The study, conducted by researchers from the University of Minnesota, Universidad Argentina de la Empresa, Universidad Austral, Centro de Investigación en Sanidad Animal (CISA-INIA), Complutense University of Madrid, Spanish Pig Producers Association (ANPROGAPOR), University of Veterinary Medicine Alfonso X El Sabio, and Doctor Armando Zamudio Hospital, distributed a questionnaire with the Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) to Spanish pig veterinarians from April to May 2026. Working in an ASF control zone, and working in Catalonia, were primary exposures of interest for anxiety and insomnia score. Data were analyzed using univariate analyses.

Fifty-three veterinarians responded to the survey. Median anxiety score was 6.00 (interquartile range [IQR]: 2.00–10.0) and median insomnia score was 8.00 (IQR: 4.00–13.0). Some veterinarians reported new feelings of uneasiness or sadness (54.7%), extreme changes in their feelings of happiness and sadness (41.5%), and less confidence in their abilities or their value (41.5%) since the ASF outbreak. Working in an ASF control zone or working in Catalonia were not significantly associated with insomnia or anxiety score (p > 0.05).

These findings help to describe the current status of anxiety and insomnia amongst Spanish pig veterinarians following the ASF detection in wild boar, and provide a baseline for future comparisons if the ASF epidemic worsens in the country. The research team notes that Spain is Europe’s largest producer and exporter of pork, including highly valued Iberian pork, and Catalonia is Spain’s biggest producing region with an estimated 2 million tonnes in pork production and more than 22 million pig heads in 2025. In 2024, Spain exported over 2.76 million tonnes of pork with an estimated value of €8.78 billion, of which about 26% is exported to non-European Union countries.

The Spanish government responded with emergency measures aimed at containing and controlling ASF, including zoning and fencing around the outbreaks, testing and removal of wild pig carcasses, general prohibition of movement of domestic pigs and products from the infected zone, and increased biosecurity and surveillance. Though domestic pigs have not been affected, the detection in wild boar triggered numerous export bans or trade restrictions based on regionalization. As of April 1, 2026, when this study was conducted, there were 42 outbreaks identified in wild boar affecting 241 wild pigs in 10 municipalities of Catalonia, and ASF has not been detected in any domestic pigs in Spain.

Workplace stress is a well-known reality of the veterinary profession. Veterinarians are at uniquely high risk for experiencing workplace and occupational-related mental health impacts. Compared to other professions and the general public, mental health in veterinarians tends to be worse. Previous work assessing mental health outcomes mainly amongst practicing veterinarians has identified increased prevalence of depression, anxiety, and stress, which is affected by gender, years of experience, the type of veterinary work or specialty, amongst other factors. Fewer years of experience and female gender has been associated with worse mental health in multiple studies. Especially alarming is the observed increased suicide rate among veterinarians compared to other medical professionals and to the general population of many countries. Burnout has also commonly been reported amongst veterinarians.

During an emergency disease response, particularly for transboundary, notifiable diseases with large animal health and socioeconomic impacts, veterinarians are one of many groups at-risk for negative mental health impacts. Veterinarians are typically involved in many frontline activities, such as working with both government officials and clients to manage and maintain farm quarantines or movement restrictions and participating in mass depopulation of animals to prevent disease spread. In particular, mass depopulation, or mass culling, has previously been shown to cause emotional conflict with veterinarians’ professional and ethical obligation to heal animals. Increased stress, strain, and in some cases long-term effects like post-traumatic stress disorder following emergency disease response have previously been documented during the foot-and-mouth disease outbreaks in the UK in 2001 and in Japan in 2010, during highly pathogenic avian influenza (HPAI) outbreaks in Canada in 2023–2024, and during African swine fever (ASF) outbreaks in the Philippines and Dominican Republic in 2023 and 2024.

As transboundary diseases continue to spread necessitating emergency response, the need for mental health preparedness and support for veterinarians who may be impacted by the disease or disease response continues to grow. Preparedness and training prior to participation in these activities could help to reduce potential impacts to veterinarians and other responders; thus, understanding both the mental impacts of outbreaks and baseline measures of the intended population for training are important for ultimately creating context-specific and appropriate preparedness programs. The primary objective of this study was to descriptively explore the anxiety and insomnia of Spanish practicing veterinarians working with swine following the November 2025 detection of ASF in wild boar and to provide a baseline for future comparison if the ASF epidemic in Spain worsens or spreads to domestic pigs. This work will aid in the development of mental health support for Spanish pig veterinarians before, during, and after emergency disease response.

