Depression, Anxiety, and Stress Associated with Coronavirus Disease (COVID-19) Pandemic among Health-care Professionals in Lebanon and Iraq

Abstract

Background: Health-care workers during the COVID-19 outbreak are vulnerable to psychological distress due to increased workload, inadequate equipment, isolation, and risk of infection transmission. The objective of this study was to assess the psychological status of health-care professionals in Lebanon and Iraq during the period of COVID-19 outbreak. The primary outcome was the prevalence of depression, anxiety, and stress among the health-care workers. Methods: We carried out a cross-sectional study to assess the psychological well-being of health-care professionals in Lebanon and Iraq during the COVID-19 pandemic. Psychological health was assessed using the validated “Depression, Anxiety, and Stress Scale-21.” Results: A total of 518 health-care professionals were included, of which 287 (55.4%) were from Lebanon and 231 (44.6%) were from Iraq. Overall, 60.0%, 42.9%, and 43.4% of all participants reported depression, anxiety, and stress, respectively. Health-care workers from Iraq had more severe symptoms on all measurements compared to those from Lebanon. Psychological distress was associated with caring for elderly parents, going home after duty only 2–4 times/week, working overtime, and in the front line. The results present concerns about the psychological health of nurses and physicians. Those who did not use protective equipment were more distressed. Participants who had direct or indirect contact with COVID-19 cases and those who tested positive had significantly higher depression, anxiety, and stress. Conclusions: This survey on health-care workers reported high rates of depression, anxiety, and stress during the COVID-19 pandemic. Protecting health-care professionals is a major public health measure for addressing COVID-19 outbreak.