Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

Andhavarapu, Sanketh; Yardi, Isha; Bzhilyanskaya, Vera; Lurie, Tucker; Bhinder, Mujtaba; Patel, Priya; Pourmand, Ali; Tran, Quincy

doi:10.1016/j.psychres.2022.114890

Cited by 41 publications

(32 citation statements)

References 167 publications

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“…Data are susceptible to selection bias as they were collected through an online survey that was conducted during the early stage of the pandemic from a single Arab country. Changes in the rates of PTSD symptoms across different waves of the pandemic have been reported e.g., PTSD rates in HCWs slightly increased following the appearance of new viral variants [12] while slight reductions in PTSD rates were reported following COVID-19 vaccinations. Therefore, PTSD reported in this study may not reflect COVID-19 trauma during the pandemic, which has been ongoing for more than three years.…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic has been extensively described as a collective trauma, which has been associated with a global increase in PTSD symptoms in different population groups [3,7,[12][13][14][15]. Variations in PTSD symptom clusters have been revealed by different robust statistical methods [15,18,29,36], and they have been integrated in the most recent versions of the DSM [3,16].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, terrorizing images of the outbreak and fake information communicated by mass/social media have accelerated fear levels regarding the effects of the pandemic on home finance and availability of food and essential supplies; they also heightened psychological distress and intensified traumatic emotions in the general public [2,10,11]. In this respect, many studies report higher occurrence of psychological trauma in COVID-19 survivors [3], healthcare workers [12], older adults (with psychiatric disorders) [13], adolescents and young adults [14,15], and even children [7].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

Ali¹,

Al-Dossary²,

Almarwani³

et al. 2023

Preprint

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The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

Ali¹,

Al-Dossary²,

Almarwani³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Since the eruption of the COVID-19 outbreak in 2019, more than two million people catastrophically died because of severe pneumonia while greater numbers of COVID-19 survivors are struggling with long-term physical and mental complications of this vigorous infection [ 17 , 48 ]. Because of the offensive effects of this serious, wide-spreading disease, the literature has extensively described the COVID-19 pandemic as a collective trauma, which has been associated with a global increase in PTSD symptoms in different population groups [ 3 , 7 , 12 , 13 , 14 , 15 ]. Methodological flaws in studies on COVID-19-related trauma have been spotted, such as the use of improper/outdated measures, cross-sectional design, and self-report methods of data collection [ 41 , 42 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, horrifying images of the pandemic and false/fake information frequently circulated in mass/social media have accelerated worries concerning the effects of COVID-19 on home finance and the availability of food and essential supplies; they also heightened psychological distress and to some extent intensified negative emotions/exaggerated fear responses to the pandemic in the general public [ 2 , 10 , 11 ]. In this respect, many studies report higher occurrences of psychological trauma in COVID-19 survivors [ 3 ], healthcare workers [ 12 ], older adults (with psychiatric disorders) [ 13 ], adolescents and young adults [ 14 , 15 ], and even children [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event

et al. 2023

View full text Add to dashboard Cite

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80–0.92 & 0.87 to 0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.

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Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

Carmassi,

Sampogna,

Di Vincenzo

et al. 2023

Brain and Behavior

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BackgroundThe coronavirus disease of 2019 (COVID‐19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well‐being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID‐19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID‐19‐related acute stress disorder (ASD) symptoms.MethodsThe present cross‐sectional study is based on an online survey carried out in the period March–May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms.ResultsThe final sample consisted of 20,720 participants. During the lockdown, subjects with pre‐existing mental health problems reported a statistically significant higher risk of acute post‐traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04–3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02–0.72; p < .05). According to multivariate regression models, the levels of acute post‐traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08–3.57).ConclusionsConcerns about the risk of infection as well as social isolation caused a higher incidence of acute post‐traumatic stress symptoms that may predict the subsequent development of post‐traumatic stress disorder symptoms in the long term.

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Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

Cited by 41 publications

References 167 publications

The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event

Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

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