Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

Letter to the editor. Healthcare workers on the edge of sanity due to COVID-19: Rapid review of the results of systematic reviews and meta-analyzes

Prevalence of Depression, Anxiety, and Insomnia Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

This study assessed the prevalence, diagnosis, and treatment of major depressive disorder and generalized anxiety disorder among New York City adults. As part of the first community-specific Health and Nutrition Examination Survey in the United States, depression and anxiety were assessed in a representative sample of 1,817 noninstitutionalized adults in 2004. A total of 8% had major depressive disorder and 4% had generalized anxiety disorder. Respondents with depression were more likely to be formerly married, publicly insured, younger, and U.S. born. Only 55% of adults with depression were diagnosed, and 38% of those with depression or anxiety were in treatment; individuals with a diagnosis of depression were more likely to receive treatment than those without a diagnosis (61% versus 7%; p<.001). Immigrants with depression were 60% less likely to be diagnosed than their U.S.-born counterparts; immigrants arriving in this country ten or more years ago had slightly more anxiety than immigrants arriving less than ten years ago (3% versus 2%, not significant). Among respondents with anxiety, 23% reported disability compared with 15% of those with depression. Compared with adults with neither diagnosis, adults with depression or anxiety were twice as likely to smoke tobacco (p<.05), adults with depression were twice as likely to have diabetes (p<.01), and those with anxiety were twice as likely to have asthma (p<.01). Mental disorders are often disabling and inadequately diagnosed and treated. Foreign-born adults experience barriers to diagnosis and treatment despite having less depression; anxiety may increase with time since immigration. Increased awareness of and linkage to mental health services are needed, especially in larger, more diverse urban communities.

Chronic kidney disease (CKD) is an emerging health problem in both developed and developing countries. Depression, anxiety and sleep disturbances are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patients' health. Assessment of key components of mental health early in disease course will help to identify high risk subjects in whom modifying these predictors will help in providing active and healthy life in CKD patients. We did a cross sectional study in 200 patients of CKD stage III to V-D fulfilling the eligibility criteria who were on follow up in a single tertiary care center in the state of Haryana, India. We assessed the prevalence of anxiety, depression and insomnia and their correlation with demographic variables in these patients. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the HADS and PSQI questionnaire. Factors associated with anxiety, depression and insomnia were examined by a multiple logistic regression analysis. The prevalence of anxiety, depression and insomnia were found to be 71%, 69% and 86.5% respectively. As the CKD stage advanced, the prevalence as well as severity of these parameters increased. Anxiety, depression and sleep quality were found to be significantly correlated to unemployment, low income, low education, urban residence and presence of co-morbidities. The anxiety, depression and insomnia scores were found to have a strong negative correlation with eGFR, hemoglobin, serum calcium (p <0.01) and a positive correlation with TLC, blood urea, serum creatinine and serum phosphate (p <0.05). We observed a high prevalence of anxiety, depression and insomnia in CKD patients. There is a need to develop strategies to accurately identify "high risk" subjects who may benefit from preventive measures before complications occur. By identifying CKD patients with high risk of developing these mental health related issues, healthcare provider may be better able to ensure the provision of appropriate rehabilitation to this population.

Background: COVID-19 pandemic and lockdown have the potential to influence the mental health of the frontline healthcare workers (HCWs), working in the time of crisis. Hence, it is essential to monitor the anxiety, sleep, along with the other mental health concerns to realize the interceding risk factors as well as to inform tailored interventions. This study therefore aims to detect the psychological impact of COVID-19 experienced by the healthcare professionals during the COVID-19 pandemic working in the Ministry of Health and Prevention (MOHAP) facilities.Methods: A descriptive cross-sectional study was carried out between 25 October 2020 to 30 September 2021 by recruiting 404 healthcare providers currently working in different hospitals of the MOHAP.Results: Of 404 healthcare workers, 76.7% were females and 23.3% were males. About 35.6% were aged 36-45 years. The majority of the participants were non-locals (84.4), 23.5% were doctors/physicians, and 58.7% were nurses, 7.7% were pharmacist, remaining were other healthcare providers. Overall, 10.6% and 3.2% of all healthcare workers reported severe symptoms of anxiety, and insomnia respectively. Only age, gender, qualification, worried about being infected with COVID-19 and likelihood of being infected from COVID-19 showed statistically significant results (p&lt;0.05).Conclusions: The pandemic with respect to the COVID-19 tends to have a noteworthy impact on the mental health of healthcare workers. This evidence indicates that substantial proportion of healthcare workers may experience sleep disturbances and anxiety during the outbreak suggesting a necessity to indicating traditions of mitigating the risks of mental health and regulate interventions under pandemic situations.

