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Psychological impact of COVID-19 pandemic on postgraduate trainees: a cross-sectional survey
  1. Nazish Imran1,
  2. Hafiz Muhammad Umar Masood2,
  3. Maryam Ayub3,
  4. Khalid Masood Gondal4
  1. 1 Child & Family Psychiatry Department, King Edward Medical University, Lahore, Pakistan
  2. 2 Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan
  3. 3 Academic Department of Psychiatry &behavioural Sciences, King Edward Medical University, Lahore, Pakistan
  4. 4 King Edward Medical University, Lahore, Pakistan
  1. Correspondence to Nazish Imran, Child & Family Psychiatry Department, King Edward Medical University, Lahore 54000, Pakistan; nazishimrandr{at}


Background The present study aimed to evaluate psychological impact of COVID-19 outbreak on postgraduate trainees in Pakistan by quantifying the symptoms of depression, anxiety and acute stress disorder and by analysing potential risk factors associated with these symptoms.

Methods Following Institutional Review Board approval, a cross-sectional study was conducted among 10,178 postgraduate trainees following COVID-19 outbreak through e-log system of College of Physicians and Surgeons of Pakistan. The nine-item Patient Health Questionnaire, seven-item Generalised Anxiety Disorder scale and Stanford Acute Stress Reaction Questionnaire were used to collect data. Statistical analyses were conducted using SPSS.26. Descriptive statistics, Mann-Whitney U test, the χ2 test and logistic regression analysis were performed. The significance level was set at α=0.05.

Results The prevalence of depressive symptoms, generalised anxiety disorder and acute stress disorder were 26.4%, 22.6% and 4.4%, respectively. Female postgraduate trainees, senior trainees and front-line workers reported experiencing more anxiety, depression and acute stress symptoms (p value<0.001). Logistic regression showed that being a front-line and senior staff member and female was associated with higher risk of experiencing symptoms of depression, anxiety and acute stress.

Conclusions Our study findings raise concerns about the psychological well-being of postgraduate trainees during the acute COVID-19 outbreak in Pakistan. It is necessary to employ strategies to minimise the psychological distress and provide adequate psychosocial support for postgraduate trainees during crisis situation such as COVID-19 pandemic.

  • Psychiatry
  • depression & mood disorders
  • adult psychiatry
  • education & training (see medical education & training)
  • infectious diseases
  • medical education & training

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  • Contributors NI and KMG conceived the idea of this study. NI, HMUM and MA did literature review. NI, HMUM and KMG collected and analysed data. NI and MA prepared tables and wrote the first draft of manuscript. HMUM and KMG helped with writing-reviewing and editing. KMG was responsible for the supervision of this project. All authors approved the final version of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approved by Institutional Review Board and permission obtained from CPSP.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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