In the healthcare system, medical health workers play an essential role, yet they are subject to unique factors and multifaceted stressors that increase their susceptibility to psychological pressure (1, 2). These stressors are not only related to the high patient loads and complex, high-stakes medical decisions they must make but also include prolonged work hours, inadequate rest, and the emotional strain from regularly confronting patients’ suffering and mortality (3). The pressure to maintain precision in fast-paced environments, coupled with the ethical and legal responsibilities inherent in patients’ care, exacerbates these challenges (4). Moreover, healthcare workers often lack sufficient institutional support, further compounding their stress and potentially leading to burnout (5).

Given the intensity and persistence of these stressors, healthcare workers are at significant risk of chronic stress, which is increasingly recognized as a contributor to a range of physical health problems, such as cardiovascular disease, hypertension, and sleep disorders (6, 7). This chronic stress not only affects their well-being but also has implications for patient care quality, as stressed healthcare workers may experience decreased job performance and increased error rates (8). Therefore, investigating the psychological and physiological impact of stress on healthcare workers is crucial for both their health and the overall efficacy of healthcare systems.

Previous research has primarily focused on the psychological effects of stress, such as burnout, depression, and anxiety (9–11). However, the connection between psychological stress and physiological changes in healthcare workers remains underexplored, despite emerging evidence suggesting that chronic stress can lead to significant physiological alterations (12). For instance, psychological stress has been linked to changes in cardiovascular function, immune response, and metabolic processes, which could predispose individuals to long-term health issues (13–15). This gap in the literature highlights the need for further investigation into how stress affects specific physiological indicators in healthcare workers. For instance, Carpenter et al. found evidence that acute psychological stress and early-life adversity can impact the immune system by affecting the response of interleukin-6 (IL-6) in white blood cells (16). Another study reviewed the impact of psychological factors, such as stress, depression, social support, and optimism, on immune function and health (17). Although the effects of psychological stress on physical health have been extensively studied in the general population, relatively limited attention has been paid to its impact on medical staff, who are exposed to a unique set of stressors in the workplace.

Therefore, the objective of this study is to identify the key physiological indicators that are significantly affected by psychological stress among healthcare workers. Understanding the physiological manifestations of stress in healthcare workers is essential for developing comprehensive interventions that address both mental and physical health. By identifying specific physical examination indicators affected by psychological stress, we can gain insight into the broader health implications of stress in this population. These indicators can serve as objective measures to complement psychological assessments, offering a more holistic approach to evaluating and managing stress.

This study sought to bridge the existing research gap by investigating the impact of depressive symptoms on the physical health of medical staff, a topic that has received relatively limited attention. While prior studies have extensively examined the association between psychological distress and physical health within the general population, the unique experiences of medical staff, who encounter distinct stressors in their work environment, remain understudied. The observed associations between depressive symptoms and specific physical health indicators, such as elevated uric acid and platelet levels, underscore the potential physiological consequences of psychological stress in healthcare workers. This highlights the need for more nuanced approaches to mental health assessments, where physical health indicators could serve as complementary markers of psychological distress. For instance, the interplay between oxidative stress and depression, as evidenced by the elevated uric acid levels, may offer novel insights into how chronic stress affects metabolic pathways.

In our study, we observed a significant positive correlation between depression severity and uric acid levels in the blood of healthcare workers. This finding is consistent with previous research that highlights elevated serum uric acid levels in individuals with depression (19–21). Specifically, studies have demonstrated that psychological distress is often associated with increased oxidative stress and lipid peroxidation, which can elevate uric acid levels (22). This aligns with our results, reinforcing the notion that uric acid may serve as a biomarker for psychological conditions. The convergence of our findings with the existing literature suggests that uric acid’s role in depression could be a reflection of its involvement in oxidative stress pathways.

From a biological perspective, depression-induced low mood may facilitate lipid peroxidation, contributing to increased oxidative damage. This oxidative stress can enhance nucleic acid degradation, subsequently elevating serum uric acid levels (23). These mechanisms underscore the importance of considering uric acid as a potential biomarker for psychological stress among healthcare workers. Furthermore, integrating our findings with research on the interplay between psychological disorders and metabolic pathways highlights the necessity for further interdisciplinary studies to explore these associations in depth (24, 25).

Our study also found a positive correlation between depression severity and platelet levels. This observation is supported by existing research, which suggests that depression and anxiety can activate the sympathetic nervous system, influencing platelet activity and production (26). Furthermore, the role of the immune system in both depression and platelet regulation warrants investigation, particularly in light of emerging research on the interactions between depressive symptoms and immune function (27, 28). Additionally, these findings hold significant clinical implications. Monitoring platelet levels may offer valuable insights into the physiological manifestations of depression (29, 30), potentially aiding in the early identification and management of depression-related issues among medical health workers.

