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.

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.

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.

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.