Impact of Covid-19 on the mental health of singaporean GPs: a cross-sectional study

Background Covid-19 has stressed healthcare systems and workers worldwide. General practitioners (GPs), as first points-of-contact between suspected cases and the healthcare system, assume frontline roles in this crisis. While the prevalence of mental health problems and illnesses arising in healthcare workers (HCWs) from tertiary care settings during Covid-19 is well-examined,(1) the impact on GPs remains understudied.

Aim To describe the prevalence and predictors of anxiety, burnout, depression, and post-traumatic stress disorder (PTSD) amongst GPs during the Covid-19 pandemic

Design & setting Survey of GPs operating in Singapore primary care clinics

Method GPs completed a survey which comprised of four validated psychometric instruments. Open-ended questions asked of respondents’ challenges and their envisaged support. Data were analysed with multiple logistic regression with demographic data as covariates; concepts of grounded theory were used to analyse the qualitative responses.

Results 257 GPs participated. 55 (21.4%) met the scales’ criteria for anxiety, 211 (82.1%) for burnout, 68 for (26.6%) for depression, and 23 (9.1%) for PTSD. Multivariate regression analysis showed working in a public primary care setting was associated with anxiety and depression. Qualitative analyses uncovered possible stressors: changes to clinical and operational practices, increased workloads, and financial difficulties.

Conclusion Mental health issues were found present in Singaporean GPs during the pandemic. Prevalence of anxiety, burnout and depression were found to be higher than those reported pre-Covid-19. Our findings also provide determinants of the issues which serve as possible foci for targeted interventions.