Prevalence and Severity of Depression Among Cardiothoracic Surgery Healthcare Workers in Baghdad: A PHQ-9 Cross-Sectional Study (DEPRESS/PHQ-9)

March 3, 2026 updated by: Abdulillah R. Khamees, Al-Nahrain University

Assessing the Prevalence and Severity of Depression Among Cardiothoracic Surgery Healthcare Workers in Baghdad Using the PHQ-9: A Cross-Sectional Study

This observational study aims to estimate the prevalence and severity of depression in HCWs in cardiothoracic surgery departments in Baghdad City, Iraq, using a self-administered PHQ-9 questionnaire. The main questions it aims to answer are:

What is the prevalence of depression among cardiothoracic surgery healthcare workers? How is the severity of depression distributed within this group? Are there specific occupational or demographic factors associated with higher levels of depression?

Participants will:

Fill out the PHQ-9 in order to measure the severity of depressive symptoms at a specific moment in time.

Demographic and occupational details such as age, gender, years of experience and position held should be taken to look for possible relationship with depression.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Major depressive disorder is a prevalent, severe, and recurring mental health condition.There is a significant difference in the prevalence of major depressive disorder across various socioeconomic contexts and countries. Depression is a debilitating mental illness, severely impacting psychosocial function and quality of life.

Individuals, including healthcare workers, are at risk of developing various psychological disorders, with depression being the most prevalent. In Iraq, healthcare workers are particularly vulnerable to psychological distress due to the nature of their job. They often have to deal with heavy workloads, night shifts, and shift work, which can take a toll on their mental well-being. These occupational stress factors can lead to burnout, anxiety, sleep problems, psychiatric disorders, or even depression. It has been reported that the screening for depression among healthcare workers is on the rise. Healthcare workers and individuals who work in the healthcare industry often experience symptoms of anxiety and depression at a significant rate.

There are several tools that can be used to screen for depressive disorders. One commonly used instrument in primary care is the Patient Health Questionnaire-9 (PHQ-9), which is a brief, self-administered, and easy-to-score tool that is well-validated for detecting and monitoring changes in depression severity. and detection of this condition in large epidemiological studies As this instrument is based on DSM-IV criteria, it tends to identify cases with Major Depressive Episode (MDE) when the scores are high. Additionally, it can be utilized to evaluate the intensity of depression by distinguishing between mild to severe cases. However, it is important to note that there is mounting evidence that the cut-off points used to determine the degree of severity may differ based on various contexts.

This study addresses the mental health gap among Iraqi healthcare workers, particularly in cardiothoracic surgery, within a healthcare system strained by war, resource shortages, and heavy patient loads. Despite these challenges, few studies assess depression in this group. Findings aim to inform mental health support policies for high-stress medical fields in Iraq.

Study Type

Observational

Enrollment (Estimated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Iraq
      • Baghdad, Iraq
        • Recruiting
        • College of Medicine - Al-Nahrain University
        • Contact:
        • Principal Investigator:
          • Abdul-Ilah R. Khamis
        • Sub-Investigator:
          • Eman Gomaa Allam, Intern doctor
        • Sub-Investigator:
          • Saja Jaafar Abotaleb, M.B.CH.B
        • Sub-Investigator:
          • Zaid Salwan Akram, Student
        • Sub-Investigator:
          • Othman M. Mutar, Student
        • Sub-Investigator:
          • Baraa AL-Obaidi M.B.CH.B

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study targets cardiothoracic surgical departments' health care workers in Baghdad's hospitals. This encompasses cardiothoracic surgeons, anesthetists, nurses, perfusionists, and many related personnel who mostly come into direct contact with the patients. These persons work in conditions that may trigger mental health problems, such as extended working hours, intricate processes, and acute status of patients. The participants are chosen to be at least 18 years old, with different years of experience, and diagnosed to determine the rate of depression in the mentioned specific medical line.

Description

Inclusion Criteria:

  • Healthcare professionals actively working in cardiothoracic surgery departments in Baghdad, including surgeons, anesthesiologists, nurses, and support staff.
  • Participants who provide informed consent for participation in the study.
  • Able to complete questionnaire form.

Exclusion Criteria:

  • Individuals with a previously diagnosed psychiatric condition other than depression that could confound the results.
  • Incomplete or missing responses on the PHQ-9 questionnaire.
  • Refusal to provide informed consent.
  • Participants are currently undergoing treatment for depression or other mental health conditions.
  • Healthcare workers on long-term leave or who have not actively worked in the cardiothoracic surgery department for the past 3 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient Health Questionnaire-9 (PHQ-9)
Time Frame: Data collection will occur over a 3-months period, with each participant completing the PHQ-9 assessment at a single point during this time frame.
The total score can range from 0 to 27. Higher scores indicate greater severity of depression.
Data collection will occur over a 3-months period, with each participant completing the PHQ-9 assessment at a single point during this time frame.
Severity of Depression
Time Frame: Data collection will occur over a 3-months period, with each participant completing the PHQ-9 assessment at a single point during this time frame.
The severity of depression in this study will be determined based on the scores obtained from the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 categorizes depression severity as follows: Minimal depression: Scores 0-4, indicating little to no symptoms. Mild depression: Scores 5-9, suggesting occasional symptoms that may not significantly affect daily functioning. Moderate depression: Scores 10-14, indicating more frequent symptoms that can interfere with daily life. Moderately severe depression: Scores 15-19, showing pronounced symptoms that significantly impact daily activities. Severe depression: Scores 20-27, with symptoms that are debilitating.
Data collection will occur over a 3-months period, with each participant completing the PHQ-9 assessment at a single point during this time frame.
Prevalence of Depression
Time Frame: Data collection will occur over a 3-months period, with each participant completing the assessment at a single point during this time frame.
Proportion of cardiothoracic surgery HCWs at Al-Kadhimiya Teaching Hospital who exhibit depressive symptoms.
Data collection will occur over a 3-months period, with each participant completing the assessment at a single point during this time frame.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Al-Nahrain University

Investigators

  • Study Director: Yaser aamer Eisa Alhaibi, Assistant professor, College Of Medicine - Nahrain University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2024

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 15, 2026

Study Registration Dates

First Submitted

November 21, 2024

First Submitted That Met QC Criteria

November 21, 2024

First Posted (Actual)

November 25, 2024

Study Record Updates

Last Update Posted (Actual)

March 4, 2026

Last Update Submitted That Met QC Criteria

March 3, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UNCOMIRB20241132

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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