Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic

Abstract

Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.

Keywords: Physician; Depression; Anxiety; Insomnia; Healthcare-seeking behavior; Undertreatment

Core Tip: Physicians are experiencing unprecedented stress and distress. They face major risks of distress and burnout, which can subsequently cause stress-related psychiatric disorders, such as insomnia, anxiety, and depression. Nevertheless, many of these vulnerable healthcare professionals do not seek medical help. There is a clear need for further research to evaluate the determinants of underrecognition and un-dertreatment of stress-related psychiatric disorders, how to enhance early detection and management of these mental health problems, and how to eliminate obstacles to the use of mental health services in this population.