Depressive symptoms and their predictors among school-teachers in Southern Tunisia during the COVID-19 outbreak: A representative cross-sectional study

Abstract

IntroductionTeachers’ mental health could be affected as a result of significant changes imposed by the COVID-19 pandemic, including everyday responsibilities outside of their profession. In this context, we aimed to explore the prevalence of depressive symptoms (DS) among school teachers in Sfax, Southern Tunisia, and to investigate their main determinants. MethodsIt was a cross-sectional study involving public-school-teachers of all levels: primary, middle and high schools in Sfax Governorate, Southern Tunisia between March and April 2021 during the third wave of COVID-19 pandemic. The DS were evaluated using a French validated 20-item-version of the self-reported Depression Scale of the Centre for Epidemiologic Studies Depression Scale (CES-D). A cut-off point of 16 was recommended to define DS. ResultsOf the 525 teachers, 292 cases were females (55.6%), 256 teachers (48.8%) worked at high-schools and 478 cases were married (91%). The teachers’ median age was 48 years (Interquartile range (IQR) = [41–53] years). There were 245 teachers (46.7%) suffering from DS. In the multivariate analysis, female gender (Adjusted Odds Ratio (AOR) = 2.3; p < 0.001), history of chronic diseases (AOR = 2.5; p < 0.001) and having close contact with COVID-19 cases (AOR = 1.4; p = 0.04) were independently associated with depressive symptoms. Besides, university educational level (AOR = 0.56; p = 0.015), perceived workplace safety (AOR = 0.4; p < 0.001), consumption of coffee (AOR = 0.5; p = 0.006) and regular mask wearing in public spaces (AOR = 0.52; p = 0.048) were independently associated with lower prevalence of DS among teachers. In the multivariate analysis, female gender (Adjusted Odds Ratio (AOR) = 2.3; p < 0.001), history of chronic diseases (AOR = 2.5; p < 0.001) and having close contact with COVID-19 cases (AOR = 1.4; p = 0.04) were independently associated with depressive symptoms. Besides, university educational level (AOR = 0.56; p = 0.015), perceived workplace safety (AOR = 0.4; p < 0.001), consumption of coffee (AOR = 0.5; p = 0.006) and regular mask wearing in public spaces (AOR = 0.52; p = 0.048) were independently associated with lower prevalence of DS among teachers. ConclusionPersonal, occupational and pandemic-related factors were found to be associated with higher risk of DS among teachers. Therefore, promoting awareness through offering psychological assistance and educational sessions about screening of mental health disorders among teachers is crucial for early detection and management.