Anxiety and depression among healthcare workers during COVID‑19 pandemic; a call for immediate action
Anxiety and depression among healthcare workers
Keywords:
Anxiety, depression, COVID-19, healthcare workers
Abstract
Objectives: Healthcare workers (HCWs) are among the many groups of vulnerable people who work in direct contact with the patients infected with the Coronavirus disease. This study aimed to assess the prevalence of depression, anxiety, and the associated risk factors among HCWs during the ongoing pandemic of Coronavirus-19 (COVID-19).
Materials and methods: This was a web-based cross-sectional study conducted among the HCWs. A semi-structured proforma was used to assess demographic variables, and the Hospital Anxiety and Depression Scale for anxiety and depression. Chi-square tests and logistic regression models were performed to explore the risk factors for anxiety or depression.
Results: A total of 107 responses were received. The participants had a mean age of 39.42±10.89 years. 51.4% of respondents were males and 42.1% belonged to staff nurses. The mean anxiety and depressive scores were 8.02±2.02 and 9.10±2.88 respectively. The proportion of HCWs with symptoms of anxiety and depression were 35.51% and 17.76%, respectively. The prevalence of depression was higher in the females than in the males (χ2 = 11.73, p =0.001); furthermore, the prevalence of anxiety (χ2 = 8.914, p =0.063) and depression (χ2 = 9.74, p =0.045) was higher in nurses compared with other occupations. Also, knowledge of relatives dying to COVID-19 and years of experience were the significant predictors of anxiety/depressive symptoms in HCWs.
Conclusions and Relevance
This survey of HCWs in hospitals equipped with COVID-19 clinics or wards reported experiencing anxiety and depression, especially among nurses, women, and those having fewer years of experience.
Clinical Significance: HCWs require psychiatric support for immediate and long-term mental health consequences of working in COVID-19 treatment settings.
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References
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35. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, Wan SW, Liu Z, Shen Q, Yang J, He HG. Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study. EClinicalMedicine. 2020 Jul 1;24:100424.
36. Xiong H, Yi S, Lin Y. The psychological status and self-efficacy of nurses during COVID-19 outbreak: a cross-sectional survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2020 Sep;57:0046958020957114.
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40. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychology, health & medicine. 2021 Jan 2;26(1):13-22.
41. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020 Mar 2;3(3):e203976-.
42. de Pablo GS, Serrano JV, Catalan A, Arango C, Moreno C, Ferre F, Shin JI, Sullivan S, Brondino N, Solmi M, Fusar-Poli P. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. Journal of affective disorders. 2020 Jun 25.
43. Serrano-Ripoll MJ, Meneses-Echavez JF, Ricci-Cabello I, Fraile-Navarro D, Fiol-deRoque MA, Pastor-Moreno G, Castro A, Ruiz-Pérez I, Campos RZ, Gonçalves-Bradley DC. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. Journal of affective disorders. 2020 Dec 1;277:347-57.
2. World Health Organization. Novel coronavirus—China. 2020. https://www.who. Int/csr/don/12-january-2020-novel-coronavirus-china/en/.(last accessed on 24/3/21)
3. Al-Mandhari A, Samhouri D, Abubakar A, Brennan R. Coronavirus Disease 2019 outbreak: preparedness and readiness of countries in the Eastern Mediterranean Region. Eastern Mediterranean health journal= La revue de sante de la Mediterranee orientale= al-Majallah al-sihhiyah li-sharq al-mutawassit. 2020 Feb 1; 26(2).
4. World Health Organization. Laboratory testing of human suspected cases of novel coronavirus ( nCoV) infection: interim guidance, 10 January 2020. World Health Organization; 2020.
5. Majidi H, Bani-Mostafavi ES, Mardanshahi Z, Godazandeh F, Ghasemian R, Heydari K, Alizadeh-Navaei R. High-resolution computed tomography finding in 552 patients with symptomatic COVID-19: first report from north of Iran. Emergency radiology. 2020 Dec;27(6):633-9.
6. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, Wang Y, Hu J, Lai J, Ma X, Chen J. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry. 2020 Mar.
7. Zarghami M, Taghizadeh F, Sharifpour A, Alipour A. Efficacy of guided self-change for smoking cessation in chronic obstructive pulmonary disease patients: A randomized controlled clinical trial. Tobacco induced diseases. 2019; 17.
8. Liao YT, Hsieh MH, Yang YH, Wang YC, Tsai CS, Chen VC, Gossop M. Association between depression and enterovirus infection: A nationwide population-based cohort study. Medicine. 2017 Feb; 96(5).
9. Wu Y, Sang ZQ, Zhang XC, Margraf J. The relationship between resilience and mental health in Chinese college students: a longitudinal cross-lagged analysis. Frontiers in psychology. 2020 Feb 5; 11:108.
10. Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, Yao L, Bai H, Cai Z, Yang BX, Hu S. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain, behavior, and immunity. 2020 Jul 1; 87:11-7.
11. Koutsimani P, Montgomery A, Georganta K. The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in psychology. 2019 Mar 13;10:284.
12. Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC pregnancy and childbirth. 2017 Dec; 17(1):1-8.
13. Krystal JH, McNeil RL. Responding to the hidden pandemic for healthcare workers: stress. Nature medicine. 2020 May; 26(5):639-.
14. Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. bmj. 2020 May 5; 369.
15. Djukanovic I, Carlsson J, Årestedt K. Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65–80 years old? A psychometric evaluation study. Health and quality of life outcomes. 2017 Dec;15(1):1-0.
16. Rishi P, Rishi E, Maitray A, Agarwal A, Nair S, Gopalakrishnan S. Hospital anxiety and depression scale assessment of 100 patients before and after using low vision care: A prospective study in a tertiary eye-care setting. Indian journal of ophthalmology. 2017 Nov;65(11):1203.
17. Bah AJ, James PB, Bah N, Sesay AB, Sevalie S, Kanu JS. Prevalence of anxiety, depression and post-traumatic stress disorder among Ebola survivors in northern Sierra Leone: a cross-sectional study. BMC public health. 2020 Dec;20(1):1-3..
18. Luceño-Moreno L, Talavera-Velasco B, García-Albuerne Y, Martín-García J. Symptoms of posttraumatic stress, anxiety, depression, levels of resilience and burnout in Spanish health personnel during the COVID-19 pandemic. International journal of environmental research and public health. 2020 Jan;17(15):5514.
19. Waterman S, Hunter EC, Cole CL, Evans LJ, Greenberg N, Rubin GJ, Beck A. Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone. International Journal of Social Psychiatry. 2018 Mar;64(2):156-65.
20. Turon H, Carey M, Boyes A, Hobden B, Dilworth S, Sanson-Fisher R. Agreement between a single-item measure of anxiety and depression and the Hospital Anxiety and Depression Scale: A cross-sectional study. PloS one. 2019 Jan 4;14(1):e0210111.
21. Mack A, Choffnes ER, Hamburg MA, Relman DA, editors. Microbial evolution and co-adaptation: a tribute to the life and scientific legacies of Joshua Lederberg: workshop summary. National Academies Press; 2009 May 10.
22. Rosenbaum L. Facing Covid-19 in Italy—ethics, logistics, and therapeutics on the epidemic’s front line. New England Journal of Medicine. 2020 May 14; 382(20):1873-5.
23. Ng K, Poon BH, Kiat Puar TH, Shan Quah JL, Loh WJ, Wong YJ, Tan TY, Raghuram J. COVID-19 and the risk to health care workers: a case report. Annals of internal medicine. 2020 Jun 2;172(11):766-7.
24. Gupta S, Prasad AS, Dixit PK, Padmakumari P, Gupta S, Abhisheka K. Survey of prevalence of anxiety and depressive symptoms among 1124 healthcare workers during the coronavirus disease 2019 pandemic across India. Medical Journal Armed Forces India. 2020 Sep 1.
