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Original Article | Open Access

Longitudinal Study on Post‐Traumatic Stress Disorder, Anxiety, and Depression Among Medical Staff in China

Zongju Chen1,2, Ruiting Cai1, Yifang Liu3, Na Tao4, Yang Fei5, Jing Wen1,6, Pu Zhang7, Yu Lu1, Jun Zhang8, Jing Wang9, Li Zou10 ( ), Wenning Fu1 ( )
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Department of Emergency Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Department of Nursing, The Central Hospital of Wuhan, Wuhan, China
School of Nursing, Yangtze University Medical School, Jingzhou, China
Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
Department of Endocrinology, Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
Department of Neurology, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China

Zongju Chen, Ruiting Cai, and Yifang Liu contributed equally as joint first authors. Li Zou and Wenning Fu jointly supervised this work and contributed equally as joint corresponding authors.

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Abstract

Background

Evidence of the longitudinal relationship between anxiety, depression, and post‐traumatic stress disorder (PTSD) is not uniform. This study aimed to explore the dynamic changes, independent factors, and bidirectional predictive relationships of anxiety, depression, and PTSD among medical staff.

Methods

This study conducted a longitudinal follow‐up with two time points, 6 months apart, to collect medical staff's psychological data. Generalized linear mixed model and cross‐lagged model were used to identify independent factors of anxiety, depression, and PTSD among medical staff and explore longitudinal predictive relationships in main variables.

Results

In total, 2650 medical staff completed both baseline and follow‐up surveys, with a follow‐up response rate of 96.3%. From the first phase of the survey (T1) to the second phase of the survey (T2), the prevalence of anxiety (28.9% at T1 and 34.5% at T2), depression (19.4% and 26.7%), and PTSD (6.1% and 13.1%) among medical staff showed an upward trend. Occupational exposure, sleep quality, and experiencing traumatic life events were identified as independent factors associated with psychological disorders among medical staff. In addition, from T1 to T2, PTSD predicted anxiety and depression, and depression predicted PTSD and anxiety. However, anxiety could not predict depression and PTSD.

Conclusions

The prevalence of anxiety, depression, and PTSD among medical staff was higher and showed an upward trend. It is recommended to conduct early screening and intervention for medical staff's mental health problems, while paying close attention to the comprehensive management and intervention of these symptoms.

Graphical Abstract

A six‐month study of 2650 medical staff found post‐traumatic stress disorder and depression bidirectionally predicted each other, and both drove later anxiety. These findings highlight the need for integrated early screening and intervention strategies targeting post‐traumatic stress disorder, anxiety and depression in high‐stress healthcare settings.

References

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Health Care Science
Pages 404-414

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Cite this article:
Chen Z, Cai R, Liu Y, et al. Longitudinal Study on Post‐Traumatic Stress Disorder, Anxiety, and Depression Among Medical Staff in China. Health Care Science, 2026, 5(5): 404-414. https://doi.org/10.1002/hcs2.70101

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Received: 03 February 2026
Revised: 07 June 2026
Accepted: 10 June 2026
Published: 13 September 2026
© 2026 The Author(s). Tsinghua University Press.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.