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Volume 9, Issue 6, November 2020, Page: 123-131
Prevalence and Factors Associated with Depression and Anxiety Among Health Care Personnel in the United States During Coronavirus Disease 2019 (COVID-19) Pandemic
Mandeep Singh, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
Khaled Mohamed Nada, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
Mirza Baig, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
Salik Malik, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
En-Shuo Hsu, Office of Biostatistics, University of Texas Medical Branch, Galveston, United States of America
Justin Seashore, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
Shawn Pua Nishi, Department of Internal Medicine, University of Texas Medical Branch, Galveston, United States of America
Received: Oct. 9, 2020;       Accepted: Oct. 24, 2020;       Published: Nov. 4, 2020
DOI: 10.11648/j.cmr.20200906.11      View  41      Downloads  72
Abstract
Introduction: Healthcare personnel (HCP) are at risk of psychological and emotional distress during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the prevalence and explore the factors associated with depression and anxiety among HCP taking care of patients with COVID-19 in the United States (US). Methods: The study is cross-sectional, anonymous, web-based survey of HCP distributed in the US via email and social media between April 14, 2020 and May 5, 2020. Participants were stratified based on their occupation (i.e., registered nurses, other first responders, physicians, respiratory therapists, and nurse practitioners or physician assistants) and specialty. Practice settings were stratified based on hospital type (academic or community-based) and location. Study outcomes were prevalence and factors associated with depression and anxiety using the 9-item Patient Health Questionnaire (PHQ-9; range: 0-27) and the 7-item Generalized Anxiety Disorder (GAD 7; range 0-21) questionnaires, respectively. Results: In all, 1426 HCP submitted surveys, predominantly females (81%), aged 31-40 years, and non-Hispanic white (78%). Overall, the prevalence of depression and anxiety was 57.4% and 56.7%, respectively. Factors associated with depression were HCP with COVID-19 risk factors (odds ratio [OR] = 1.46; 95% confidence interval [CI] = 1.1–1.94; P = .009), exposure (OR = 1.87; 95% CI = 1.44–2.44; P = <.001), and being uncomfortable with hospital infection control policies (OR = 1.87; 95% CI = 1.28–2.71; P = .001). Similarly, factors associated with anxiety included HCP with COVID-19 risk factors (OR = 1.36; CI = 1.03–1.81; P = .03), COVID-19 exposure (OR = 1.43; 95% CI = 1.09–1.86; P = .01), and not being comfortable with the healthcare facility infection control policies (OR = 1.66; 95% CI = 1.14–2.41; P = .008). Conclusion and Relevance: The majority of HCP surveyed had a high burden of depression and anxiety early in the COVID-19 pandemic in the US. Organizations and institutions will need to develop preventive and management strategies to optimize and sustain the mental health of HCP, particularly under pandemic conditions.
Keywords
Coronavirus, COVID-19, Pandemic, Health Care Personnel, Depression, Anxiety
To cite this article
Mandeep Singh, Khaled Mohamed Nada, Mirza Baig, Salik Malik, En-Shuo Hsu, Justin Seashore, Shawn Pua Nishi, Prevalence and Factors Associated with Depression and Anxiety Among Health Care Personnel in the United States During Coronavirus Disease 2019 (COVID-19) Pandemic, Clinical Medicine Research. Vol. 9, No. 6, 2020, pp. 123-131. doi: 10.11648/j.cmr.20200906.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic [published online Mar 19, 2020]. Acta Biomed. 2020; 91 (1): 157-160. doi: 10.23750/abm.v91i1.9397.
[2]
European Centre for Disease Prevention and Control. COVID-19 situation update worldwide, as of 18 August 2020. Published August 18, 2020. Accessed August 18, 2020. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases
[3]
Centers for Disease Control and Prevention. Cases in the U.S. Updated August 17, 2020. Accessed August 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
[4]
Kaiser Family Foundation. Total Health Care Employment. Published May 2018. Accessed August 10, 2020. https://www.kff.org/other/state-indicator/total-health-care-employment.
[5]
National Academies of Sciences, Engineering, and Medicine. 2019. Taking action against clinician burnout: A systems approach to professional well-being. Washington, DC: The National Academies Press. doi: 10.17226/25521.
