Prevalence and Predictors of Stress, Anxiety, and Depression among Physicians in Two Selected Hospitals in Accra, Ghana

Abstract

Although work-related stress, anxiety, and depression are well-established globally, the mental well-being of healthcare professionals is often underprioritised in Sub-Saharan Africa. These conditions can impair communication, reduce productivity, increase absenteeism, and compromise the quality and safety of patient care. Little is known about the prevalence and determinants of stress, anxiety, and depression among physicians at two major referral hospitals in Accra: Korle Bu Teaching Hospital (KBTH) and Greater Accra Regional Hospital (GARH). A cross-sectional study involving 394 physicians — 334 (85%) general physicians and 60 (15%) specialists — was conducted from June to August 2023 at KBTH and GARH, the two largest hospitals in the Greater Accra Region, selected because of their status as the principal referral centres serving the highest patient volumes in Ghana. The DASS-21 questionnaire measured levels of stress, anxiety, and depression. Multiple logistic regression identified associated risk factors. Stress, anxiety, and depression were reported by 24.9% (95% CI: 0.21–0.29), 57.4% (95% CI: 0.52–0.62), and 36.0% (95% CI: 0.31–0.41) of participants, respectively. Stress was significantly associated with working at KBTH (AOR=2.27; p=0.031), being a medical officer (AOR=0.21; p=0.005), 1–3 years of experience (AOR=9.83; p<0.001), and seeing 10–20 (AOR=4.12; p<0.001) or >20 patients daily (AOR=6.38; p<0.001). Anxiety was associated with KBTH (AOR=1.95; p=0.005), 4–6 years of practice (AOR=1.78; p=0.039), ≥7 years (AOR=0.29; p=0.001), working in surgery (AOR=0.43; p=0.043) or theatre (AOR=4.02; p=0.019), and patient volume. Depression was linked to KBTH (AOR=2.50; p=0.004), age ≥50 years (AOR=32.88; p=0.010), medical officer rank (AOR=0.14; p<0.001), and higher patient load. The study revealed a high burden of psychological distress among physicians. Key predictors included workplace environment (KBTH), limited clinical experience, patient volume, and inadequate institutional support. Targeted interventions addressing workload management and mental health promotion are urgently needed in Ghana’s major referral hospitals.