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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2023; 13(4): 131-140
Published online Apr 19, 2023. doi: 10.5498/wjp.v13.i4.131
Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic
Charles Lung-Cheng Huang
Charles Lung-Cheng Huang, Department of Psychiatry, Chi Mei Medical Center, Tainan 710, Taiwan
Charles Lung-Cheng Huang, Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Author contributions: Huang CLC designed the research study, performed the research, wrote the manuscript, and approve the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Charles Lung-Cheng Huang, MD, PhD, Associate Professor, Chief Physician, Department of Psychiatry, Chi Mei Medical Center, No. 901 Zhonghua Road, Yongkang Dist, Tainan 710, Taiwan. da002p1@mail.chimei.org.tw
Received: December 18, 2022
Peer-review started: December 18, 2022
First decision: February 20, 2023
Revised: March 12, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: April 19, 2023
Processing time: 121 Days and 1.5 Hours
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.