Psychological distress among healthcare workers in Kabul following the 2021 transition

Abstract Background Healthcare workers (HCWs) in conflict and post-conflict settings are particularly susceptible to psychological distress due to persistent occupational stress and limited systemic support. This study examined the prevalence of psychological distress among HCWs in Kabul, Afghanista...

Full description

Saved in:
Bibliographic Details
Main Authors: Shoaib Naeemi, Sayed Murtaza Sadat Hofiani, Ahmad Komail Frogh, Said Mohammad Rahim Niazy, Ali Mirzazadeh, Said Iftekhar Sadaat, Narges Neyazi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Conflict and Health
Subjects:
Online Access:https://doi.org/10.1186/s13031-025-00702-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849763208843231232
author Shoaib Naeemi
Sayed Murtaza Sadat Hofiani
Ahmad Komail Frogh
Said Mohammad Rahim Niazy
Ali Mirzazadeh
Said Iftekhar Sadaat
Narges Neyazi
author_facet Shoaib Naeemi
Sayed Murtaza Sadat Hofiani
Ahmad Komail Frogh
Said Mohammad Rahim Niazy
Ali Mirzazadeh
Said Iftekhar Sadaat
Narges Neyazi
author_sort Shoaib Naeemi
collection DOAJ
description Abstract Background Healthcare workers (HCWs) in conflict and post-conflict settings are particularly susceptible to psychological distress due to persistent occupational stress and limited systemic support. This study examined the prevalence of psychological distress among HCWs in Kabul, Afghanistan, in the wake of the political changes in August 2021. Methods A cross-sectional survey study was conducted from September to October 2021 in 16 public tertiary hospitals in Kabul. The Afghan Symptoms Checklist (ASCL) was used to assess psychological distress and its related symptoms. Multivariable analysis using Generalized Linear Model (GLM) was performed to find the associated factors of psychological distress utilizing STATA 18. Results A total of 277 HCWs participated in the study, with 48.4% identifying as female. Approximately 62% had considered leaving Afghanistan, and 64% had witnessed colleagues emigrate. The overall prevalence of psychological distress was 25% (CI 95%: 19.9–30.6), with stress-induced reactivity as the most prevalent symptom (35%, CI 95%: 29.8–41.4). Female HCWs were significantly more likely to report sadness with social withdrawal and somatic distress (POR = 2.32, CI 95%: 1.07–5.02, p = 0.03) and stress-induced reactivity (POR = 2.56, CI 95%: 1.22–5.44, p = 0.013). A lack of optimism about the future was associated with higher odds of stress-induced reactivity (POR = 3.14, CI 95%: 1.55–6.38, p = 0.001), ruminative sadness without withdrawal (POR = 3.05, CI 95%: 1.68–6.24, p = 0.002), and sadness with withdrawal and somatic distress (POR = 3.73, CI 95%: 1.71–8.13, p = 0.001). Conclusion One in four HCWs reported psychological distress, with stress-induced reactivity being the most common symptom. Female gender and pessimism about the future were key associated factors of elevated distress. The findings highlight the critical need for long-term mental health support programs specifically designed for HCWs, broader support within the health system, and continued research into how HCWs cope and build resilience.
format Article
id doaj-art-ba55baf471db4a60b3ff7dd962118391
institution DOAJ
issn 1752-1505
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series Conflict and Health
spelling doaj-art-ba55baf471db4a60b3ff7dd9621183912025-08-20T03:05:29ZengBMCConflict and Health1752-15052025-08-011911810.1186/s13031-025-00702-zPsychological distress among healthcare workers in Kabul following the 2021 transitionShoaib Naeemi0Sayed Murtaza Sadat Hofiani1Ahmad Komail Frogh2Said Mohammad Rahim Niazy3Ali Mirzazadeh4Said Iftekhar Sadaat5Narges Neyazi6Afghanistan Country Office, Eastern Mediterranean Public Health Network (EMPHNET)HealthNet TPOAction Against Hunger (AAH)Cheragh Medical Institute of Higher EducationCenter for Tobacco Control Research and Education, University of California San FranciscoInstitute for Global Health Sciences, University of California San FranciscoCenter for Tobacco Control Research and Education, University of California San FranciscoAbstract Background Healthcare workers (HCWs) in conflict and post-conflict settings are particularly susceptible to psychological distress due to persistent occupational stress and limited systemic support. This study examined the prevalence of psychological distress among HCWs in Kabul, Afghanistan, in the wake of the political changes in August 2021. Methods A cross-sectional survey study was conducted from September to October 2021 in 16 public tertiary hospitals in Kabul. The Afghan Symptoms Checklist (ASCL) was used to assess psychological distress and its related symptoms. Multivariable analysis using Generalized Linear Model (GLM) was performed to find the associated factors of psychological distress utilizing STATA 18. Results A total of 277 HCWs participated in the study, with 48.4% identifying as female. Approximately 62% had considered leaving Afghanistan, and 64% had witnessed colleagues emigrate. The overall prevalence of psychological distress was 25% (CI 95%: 19.9–30.6), with stress-induced reactivity as the most prevalent symptom (35%, CI 95%: 29.8–41.4). Female HCWs were significantly more likely to report sadness with social withdrawal and somatic distress (POR = 2.32, CI 95%: 1.07–5.02, p = 0.03) and stress-induced reactivity (POR = 2.56, CI 95%: 1.22–5.44, p = 0.013). A lack of optimism about the future was associated with higher odds of stress-induced reactivity (POR = 3.14, CI 95%: 1.55–6.38, p = 0.001), ruminative sadness without withdrawal (POR = 3.05, CI 95%: 1.68–6.24, p = 0.002), and sadness with withdrawal and somatic distress (POR = 3.73, CI 95%: 1.71–8.13, p = 0.001). Conclusion One in four HCWs reported psychological distress, with stress-induced reactivity being the most common symptom. Female gender and pessimism about the future were key associated factors of elevated distress. The findings highlight the critical need for long-term mental health support programs specifically designed for HCWs, broader support within the health system, and continued research into how HCWs cope and build resilience.https://doi.org/10.1186/s13031-025-00702-zHealth personnelDistressPsychologicalConflictAfghanistan
spellingShingle Shoaib Naeemi
Sayed Murtaza Sadat Hofiani
Ahmad Komail Frogh
Said Mohammad Rahim Niazy
Ali Mirzazadeh
Said Iftekhar Sadaat
Narges Neyazi
Psychological distress among healthcare workers in Kabul following the 2021 transition
Conflict and Health
Health personnel
Distress
Psychological
Conflict
Afghanistan
title Psychological distress among healthcare workers in Kabul following the 2021 transition
title_full Psychological distress among healthcare workers in Kabul following the 2021 transition
title_fullStr Psychological distress among healthcare workers in Kabul following the 2021 transition
title_full_unstemmed Psychological distress among healthcare workers in Kabul following the 2021 transition
title_short Psychological distress among healthcare workers in Kabul following the 2021 transition
title_sort psychological distress among healthcare workers in kabul following the 2021 transition
topic Health personnel
Distress
Psychological
Conflict
Afghanistan
url https://doi.org/10.1186/s13031-025-00702-z
work_keys_str_mv AT shoaibnaeemi psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT sayedmurtazasadathofiani psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT ahmadkomailfrogh psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT saidmohammadrahimniazy psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT alimirzazadeh psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT saidiftekharsadaat psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition
AT nargesneyazi psychologicaldistressamonghealthcareworkersinkabulfollowingthe2021transition