[6]
Maunder R, Hunter J, Vincent L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003; 168 (10): 1245-1251.
[7]
Lee AM, Wong JG, McAlonan GM, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007; 52 (4): 233-240. doi: 10.1177/070674370705200405.
[8]
Bai Y, Lin CC, Lin CY, Chen JY, Chue CM, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatry Serv. 2004; 55 (9): 1055-1057. doi: 10.1176/appi.ps.55.9.1055.
[9]
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16 (9): 606-613. doi: 10.1046/j.1525-1497.2001.016009606.x.
[10]
Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007; 146 (5): 317-325. doi: 10.7326/0003-4819-146-5-200703060-00004.
[11]
Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020; 3 (3): e203976. doi: 10.1001/jamanetworkopen.2020.3976.
[12]
Kang L, Ma S, Chen M, et al. 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 Behav Immun. 2020; 87: 11-17. doi: 10.1016/j.bbi.2020.03.028.
[13]
Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020; 26: e923549. doi: 10.12659/MSM.923549.
[14]
Cai H, Tu B, Ma J, et al. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID19) in Hubei, China. Med Sci Monit. 2020; 26: e924171. doi: 10.12659/MSM.924171.
[15]
Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020. doi: 10.1016/j.bbi.2020.05.026.
[16]
Lin K, Yang BX, Luo D, et al. The Mental Health Effects of COVID-19 on Health Care Providers in China. Am J Psychiatry. 2020; 177 (7): 635-636. doi: 10.1176/appi.ajp.2020.20040374.
[17]
Dong ZQ, Ma J, Hao YN, et al. The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study. Eur Psychiatry. 2020; 63 (1): e65. doi: 10.1192/j.eurpsy.2020.59.
[18]
Tu ZH, He JW, Zhou N. Sleep quality and mood symptoms in conscripted frontline nurse in Wuhan, China during COVID-19 outbreak: A cross-sectional study. Medicine (Baltimore). 2020; 99 (26): e20769. doi: 10.1097/MD.0000000000020769.
[19]
Xing J, Sun N, Xu J, Geng S, Li Y. Study of the mental health status of medical personnel dealing with new coronavirus pneumonia. PLoS One. 2020; 15 (5): e0233145. doi: 10.1371/journal.pone.0233145.
[20]
Rossi R, Socci V, Pacitti F, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Netw Open. 2020; 3 (5): e2010185. doi: 10.1001/jamanetworkopen.2020.10185.
[21]
Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020. doi: 10.1001/jama.2020.6775.
[22]
Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020; 369: m1966. doi: 10.1136/bmj.m1966.
[23]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020; 395 (10229): 1054-1062. doi: 10.1016/S0140-6736(20)30566-3.
[24]
Centers for Disease Control and Prevention. Information for Healthcare Professionals about Coronavirus (COVID-19). Updated August 16, 2020. Accessed August 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html
[25]
Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. 2020. doi: 10.1001/jama.2020.3972.
[26]
Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China [published online ahead of print, 2020 Mar 17]. Clin Infect Dis. 2020; ciaa 287. doi: 10.1093/cid/ciaa287.
[27]
Centers for Disease Control and Prevention. Information for Healthcare Professionals about Coronavirus (COVID-19). Published July 22, 2020. Accessed August 10, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html.
[28]
Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020. doi: 10.1001/jama.2020.5893.
[29]
Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, Deitchman SD. Guideline for Infection Control in Healthcare Personnel, 1998. Infection Control & Hospital Epidemiology. 1998; 19 (6): 407-463. doi: 10.2307/30142429.
[30]
Centers for Disease Control and Prevention. Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic. Published May 5, 2020. Accessed August 10, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/mental-health-healthcare.html
[31]
Shanafelt T, Ripp J, Brown M, Sinsky C. Caring for the Health Care Workforce During Crisis. American Medical Association. 2020.
[32]
Managing Healthcare Workers' Stress Associated with the COVID-19 Virus Outbreak. National Center for PTSD. Published March 9, 2020. Accessed July 22, 2020. https://www.ptsd.va.gov/covid/COVID_healthcare_workers.asp
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