Mental Health Burden in Different Professions During the Final Stage of the COVID-19 Lockdown in China: Cross-sectional Survey Study (Preprint)

Abstract

BACKGROUND COVID-19 has resulted in considerable mental health burden in the Chinese general population and health care workers at the beginning and peak of the pandemic. However, little is known about potentially vulnerable groups during the final stage of the lockdown. OBJECTIVE The aim of this survey study was to assess the mental health burden of different professions in China in order to find vulnerable groups, possible influencing factors, and the successful ways of coping during the last four weeks of the lockdown in Hubei province. METHODS A cross-sectional online survey asked participants about current residence, daily working hours, exposure to COVID-19 at work and media preferences. We used Depression-Anxiety-Stress Scales (DASS-21) for the assessment of mental health. Further assessments included perceived stress (CPSS-14), coping strategies for all participants and specific stressors for health care workers. We follow the reporting guidelines of the STROBE statements for observational studies. RESULTS The sample (N=687) consisted of 158 doctors, 221 nurses, 24 other medical staff, 43 students, 60 teachers/government staff, 135 economy staff, 26 workers/farmers and 20 others. We found 17.9% cases of increased depression, 30.3% anxiety and 13.7% stress. Other medical staff and students were vulnerable to depression while doctors, nurses and students were vulnerable to anxiety. Other medical staff, students and economy staff were vulnerable to stress. Coping strategies were reduced to three factors: active, mental and emotional. Being female and emotional coping were independently associated with depression, anxiety or stress. Applying active coping strategies showed lower odds for anxiety while mental coping strategies showed lower odds for depression, anxiety and stress. Age, being inside a lockdown area, exposure to COVID-19 at work and having a high workload (8-12h per day) was not associated with any symptoms. WeChat was the preferred way of staying informed in all groups. CONCLUSIONS By the end of the lockdown a considerable part of the Chinese population showed increased levels of depression and anxiety. Students and other medical staff were the most affected, while economy staff were highly stressed. Doctors and nurses need support regarding potential anxiety disorders. Future work should focus on longitudinal results of the pandemic and develop targeted preventive measures. CLINICALTRIAL not applicable