25. Aksoy YE, Koçak V. Psychological effects of nurses and midwives due to COVID-19 outbreak: The case of Turkey. Archives of psychiatric nursing. 2020 Oct 1;34(5):427-33.
26. Hong S, Ai M, Xu X, Wang W, Chen J, Zhang Q, Wang L, Kuang L. Immediate psychological impact on nurses working at 42 government-designated hospitals during COVID-19 outbreak in China: A cross-sectional study. Nursing outlook. 2021 Jan 1;69(1):6-12.
27. Zhu Z, Xu S, Wang H, Liu Z, Wu J, Li G, Miao J, Zhang C, Yang Y, Sun W, Zhu S. COVID-19 in Wuhan: Sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020 Jul 1;24:100443.
28. Krishnamoorthy, Y., Nagarajan, R., Saya, G.K., Menon, V., 2020. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res., 113382, 2020 August 11.
29. Wong TW, Yau JK, Chan CL, Kwong RS, Ho SM, Lau CC, Lau FL, Lit CH. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. European Journal of Emergency Medicine. 2005 Feb 1;12(1):13-8.
30. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. New England Journal of Medicine. 2020 Mar 19;382(12):1177-9.
31. Chan-Yeung M. Severe acute respiratory syndrome (SARS) and healthcare workers. International journal of occupational and environmental health. 2004 Oct 1;10(4):421-7.
32. Allan SM, Bealey R, Birch J, Cushing T, Parke S, Sergi G, Bloomfield M, Meiser-Stedman R. The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. European journal of psychotraumatology. 2020 Dec 31;11(1):1810903.
33. Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. Journal of occupational and environmental medicine. 2018 Mar 1;60(3):248-57.
34. Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, Di Pierro R, Madeddu F, Calati R. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Current psychiatry reports. 2020 Aug;22(8):1-22.
35. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, Wan SW, Liu Z, Shen Q, Yang J, He HG. Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study. EClinicalMedicine. 2020 Jul 1;24:100424.
36. Xiong H, Yi S, Lin Y. The psychological status and self-efficacy of nurses during COVID-19 outbreak: a cross-sectional survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2020 Sep;57:0046958020957114.
37. Hassannia L, Taghizadeh F, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, Fathi M, Alizadeh‐Navaei R, Hedayatizadeh‐Omran A, Dehghan N. Anxiety and Depression in Health Workers and General Population During COVID‐19 in IRAN: A Cross‐Sectional Study. Neuropsychopharmacology Reports. 2020 Jan 1.
38. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020 Mar 2;3(3):e203976-.
39. Padkapayeva K, Gilbert-Ouimet M, Bielecky A, Ibrahim S, Mustard C, Brisson C, Smith P. Gender/Sex differences in the relationship between psychosocial work exposures and work and life stress. Annals of work exposures and health. 2018 Apr 18;62(4):416-25.
40. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychology, health & medicine. 2021 Jan 2;26(1):13-22.
41. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020 Mar 2;3(3):e203976-.
42. de Pablo GS, Serrano JV, Catalan A, Arango C, Moreno C, Ferre F, Shin JI, Sullivan S, Brondino N, Solmi M, Fusar-Poli P. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. Journal of affective disorders. 2020 Jun 25.
43. Serrano-Ripoll MJ, Meneses-Echavez JF, Ricci-Cabello I, Fraile-Navarro D, Fiol-deRoque MA, Pastor-Moreno G, Castro A, Ruiz-Pérez I, Campos RZ, Gonçalves-Bradley DC. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. Journal of affective disorders. 2020 Dec 1;277:347-57.
Published
2021-07-01
How to Cite
1.
Dar S, Bhat BA, Shah NN, Hussain A, Dar MM, Wani ZA. Anxiety and depression among healthcare workers during COVID‑19 pandemic; a call for immediate action. jms [Internet]. 2021Jul.1 [cited 2026Oct.2];24(2):27-5. Available from: http://ano.jmsskims.org/index.php/jms/article/view/856
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