Prevalence of PTSD, other mental disorders higher with screening tools than interviews

Among health care workers in England, prevalence estimates of PTSD and common mental disorders were markedly lower when assessed using diagnostic interviews compared with screening tools, per a study published in Lancet Psychiatry.

“Numerous studies estimating the prevalence of mental disorders among health care workers have been conducted since the start of the COVID-19 pandemic,” Hannah R. Scott, PhD, of the department of psychological medicine, Kings College London, and colleagues wrote. “[PTSD] was less commonly assessed, with prevalence estimates between 7% and 37%.”

Scott and fellow researchers sought to estimate prevalence of common mental disorders and PTSD among health care workers in England through diagnostic interviews.

They employed a two-phase, cross-sectional study comprised of diagnostic interviews within a larger multisite longitudinal cohort of health care workers (n = 23,462) during the COVID-19 pandemic.

In the initial phase, participants were recruited from 18 NHS England Trusts, with baseline assessments made through online surveys between April 24, 2020, and Jan. 15, 2021. In the second phase, researchers selected a proportion of participants who had responded to surveys and conducted diagnostic interviews between March and August 2021 to establish the prevalence of mental disorders.

All participants were screened with the 12-item General Health Questionnaire (GHQ-12) and assessed with the Clinical Interview Schedule-Revised (CIS-R) for common mental disorders or were screened with the six-item Post-Traumatic Stress Disorder Checklist (PCL-6) and assessed with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD.

A total of 2,079 participants were excluded due to missing values on the GHQ-12 and 11,147 participants were excluded due to missing values on the PCL-6. A total of 243 individuals participated in diagnostic interviews for common mental disorders (CIS-R; mean age 42 years, 76% women) and 94 individuals participated in diagnostic interviews for PTSD (CAPS-5; mean age 44 years, 84% women). GHQ-12 screening caseness for common mental disorders was 52.8% (95% CI, 51.7–53.8).

Using CIS-R diagnostic interviews, researchers further discovered that estimated population prevalence of generalized anxiety disorder was 14.3% (95% CI, 10.4–19.2), population prevalence of depression was 13.7% (95% CI, 10.1–18.3), and combined population prevalence of generalized anxiety disorder and depression was 21.5% (95% CI, 16.9–26.8).

PCL-6 screening caseness for PTSD was 25.4% (95% CI, 24.3–26.5). Using CAPS-5 diagnostic interviews, the estimated population prevalence of PTSD was 7.9% (95% CI, 4.0–15.1).

“Further longitudinal research should be carried out to ascertain whether estimates of common mental disorders and PTSD among health care workers exist before they start their role, are sustained during employment or decrease over time,” Scott and colleagues wrote.