Monday, March 23, 2020

Survey Finds COVID-19 Takes Heavy Psychological Toll on Health Care Workers

As communities across the world continue to grapple with containing the spread of the novel coronavirus (COVID-19) and deal with the quickly proliferating number of cases, a study out of China reports troubling information on the psychological ramifications of COVID-19 on health care workers: A survey of more than 1,200 nurses and physicians working in hospitals in the Wuhan region (where the outbreak originated) and across mainland China revealed that more than 50% reported symptoms of depression, and more than 70% reported symptoms of psychological distress. The findings were published today in JAMA Network Open.

“Protecting health care workers is an important component of public health measures for addressing the COVID-19 epidemic. Special interventions to promote mental well-being in health care workers exposed to COVID-19 need to be immediately implemented, with women, nurses, and frontline workers requiring particular attention,” wrote Jianbo Lai, M.Sc., of Renmin Hospital of Wuhan University in China and colleagues.

The researchers surveyed health care workers from 34 hospitals in China with fever clinics or wards for COVID-19 between January 29, 2020, and February 3, 2020. (During this period, the total confirmed cases of COVID-19 exceeded 10,000 in China, according to the authors.) The researchers assessed the survey respondents’ depression, anxiety, insomnia, and distress using the Chinese versions of the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, the Insomnia Severity Index, and the Impact of Event Scale–Revised.

Of the 1,257 surveyed (493 physicians and 764 nurses), 634 (50.4%) reported depression symptoms, 560 (44.6%) reported anxiety, 427 (34.0%) reported insomnia, and 899 (71.5%) reported distress. Health care workers engaged in the direct diagnosis, treatment, and care of patients with COVID-19 were more likely to report symptoms of depression (odds ratio, 1.52), anxiety (odds ratio, 1.57), insomnia (odds ratio, 2.97), and distress (odds ratio, 1.60) compared with those not involved in the diagnosis, treatment, and care of patients with COVID-19.

“These findings, consistent with those observed in the 2003 severe acute respiratory system (SARS) epidemic, may help to guide strategies for responding to mental health sequelae of this and future epidemics,” wrote Roy Perlis, M.D., a professor of psychiatry at Harvard Medical School, in an accompanying commentary.

“While the peak of the COVID-19 epidemic remains to be seen, it will ultimately subside. The work of Lai et al. provides a reminder of the toll that will likely linger: the consequences of chronic stress, including major depression and anxiety disorders. … [J]ust as the world has joined efforts to manage COVID-19 infection, it will be critical not to neglect the mental health consequences of the fight against the epidemic.”

For related information, see “Coronavirus and Mental Health: Taking Care of Ourselves During Infectious Disease Outbreaks,” by Joshua Morganstein, M.D., chair of the APA Committee on Psychiatric Dimensions of Disasters.

(Image: iStock/Hispanolistic)

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