AU)
Corresponding author: Lee, Brian En Chyi
ORCID: Lee, Brian En Chyi
Ling, Mathew
Boyd, Leanne
Olsson, Craig
Sheen, Jade
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2023-06
Volume: 330
Pages: 329-345
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2023.03.012
PMC: PMC10017178
OpenAlex: W4324335442
Cited by: 120
References: 124
Citations by year: 2026: 17 · 2025: 34 · 2024: 55 · 2023: 14
FWCI: 6.09
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Journal of Affective Disorders (publishedVersion, cc-by)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: State Government of Victoria
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 › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: COVID-19 pandemic, mental illness, depression, anxiety, post-traumatic stress disorder, alcohol and substance use disorders, insomnia, prevalence, nurses, physicians, health professions students, workplace mental health, sex differences, direct care workers
MeSH terms: COVID-19, Delivery of Health Care, Depression, Female, Health Personnel, Hospitals, Humans, Mental Health, Prevalence, Pandemics

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The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis

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