Most Accurate Prevalence of PTSD and Common Mental Disorders in Healthcare Workers in England: A Two-Phase Epidemiological Survey

Previous studies on impact of the COVID-19 pandemic on healthcare workers’ (HCWs) mental health relied on self-reported screening measures to estimate point prevalence. Screening measures, designed to be sensitive, have low positive predictive value and often overestimate prevalence. We present a more accurate prevalence of common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) among HCWs in England using diagnostic interviews. A two-stage, cross-sectional study comprising diagnostic interviews (n=337) within a larger multi-site longitudinal cohort of HCWs (n=23,462) was conducted during the COVID-19 pandemic. This included two representative participant groups: i) 243 participants completed the General Health Questionnaire (GHQ-12) and the Clinical Interview Schedule – Revised (CIS-R) to assess CMDs; ii) 94 participants completed the PCL-6 and the Clinician Administered PTSD Scale (CAPS-5) for DSM-5 – to assess PTSD. The GHQ screening caseness for any CMD was 52·8% (95% CI 51.7 to 53.8). Using the CIS-R diagnostic interviews, the estimated population prevalence of generalised anxiety disorder was 14.3% (95% CI 10.4 to 19.2) and for depression 13.7% (95% CI 10.1 to 18.3). The PCL-6 screening caseness for PTSD was 25·4% (95% CI 24.3 to 26.5). Using the CAPS-5 diagnostic interviews, estimated population prevalence of PTSD was estimated at 7·9% (95% CI: 4.0 to 15.1). Implications for clinical practice, policy and future research will be discussed. Prevalence estimates of CMDs in HCWs are considerably lower when estimated using diagnostic interviews than through screening tools. Nevertheless, 1-in-7 HCWs met the threshold for a clinically diagnosable mental disorder who might benefit from intervention.