Since the pandemic of the novel 2019 coronavirus disease (COVID-19), in addition to the harm caused by the disease itself, the psychological damage caused to the public by the pandemic is also a serious problem. The aim of our study was to summarize the systematic reviews/meta-analyses (SRs/MAs) of the prevalence of anxiety, depression and insomnia in different populations during the COVID-19 pandemic and to qualitatively evaluate these SRs/MAs. We searched the Cochrane Library, PubMed and Web of Science to obtain SRs/MAs related to anxiety, depression, and insomnia in different populations during the COVID-19 pandemic. The main populations we studied were healthcare workers (HCWs), college students (CSs), COVID-19 patients (CPs), and the general populations (GPs). A subgroup analysis was performed of the prevalence of psychological disorders. A total of 42 SRs/MAs (8,200,330 participants) were included in calculating and assessing the prevalence of anxiety, depression, and insomnia in these populations. The results of subgroup analysis showed that the prevalence of anxiety in different populations were: HCWs (20-44%), CSs (24-41%), CPs (15-47%), and GPs (22-38%). The prevalence of depression were: HCWs (22-38%), CSs (22-52%), CPs (38-45%), and GPs (16-35%), statistically significant differences between subgroups (p < 0.05). The prevalence of insomnia were: HCWs (28-45%), CSs (27-33%), CPs (34-48%), and GPs (28-35%), statistically significant differences between subgroups (p < 0.05). The comparison revealed a higher prevalence of psychological disorders in the CP group, with insomnia being the most pronounced. The methodological quality of the included SRs/MAs was then evaluated using AMSTAR 2 tool. The results of the methodological quality evaluation showed that 13 SRs/MAs were rated "medium," 13 were rated "low," and 16 were rated "very low." Through the subgroup analysis and evaluation of methodological quality, we found a higher prevalence of insomnia than anxiety and depression among the psychological disorders occurring in different populations during the pandemic, but the sample size on insomnia is small and more high-quality studies are needed to complement our findings.

Introductionthe COVID-19 pandemic had a devastating impact on society, with healthcare workers (HCWs) on the frontline bearing the brunt. As such, HCWs directly involved in the diagnosis, treatment, and care of patients with COVID-19 were at risk of developing psychological distress and other mental health symptoms. The overall aim of this study was to assess mental health symptoms among HCWs treating patients exposed to COVID-19 in Gauteng, South Africa. This research was critically important to determine the physiological burden on HCWs in response to the pandemic, so that mental health responses to the pandemic by HCWs, and psychosocial support structures in place for HCWs in South Africa can be considered.Methodsa cross-sectional study was conducted among frontline HCWs in the Inner City and Johannesburg South region (region F) of Gauteng, South Africa. Data was collected through both an online and an in-person approach. All participants completed a questionnaire enquiring about their socio-demographic characteristics and mental health symptoms. The presence and severity of symptoms of depression, anxiety, and insomnia of HCWs exposed to COVID-19 were assessed using the patient health questionnaire-9 (PHQ-9), the generalised anxiety disorder-7 (GAD-7), and the insomnia severity index-7 (ISI-7). Data analysis was performed using SPSS version 26.0 statistical software.Resultsa total of 234 out of 260 contacted individuals completed the survey. The majority of the participants were female (n=190, 81.2%), aged between 36 and 45 years (n=79, 33.8%), were unmarried (n=105,44.9%), and had a tertiary education (n=217, 92.7%). The majority of the participants worked in the public sector (151, 64.5%), while the minority (n=83, 35.5%) worked in the private sector. A considerable proportion of HCWs reported symptoms of depression (n=102, 43.6%), anxiety (n=105, 44.9%), and insomnia (n=70, 29.9%). It was found that there were no significant differences in symptoms of depression (X2=4.8, p>0.05), anxiety (X2=0.8, p>0.05), and insomnia (X2=2.1, p>0.05) between public and private sector HCWs. The results further showed that 49.1% of the participants indicated that psychological services did exist in their place of work, and 50.9% said they did not exist. Perceptions that psychological services existed were more common among HCWs in private healthcare facilities (66.3%) than among HCWs in public healthcare facilities (39.7%). Psychosocial support systems such as mental health counselling, support groups, psychological services, and employee assistance programmes were identified as some of the key services requested by HCWs.Conclusionthe prevalence of depression, anxiety, and insomnia was shown in HCWs in Gauteng, South Africa, and there were differences in perceptions of the psychosocial support systems that exist in the region between private and public sector HCWs. The results indicate that a considerable proportion of HCWs have depression, anxiety, or insomnia, with only half indicating the presence of workplace psycho-social support structures. Psycho-social support structures for HCWs need to be strengthened and made more visible.