We identified a positive correlation between higher depression severity and increased hemoglobin levels, as well as a negative correlation with red blood cell count. This seemingly contradictory discovery may have rational explanations, which include the following three possibilities: (1) Depression may lead to the breakdown of red blood cells, resulting in the release of hemoglobin into the bloodstream. This could cause an elevation in hemoglobin levels while decreasing the overall count of intact red blood cells. (2) Depression may cause a transfer of red blood cells from peripheral circulation to specific organs or tissues, thereby reducing their total count, but increasing the levels of hemoglobin. (3) The body may respond to depression by compensating for the decreased red blood cell count through increased production of hemoglobin. (4) The relationship between hemoglobin levels and depression severity may be influenced by other unmeasured factors, such as nutritional status, hydration levels, or the presence of chronic inflammatory conditions. Additionally, the observed correlations might be confounded by external stressors unrelated to occupational factors, suggesting the need for more comprehensive assessments that account for these variables in future research. These explanations align with existing research on the physiological responses to depression and provide insight into the complex interactions between depression and hematological parameters (31).

Our study has important implications and contributions in the field of healthcare (32). Firstly, we have identified specific physical examination indicators that may be influenced by depressive symptoms among medical staff, thereby contributing to their overall health and welfare (33). The integration of these biomarkers into routine health evaluations can potentially transform how depression is managed among healthcare professionals. Early identification through these indicators allows for timely, targeted interventions that not only address mental health symptoms but also prevent the potential downstream physiological consequences. This approach could reduce the burden of disease associated with untreated depression and improve overall workforce health and productivity. Secondly, the recognition of these impacts enhances patient care, as appropriate measures can be implemented to effectively address and manage depression, leading to improved health outcomes. Offering access to counseling services, stress management programs, and mental health resources not only addresses current mental health concerns but also helps prevent the escalation of depressive symptoms. Thirdly, the findings of our study can inform the development of preventive strategies aimed at reducing depression levels among medical staff (34). By taking proactive measures to assist medical professionals in managing depression before it adversely affects their health, we can promote their well-being. Additionally, our study provides a valuable foundation for future research in this area, which can explore the underlying mechanisms and evaluate targeted interventions to enhance the well-being of medical professionals.

An important advantage of studying medical staff with less occupational heterogeneity is the increased precision and validity of assessing the impact of specific occupational factors on health outcomes. As medical staff share similar occupational exposures and work-related risks, the homogeneity of this population allows for more accurate evaluations of the effects of occupational factors on health. This unique advantage enhances the internal validity of the study findings, providing robust evidence for the associations between occupational factors and health outcomes. By minimizing the confounding effects of diverse occupations, research on medical staff can provide valuable insights into targeted interventions and policies in the field of occupational health.

This study also has several limitations that need to be acknowledged. Firstly, the retrospective study design imposes inherent constraints that make it difficult to completely avoid selection bias, potentially distorting our findings. This design also restricts our ability to establish temporality, making it difficult to determine whether the observed correlations are causal or simply associative. For example, while we found significant correlations between depression severity and certain physical examination indicators, we cannot definitively conclude that depression caused these changes, as the retrospective nature of the study does not allow us to rule out the possibility of reverse causation or other underlying factors. Secondly, since the study was conducted solely within a single medical center, caution is advised when generalizing and applying our results to broader populations or settings. The specific work environment, stressors, and population characteristics of this medical center might not fully represent those of other healthcare settings, thereby cautioning against broadly applying these findings to all medical staff. Thirdly, as the study is cross-sectional, it captures data at a single point in time, which precludes us from assessing the longitudinal effects of depression on physical health indicators. Without follow-up data, we cannot confirm whether the associations we observed persist over time or if they are influenced by transient factors. Fourthly, our exclusion criteria are not sufficient since there are other factors that might change blood indicator, such as unbalanced diabetes, history of psychiatric and neurological disorders, trauma, etc. Besides, measuring stress should be done through assessing the cortisol level in the appropriate day time. To address these limitations, future research should incorporate the measurement of cortisol levels at appropriate times of the day to more accurately assess physiological stress and consider prospective cohort studies that follow medical staff over time to better understand the directionality of these relationships and the potential causal pathways. Additionally, expanding the study to include multiple centers with diverse populations would enhance the generalizability of the findings and provide more robust evidence for the observed associations.

In summary, our study revealed a significant association between depression level and several physiological indicators in healthcare professionals, highlighting the need for targeted mental health strategies. Healthcare institutions should incorporate regular mental health evaluations, develop personalized support programs, and implement preventive health monitoring of relevant biomarkers. In order to enhance the health and overall well-being of medical personnel, it is imperative to conduct multi-center and prospective investigations with larger cohorts to validate the veracity of our findings. Future studies should expand on our findings by conducting longitudinal research to establish causal relationships between depression and physiological changes. This could include exploring the temporal dynamics of depression and physical health indicators over time, as well as investigating the potential mediating roles of lifestyle factors, such as diet, physical activity, and sleep. Moreover, examining the efficacy of targeted interventions, such as antioxidant therapy or stress reduction programs, in modulating these physiological markers could provide actionable strategies to mitigate the impact of depression in healthcare settings. Finally, future research should aim to explore the heterogeneity in responses to depression among healthcare workers, possibly considering genetic, environmental, and occupational differences that might influence these outcomes.