The study was approved by the University of Minnesota Institutional Review Board (STUDY00020636). The study population was defined as any veterinarians working with swine or the ASF response in Spain. A questionnaire was designed using multiple choice, multiple selection, short answer, and Likert scale questions to capture information on the potential impacts of the ASF emergency on Spanish pig veterinarians. The Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were included in the questionnaire to assess signs and symptoms of anxiety and insomnia, respectively. Questions previously used on questionnaires to assess the impacts of ASF emergency response on Filipino and Dominican Republic veterinarians were also included. Already-validated translations for Spanish were used for GAD-7 and ISI items, and all other materials were translated into Spanish by members of the research team who were native-Spanish speakers. An online version of the survey was made using Qualtrics. Within the Qualtrics questionnaire, all respondents were given a downloadable, electronic consent form, and consent to participate was given by selecting “Yes” to a mandatory Yes/No question. If “No” were selected, the survey was immediately concluded. The survey was distributed online from April 1, 2026 through May 30, 2026 to veterinarians working with pigs in Spain. The questionnaire was distributed by email and WhatsApp to the Presidents of the Swine Veterinarians’ Associations, comprised by 5 Regional Associations (Catalonia, Aragon, Galicia, Castile-and-Leon, Murcia), the Iberian Pig Vets Association, the National Pig Vets Association, the National Association of Scientific Pig Farming, and by email to official veterinarians. A reminder message was sent in late April. The questionnaire was also advertised at several in-person meetings held between the President of the Swine Producers’ Association and veterinarians from the affected area. Because recruitment was conducted indirectly through multiple professional associations and overlapping email, WhatsApp and meeting-based channels, the investigators did not have access to a roster of unique eligible recipients. Consequently, the number of individuals who received the invitation and the participation rate could not be determined. Security features in Qualtrics were used to prevent duplicate responses. Data were downloaded from Qualtrics and imported into R version 4.4.2 for cleaning and analysis. Data were cleaned by removing responses with less than 75% completion. Composite scores were calculated for anxiety and insomnia. The anxiety and insomnia scores were the primary outcomes assessed, while all other responses were exploratory. Scores were only calculated for a given individual if they had completed all items, i.e., those with missing responses to any scored items were excluded. All respondents completed all items for both the GAD-7 and ISI. For anxiety score, each item of the GAD-7 was assigned a score of 0 to 3 (Never = 0, Some days = 1, More than half of days = 2, and Almost every day = 3), then summed across all seven items, giving a score ranging from 0–21. For insomnia score, each item of the ISI was assigned a score as follows: None = 0, Little = 1, Moderate = 2, Severe = 3, Very severe = 4; Very satisfied = 0, Satisfied = 1, Moderately satisfied = 2, Dissatisfied = 3, Very dissatisfied = 4; Not noticeable = 0, A little noticeable = 1, Moderately noticeable = 2, Very noticeable = 3, Too noticeable = 4; Not at all worried = 0, A little worried = 1, Moderately worried = 2, Very worried = 3, Too worried = 4; Does not interfere = 0, Interferes a little = 1, Interferes moderately = 2, Interferes a lot = 3, Interferes too much = 4, giving a score ranging from 0–28. Cronbach’s alpha was used to assess internal consistency of the composite scores. Anxiety score was categorized as minimal = 0–4, mild = 5–9, moderate = 10–14, and severe = 15–21. Insomnia score was categorized as no insomnia = 0–7, sub-threshold insomnia = 8–14, moderate insomnia = 15–21, and severe insomnia = 22–28. Descriptive statistics were performed as counts, histograms, and summary statistics. Univariate analysis was used to assess associations between variables and anxiety score, insomnia score, and symptom presence/absence. Relating to the main objective, two main variables were explored: (1) having worked on any farms in an ASF control area or with producers who have a farm in an ASF control area, and (2) working in the Catalonia region compared to working in the rest of Spain. Age, gender, education, and years of veterinary experience were also explored as potentially associated variables. Because data were not normally distributed and sample size was small, nonparametric Wilcoxon rank-sum test and Kruskal–Wallis tests were used for score outcomes. Pairwise Wilcoxon rank-sum tests with Bonferroni correction were used for post-hoc analysis of significant Kruskal–Wallis associations (p < 0.05). Contingency tables and Fisher’s Exact tests were for presence/absence of specific symptoms, and odds ratios (OR) were calculated directly from contingency tables with 95% confidence intervals (CI) calculated using the Wald method. To descriptively explore potential clusters of respondents, which could ultimately inform development of tailored support and outreach strategies, factor analysis of mixed data (FAMD) and hierarchical cluster analysis on principal components (HCPC) were used. These were implemented using the FactoMineR and factoextra packages in R. Only fully complete responses can be used for FAMD-HCPC, so 45 observations were available for the cluster analysis. The FAMD was conducted using 27 variables. Eigenvalues and a scree plot were examined to explore the total variance explained by each additional principal component dimension. Elbows were identified after 3, 5, and 8 principal dimensions, and HCPC was conducted using each number of dimensions, respectively. HCPC was performed using Euclidian distance, Ward’s agglomerative method, and consolidation using k-means clustering with a maximum of 10 iterations. Three dimensions were chosen for the final HCPC analysis after assessing cluster stability and interpretability. Five and eight dimensions resulted in many small clusters which prevented meaningful interpretation; further details on cluster stability are available through Sankey/Alluvial plots and Adjusted Rand Index Values in Supplementary File 2. Significant describing variables as identified through the HCPC analysis were used to examine and describe each cluster.

Subject of Research: Cross-sectional assessment of anxiety and insomnia of Spanish veterinarians following African swine fever wild boar detection in Spain

Article Title: Cross-sectional assessment of anxiety and insomnia of Spanish veterinarians following African swine fever wild boar detection in Spain

Article References: Schambow, R. A., Guerra, P., Aviles, M. M., Iglesias, I., Yagüe, A. P., Higuera, M. A., Perez, A. D., & Perez, A. M. (2026). Cross-sectional assessment of anxiety and insomnia of Spanish veterinarians following African swine fever wild boar detection in Spain. Frontiers in Veterinary Science, 13, Article 1961344. https://doi.org/10.3389/fvets.2026.1961344

Image Credits: AI Generated

DOI: 10.3389/fvets.2026.1961344

Keywords: African swine fever, veterinarians, mental health, anxiety, insomnia, Spain, occupational health, Cross-sectional, assessment, Spanish, following, African