FREQUENCY AND DETERMINANTS OF DEPRESSION, ANXIETY, AND STRESS AMONG ANESTHESIOLOGISTS WORKING IN GOVERNMENT HEALTH CENTERS OF KARACHI

Abstract

Background: Anesthesiology is widely recognized as one of the most psychologically demanding specialties in modern medicine. The nature of anesthetic practice — requiring sustained vigilance, rapid life-or-death decision-making, and extended working hours — creates a chronic occupational stress environment that predisposes practitioners to clinically significant psychological disorders. Depression, anxiety, and stress impair cognitive function, decision-making capacity, and interpersonal performance, all of which are directly relevant to patient safety. Despite a growing body of international evidence on physician burnout and psychological distress, published data from Pakistan — particularly concerning anesthesiologists working in resource-constrained government hospitals — remains sparse.

Objective: To determine the frequency of depression, anxiety, and stress among anesthesiologists working in government health centers of Karachi, and to identify the associated demographic and occupational determinants.

Methods: This cross-sectional descriptive study was conducted at four major government tertiary care hospitals in Karachi (Civil Hospital, JPMC, Abbasi Shaheed Hospital, and NICVD) from October 2022 to April 2023. A total of 121 anesthesiologists were enrolled using consecutive non-probability sampling. Psychological assessment was performed using the validated Depression Anxiety Stress Scale-21 (DASS-21). Normality of data was confirmed by the Shapiro-Wilk test. Frequencies and percentages were computed for categorical variables; means ± standard deviations for continuous variables. Post-stratification chi-square testing was applied with statistical significance set at p ≤ 0.05.

Results: The mean age was 38.9 ± 12.1 years; 56.2% were female and 43.8% were male. Depression was identified in 28.1%, anxiety in 53.7%, and stress in 36.4% of participants. Mean weekly working hours were 65.6 ± 9.8, with an average of 14.3 ± 2.2 calls per month and 19.7 ± 1.9 cases per week. Younger anesthesiologists (age 25–40 years) demonstrated significantly higher rates of depression (p = 0.001). Anxiety was significantly associated with marital status (p = 0.002), job title (p < 0.0001), and smoking status (p = 0.001). Job title was also a significant predictor of depression (p < 0.0001).

Conclusion: A substantial burden of psychological distress exists among anesthesiologists in Karachi's government hospitals. Anxiety is the most prevalent condition. Age, job title, marital status, and smoking status are significant determinants. Targeted institutional mental health programs and workload regulation are urgently needed.