{
  "abstract": "Objective To propose and test psychometric models that establish direct, cross-lagged, and reciprocal longitudinal relationships between burnout, depression, and anxiety among occupational physicians during the COVID-19 pandemic.Methods This short-term prospective cohort study employed repeated online questionnaires at three time points (T1: Oct 2020–Jan 2021; T2: May–Sep 2021; T3: Nov 2021–Jan 2022). A convenience sample of occupational physicians was recruited through professional networks and scientific associations. Instruments included a sociodemographic questionnaire, the Stanford Professional Fulfillment Index (PFI) and the Depression, Anxiety, and Stress Scale (DASS-21) questionnaires. Path analysis with Reciprocal Cross-Lagged Panel Models (RCLPM) was used to assess dynamic, bidirectional relationships among the psychological variables over time, controlling for age, sex, and years of practice. Three panel models were specified with burnout, anxiety, or depression as the central construct to determine which configuration provided the best fit to the observed data. IBM SPSS AMOS 24 was used for analysis.Results Of 540 participants, 124 completed all waves; 435 participated in wave 1, 220 in wave 2, and 265 in wave 3. Most participants were women, with similar age and work experience across waves. Burnout levels declined from T1 to T2 and remained stable in T3. Depression and anxiety scores showed a consistent decrease over time. The three panel models demonstrated significant reciprocal cross-lagged effects between variables, with feedback loops indicating mutual reinforcement across waves. Anxiety emerged as a particularly influential factor over time. Model fit indices supported the robustness of the models. Stability indices suggested a tendency toward psychological stabilization over time.Conclusion Burnout, depression, and anxiety are reciprocally interrelated and evolve dynamically over time among occupational physicians. Burnout appears central to these interactions. The findings highlight the need for integrated strategies addressing individual and organizational contributors to mental distress, especially in crisis contexts like the pandemic.",
  "authors": [
    {
      "affiliations": [
        "University of São Paulo Medical School Department of Medicine. Hospital Israelita Albert Einstein. Fundação Getúlio Vargas"
      ],
      "name": "João Silvestre Silva-Junior"
    },
    {
      "affiliations": [
        "University of São Paulo Medical School Department of Medicine. Hospital Israelita Albert Einstein. Fundação Getúlio Vargas"
      ],
      "name": "Paulo Sergio Panse Silveira"
    },
    {
      "affiliations": [
        "University of São Paulo Medical School Department of Medicine. Hospital Israelita Albert Einstein. Fundação Getúlio Vargas"
      ],
      "name": "Alberto Jose Niituma Ogata"
    },
    {
      "affiliations": [
        "University of São Paulo Medical School Department of Medicine. Hospital Israelita Albert Einstein. Fundação Getúlio Vargas"
      ],
      "name": "Rodrigo Bornhausen Demarch"
    },
    {
      "affiliations": [
        "University of São Paulo Medical School Department of Medicine. Hospital Israelita Albert Einstein. Fundação Getúlio Vargas"
      ],
      "name": "José Oliveira Siqueira"
    }
  ],
  "title": "8291388 Longitudinal dynamics of burnout, depression, and anxiety among occupational physicians: a cross-lagged panel analysis",
  "uid": "cd7b02bc-82c6-5d57-8c18-cc0ede1c3f55"
}