Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Abstract

IMPORTANCE Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed. OBJECTIVE To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China. DESIGN, SETTINGS, AND PARTICIPANTS This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible. MAIN OUTCOMES AND MEASURESThe degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes. RESULTSA total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women

Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms

“…Depression, anxiety, and trauma-related symptoms have been associated with CoV outbreaks, but it remains unclear whether the risks are attributable to viral infections per se or the host immune response. Studies of healthcare workers during the SARS-CoV-1 epidemic, MERS-CoV outbreak, and the current SARS-CoV-2 pandemic suggest that the frequency and severity of psychiatric symptoms are associated with proximity to CoV-infected patients (Kang et al, 2020b; Neuropsychiatric sequelae of COVID-19 8 Lai et al, 2020;Lee et al, 2018;Lin et al, 2007). However, these studies did not test serology or immune markers in healthcare workers, and no studies have been performed comparing psychiatric outcomes in healthcare workers who contracted CoV during pandemics versus those who did not.…”

Les professionnels de santé face à la pandémie de la maladie à coronavirus (COVID-19) : quels risques pour leur santé mentale ?

“…Les troubles psychiques sont plus marqués chez les femmes jeunes que chez les hommes, et les infirmiers que chez les médecins (24,25). Ces données récentes sont toutefois contradictoires concernant les soignants de première et deuxième ligne.…”

“…Ces données récentes sont toutefois contradictoires concernant les soignants de première et deuxième ligne. Pour Li et al, les soignants travaillant en deuxième ligne, souffrent de plus de traumatismes par procuration (26), tandis que pour Lu et al (27), les soignants en contact direct avec les patients infectés (réanimation, pneumologie, urgences…) ont plus de symptômes d'anxiété et de dépression, voire de TSPT (24,25).…”

“…Au-delà des perturbations psychiques, le risque est l'émergence de troubles psychiatriques caractérisés chez les soignants impliqués dans la gestion de cette épidémie, notamment de l'épisode dépressif caractérisé (EDC ; 25 % des cas) (25). Les prodromes de l'EDC sont l'insomnie, l'anxiété et les états de stress (25).…”

“…Au-delà des perturbations psychiques, le risque est l'émergence de troubles psychiatriques caractérisés chez les soignants impliqués dans la gestion de cette épidémie, notamment de l'épisode dépressif caractérisé (EDC ; 25 % des cas) (25). Les prodromes de l'EDC sont l'insomnie, l'anxiété et les états de stress (25). Considérant la prévalence élevée des troubles dépressifs chez les soignants en dehors de tout contexte épidémique (28), il est logique d'anticiper l'augmentation de l'incidence après la pandémie et des complications associées, comme les addictions et les conduites suicidaires (20).…”