# Anxiety and Depression and Related Risk Factors in Italian Healthcare Providers Involved in Adverse Events

## TL;DR

This study examines anxiety and depression among Italian healthcare workers after adverse events, identifying risk factors like self-perceived responsibility and workplace climate.

## Contribution

The study provides new insights into mental health risks for Italian healthcare providers following adverse events, highlighting both individual and systemic factors.

## Key findings

- 59% of participants showed anxiety symptoms, 37% depression symptoms, and 35% both.
- Anxiety was linked to pre-event anxiety, psychological help-seeking, self-perceived responsibility, and punitive workplace climate.
- Depression was associated with pre-existing depression, event severity, and punitive or neutral workplace climates.

## Abstract

Background/Objectives: Despite the importance of the second victim phenomenon for healthcare systems, there is limited research on Italian healthcare providers. We assessed emotional distress in individuals impacted by an adverse event using the Withstand-PSY Questionnaire (WS-PSY-Q). Additionally, we aimed to identify potential risk factors for anxiety and depression. Methods: A cross-sectional online survey of 284 participants. Measures included the WS-PSY-Q, Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI-Y). Descriptive analyses and seemingly unrelated regression, jointly estimating anxiety and depression, were conducted using Stata (version 18). Results: Fifty-nine percent of the participants tested positive for anxiety (WS-PSY-Q anxiety subscale ≥ 16), thirty-seven percent for depression (WS-PSY-Q depression subscale ≥ 22), and thirty-five percent for both. In the final model, anxiety symptoms following the adverse event were associated with pre-event anxiety levels (p < 0.01), seeking psychological help (p < 0.05), self-perceived responsibility (p < 0.01), severity of the adverse event for the patient (p < 0.05), and punitive workplace climate (p < 0.05). Correlates of post-event depressive symptoms included pre-existing depression (p < 0.01), self-perceived responsibility (p < 0.01), severity of the impact of the adverse event (p < 0.01), punitive or neutral workplace climate (p < 0.05), and seeking psychological help (p < 0.01). Conclusions: This study adds to the growing understanding of the mental health difficulties that healthcare workers in Italy encounter after adverse events, addressing both individual and systemic risk factors. Proactive implementation of mental health measures for healthcare workers could foster their well-being after adverse events and promote a stronger, more just organizational culture.