Burnout in Italian hospital physicians during the COVID-19 pandemic: a pilot study on the roles of alexithymia and defense mechanisms

Background: COVID-19 pandemic placed unusual additional burden upon international healthcare systems. This study aims to explore the associations between burnout, alexithymia and defense mechanisms in a group of Italian hospital physicians during the COVID-19 pandemic.Methods: 96 hospital physicians completed self-reported questionnaires through Google Forms platform, including Maslach Burnout Inventory (MBI), Defense Style Questionnaire-40 (DSQ-40), and 20- item Toronto Alexithymia Scale (TAS-20).Results: Emotional Exhaustion (EE) and Depersonalization (DP) burnout dimensions were positively correlated with alexithymia and with immature and neurotic defenses, while negative associations were correlated with a mature defensive style. MBI Personal Accomplishment (PA) was negatively correlated with alexithymia levels but positively correlated with mature defenses. According to regression models, EE levels were predicted by female gender (beta = -0.20; p <.04) and DSQ mature defenses (beta= -.24; p<.02); DP levels were predicted by alexithymia total score (beta= 0.26; p <.04) and DSQ mature defenses (beta= -.20; p<.05); and PA levels were predicted by alexithymia total score (beta = -0.29; p <.02) and DSQ mature defense (beta=.45; p<.001).Conclusions: Consistent with the broader literature, an association between burnout and both alexithymia and defense mechanisms emerged. These findings highlight the importance of reducing occupational-related burden on healthcare workers and of promoting protecting strategies to deal with emergency situations.