Abstract
The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline health workers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started. During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during, and after an epidemic wave of infections, in order to enable coping during successive sanitary crises.
Highlights
Stress can be considered as an expression of alarm towards stimuli arising from the environment or from internal cues that are interpreted as a disruption of homeostasis, including physiological and behavioral responses [1,2]
Compared to participants included in the study at the beginning of the pandemic, participants included in the study at the second epidemic wave reported more symptoms of depression and bad quality of sleep, with a higher frequency of acute stress reaction during the second epidemic wave
These results are consistent with a repeated cross-sectional study of the mental health status of intensivists at the first two epidemic waves in Italy that showed increased anxiety and bad sleep during the first wave, while compassion fatigue and depression increased at the second wave [41]
Summary
Stress can be considered as an expression of alarm towards stimuli arising from the environment or from internal cues that are interpreted as a disruption of homeostasis, including physiological and behavioral responses [1,2]. Several brain areas participate in modulating stress responses through the sympathetic nervous system, and the.
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