# Health-Related Quality of Life and Frequency of Depressive Episodes Among Healthcare Professionals in an Outpatient Health Facility in Italy: A Comparison Between 2017 (Pre-COVID) and 2025 (Post-COVID)

## TL;DR

This study found that healthcare workers in Italy experienced worse mental health and quality of life after the pandemic compared to before.

## Contribution

The study compares mental health outcomes of healthcare professionals pre- and post-pandemic in an outpatient setting.

## Key findings

- Depressive episodes increased from 33.2% in 2017 to 38.1% in 2025.
- Low health-related quality of life rose from 43.5% in 2017 to 62.9% in 2025.
- Non-medical workers and women showed higher vulnerability to mental health issues post-pandemic.

## Abstract

Background/Objectives: The COVID-19 pandemic severely impacted healthcare systems globally, with Italian healthcare professionals experiencing heightened stress, organizational challenges, and a significant psychological burden. This study investigates the frequency of depressive symptoms and health-related quality of life (H-QoL) among outpatient healthcare workers in Italy, comparing pre-pandemic (2017) and post-pandemic (2025) periods. Methods: A cross-sectional study was conducted in 2025, including 97 healthcare professionals from five outpatient departments at the University Hospital of Cagliari. Participants completed demographic surveys, the Short Form Health Survey (SF-12), and the Patient Health Questionnaire (PHQ-9) to assess H-QoL and depressive symptoms. Data were compared with previously published data from the same facility collected in 2017 and with pre-pandemic Italian community surveys. Results: Compared to 2017, there was a statistically significant increase in depressive episodes (38.1% vs. 33.2%, p = 0.01) and a higher proportion of individuals with low H-QoL (62.9% vs. 43.5%, p < 0.0001) in 2025. After age- and sex-standardization, both depressive symptoms and low H-QoL were significantly more prevalent among healthcare professionals in 2025 compared with the general population before the pandemic. Within the 2025 sample, non-medical healthcare workers showed a significantly higher prevalence of depressive symptoms than medical doctors, while female healthcare workers were more likely to report low H-QoL. Conclusions: Despite the pandemic’s end, healthcare workers, especially those in outpatient settings, continue to face elevated psychological distress. Specific professional and gender-related vulnerabilities persist, and structural challenges, such as staff shortages and organizational issues, may exacerbate this burden. Sustained mental health support and targeted systemic interventions remain crucial to mitigate the long-term impact on the healthcare workforce.