PTSD and Depression in Healthcare Workers in the Italian Epicenter of the COVID-19 Outbreak

Claudia Carmassi1, Virginia Pedrinelli1, *
, Valerio Dell’Oste1, 2, Carlo Antonio Bertelloni1
, Chiara Grossi3, Camilla Gesi4, Giancarlo Cerveri3, Liliana Dell’Osso1

1 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
2 Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
3 Department of Mental Health and Addiction, ASST Lodi, Lodi, Italy
4 Department of Mental Health and Addiction, ASST Fatebenefratelli Sacco, Milan, Italy

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© 2021 Carmassi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy; Tel: +39 050 2219760; Fax: +39 050 2219787; E-mail:



Increasing evidence highlights the susceptibility of Healthcare Workers to develop psychopathological sequelae, including Post-Traumatic Stress Disorder (PTSD) and depression, in the current COronaVIrus Disease-19 (COVID-19) pandemic, but little data have been reported in the acute phase of the pandemic.


To explore Healthcare Workers’ mental health reactions in the acute phase of the COVID-19 pandemic in the first European epicenter (Lodi/Codogno, Italy), with particular attention to post-traumatic stress and depressive symptoms and their interplay with other psychological outcomes.


74 Healthcare Workers employed at the Azienda Socio Sanitaria Territoriale of Lodi (Lombardy, Italy) were recruited and assessed by means of the Impact of Event Scale- Revised, the Professional Quality of Life Scale-5, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 item, the Resilience Scale and the Work and Social Adjustment Scale. Socio-demographic and clinical variables were compared across three subgroups of the sample (No PTSD, PTSD only, PTSD and depression).


A total of 31% of subjects endorsed a diagnosis of PTSD and 28.4% reported PTSD comorbid with major depression. Females were more prone to develop post-traumatic stress and depressive symptoms. Subjects with PTSD and depression groups showed high levels of PTSD, depression, burnout and impairment in functioning. Anxiety symptoms were higher in both PTSD and depression and PTSD groups rather than in the No PTSD group.


Our results showed high rates of PTSD and depression among Healthcare Workers and their comorbidity overall being associated with worse outcomes. Current findings suggest that interventions to prevent and treat psychological implications among Healthcare Workers facing infectious outbreaks are needed.

Keywords: Healthcare workers, Stress, Post-Traumatic Stress Disorder, Depression, Psychological distress, COVID-19.