Abstract
IntroductionDuring the COVID-19 pandemic, healthcare workers in Italy have been exposed to an unprecedented pressure and traumatic events. However, no direct comparison with the general population is available so far. The aim of this study is to detail mental health outcomes in healthcare workers compared to the general population.Methods24050 respondents completed an on-line questionnaire during the contagion peak, 21342 general population, 1295 second-line healthcare workers, and 1411 front-line healthcare workers. Depressive, anxious, post-traumatic symptoms and insomnia were assessed. Specific COVID-19 related potential risk factors were also considered in healthcare workers.ResultsDepressive symptoms were more frequent in the general population (28.12%) and front-line healthcare workers (28.35%) compared to the second-line healthcare workers (19.98%) groups. Anxiety symptoms showed a prevalence of 21.25% in the general population, 18.05% for second-line healthcare workers, and 20.55% for front-line healthcare workers. Insomnia showed a prevalence of 7.82, 6.58, and 9.92% for the general population, second-line healthcare workers, and front-line healthcare workers, respectively. Compared to the general population, front-line healthcare workers had higher odds of endorsing total trauma-related symptoms. Both second-line healthcare workers and front-line healthcare workers had higher odds of endorsing core post-traumatic symptoms compared to the general population, while second-line healthcare workers had lower odds of endorsing negative affect and dissociative symptoms. Higher total traumatic symptom score was associated with being a front-line healthcare worker, having a colleague infected, hospitalized, or deceased, being a nurse, female gender, and younger age.ConclusionThis study suggests a significant psychological impact of the COVID-19 pandemic on the Italian general population and healthcare workers. Front-line healthcare workers represent a specific at-risk population for post-traumatic symptoms. These findings underline the importance of monitoring and intervention strategies.
Highlights
During the COVID-19 pandemic, healthcare workers in Italy have been exposed to an unprecedented pressure and traumatic events
We reported preliminary data on the very immediate burden of the COVID-19 outbreak on mental health on 1300 Italian healthcare workers (HCW), finding that frontline young women, regardless of the working position (i.e., nurse, physician, healthcare assistant (HCA), etc.), had higher odds of several mental health outcomes, including PTSD symptoms, anxiety, depression and insomnia (Rossi et al, 2020a)
Geographical distribution showed a higher abundance of front-line healthcare workers (FHCW) in the northern regions compared to central and southern Italy (χ24 = 364.543, p < 0.001)
Summary
During the COVID-19 pandemic, healthcare workers in Italy have been exposed to an unprecedented pressure and traumatic events. The aim of this study is to detail mental health outcomes in healthcare workers compared to the general population. Despite evidence of a relevant impact of the lockdown measures on mental health in the general population (GP) (Rossi et al, 2020b), healthcare workers (HCW) were exposed to a number of additional stressful events while working under extreme pressure with COVID19 patients, and represent a highly at-risk population (Rossi et al, 2020a). In the very early stages of the pandemic, the Italian national healthcare service and its regional articulations were subject to a never seen before pressure, with most intensive care units (ICU) running short of beds in a few days. Lack of preparation for such a pandemic resulted in lack of security protocols and protection devices for HCW, which resulted in a tremendously high number of infected and deceased personnel.
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