Mental health symptoms in a cohort of hospital healthcare workers following the first peak of the Covid-19 pandemic in the United Kingdom

Abstract

Background The Covid-19 pandemic is likely to lead to a significant increase in mental health disorders amongst healthcare workers (HCW). Aims We evaluated the prevalence of anxiety, depressive and post-traumatic stress disorder (PTSD) symptoms in a HCW population in the United Kingdom (UK), to identify subgroups most at risk. Methods An electronic survey was conducted between the 05/06/2020 and 31/07/2020 of all hospital HCW in the West Midlands, UK using clinically validated questionnaires: Patient Health Questionnaire-4 (PHQ-4) and the Impact of Event Scale-Revised (IES-R). Univariate analyses and adjusted logistic regression analyses were performed to estimate the strengths in associations. Results There were 2638 eligible participants who completed the survey (female: 79.5%, median age: 42 [IQR: 32-51] years). The prevalence rates of clinically significant symptoms of anxiety, depression and PTSD were 34.3%, 31.2% and 24.5% respectively. In adjusted analysis a history of mental health conditions was associated with clinically significant symptoms of anxiety (odds ratio 2.3 [95% CI 1.9-2.7]; p<0.001), depression (2.5 [2.1-3.0]; p<0.001) and PTSD (2.1 [1.7-2.5]; p<0.001). The availability of adequate personal protective equipment (PPE), wellbeing support and lower exposure to moral dilemmas at work demonstrated significant negative associations with former symptoms (p≤0.001). Conclusions We report a high prevalence of clinically significant symptoms of anxiety, depression and PTSD in hospital HCW following the initial Covid-19 pandemic peak in the UK. Those with a history of mental health conditions were most at risk. Adequate PPE availability, access to wellbeing support and reduced exposure to moral dilemmas may protect hospital HCW from mental health symptoms.

Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis

“…All studies were conducted between January 2020 and September 2020: eight in January, 36 in February, 13 in March, 13 in April, six in May, two in June, two in July and one in September. Twenty preprint studies [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ] were included in the analyses. All studies included in this meta-analysis were of cross sectional design.…”

“…Stress was estimated in 40 studies [ 18 , 20 , 25 , 27 , 29 , 33 , 35 , 36 , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] ]. The overall pooled point estimates of prevalence for stress varied between 10% and 84% ( Fig.…”

“…The pooled prevalence according to the month of data collected was as follows: February: 32% ( n = 14; 95% CI 25–41; I2 = 98), March: 45% (n = 6; 95% CI 37–53; I2 = 96) and April: 50% ( n = 13; 95% CI 35–66; I2 = 98). Seventeen studies [ 20 , 35 , 36 , 39 , 43 , 44 , 46 , 54 , [57] , [58] , [59] , [60] , [61] , [62] , [63] , 67 , 69 ] involving nurses who were working on the frontline showed stress prevalence at 46% (95% CI = 39–54; I 2 = 97), whereas 20 studies including mixed nurses working in the frontline and second line showed the stress prevalence was 42% (95% CI = 31–53, I 2 = 99). Thirteen studies that used the Perceived Stress Scale (PSS) showed a pooled prevalence of stress at 50% (95% CI = 41–59, I 2 = 98), whereas eight studies [ 35 , 45 , [54] , [55] , [56] , 63 , 64 , 67 ] using the Impact of Event Scale-Revised (IES-R) had a pooled prevalence of 50% (95% CI = 37–63, I 2 = 99).…”

“…The overall pooled point estimates of prevalence for anxiety varied between 8% and 91%, which was reported by 73 studies [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [28] , [29] , [30] , 32 , 34 , 35 , [37] , [38] , [39] , [42] , [43] , [44] , [45] , [46] , 48 , 49 , 51 , [53] , [54] , [55] , [56] , [57] , 62 , [64] , [65] , [66] , [67] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] ,…”

Experiences of mental health professionals supporting front-line health and social care workers during COVID-19: qualitative study

“…The coronavirus disease 2019 (COVID-19) pandemic is having a well-documented impact on the mental health of front-line Health and Social Care Workers (HSCWs). 1,2 In anticipation, a national 'call for action' was made to the UK mental health community to urgently provide additional support for front-line workers' well-being. 3 The experiences, views and needs of the mental health professionals called upon to provide this support have, however, so far been overlooked, both in the UK and globally.…”