Background: Medical professionals' psychological health has been significantly damaged by the COVID-19 pandemic, with nurses being a particularly susceptible group. The purpose of this study is to assess the prevalence of depression among healthcare professionals during the pandemic, investigate risk variables, and provide suitable supportive treatments. Objective: This research combines data from 11 studies involving 424 healthcare professionals, including doctors, nurses, and others. The prevalence of depression and associated variables in these professions during the COVID-19 outbreak are examined. Methods: Data were gathered from many study initiatives that covered the 2020 to 2023 time period. In these research, the Impact of Events Scale Revised (IES-R), the Patient Health Questionnaire (PHQ-9), and the Perceived Stress Scale (PSS-10) were used to assess post-traumatic stress, depression, and stress levels. The study looked into demographic variables, individuals' mental health backgrounds, and aspects connected to their jobs in the healthcare industry. Results: COVID-19 pandemic led to 19% severe depression symptoms in healthcare professionals, with females, younger workers, and nursing professionals more susceptible. Social support strongly influences the results of mental health. Conclusion: Medical staff's mental health has been severely impacted by the COVID-19 epidemic, with nurses experiencing increased levels of despair and anxiety. Gender disparities in mental health outcomes highlight the need for targeted support for female healthcare workers. Improving working conditions and strengthening social support networks are essential steps in addressing these mental health challenges. To fully understand the long-term consequences on the mental health of healthcare workers, taking into consideration cultural and socioeconomic factors, further longitudinal study is needed. Offering culturally sensitive mental health support is pivotal for the welfare of healthcare workers.

The COVID-19 pandemic has impacted the well-being of millions of people around the globe. The evidence has shown that during the COVID-19 pandemic, the mental health of the population was affected, which means that there is an extra demand to implement different actions to mitigate and treat mental health disorders result of the pandemic. According to the literature it was expected that the prevalence of mental health disorders, such as anxiety and depression increased by 25 per cent worldwide, and Colombia was not the exception. However, there is not clear evidence on how much this increase might be. This study aims to estimate the prevalence of anxiety and depression for female and male adolescents and adults in Colombia before and during the COVID-19 pandemic. It estimated the potential increase of the prevalence in each group as a result of the COVID-19 pandemic in 2020. We used the Individual Registry of Health Services Delivery data from 2015-2021 to estimate the observed prevalence of anxiety and depression in Colombia for female and male adults. In addition, using the National Mental Health Survey 2015, we simulated the prevalence of anxiety and depression for adolescents (12 to 17 years) and adults (18 or older) in 2015 and using a static Monte Carlo simulation process we estimated the expected prevalence of depression and anxiety for each group from 2016 to 2021. The results of the analysis using revealed an important increase in the observed prevalence of depression and anxiety for adults and adolescents and men and women between 2015 and February 2020. When we simulated different scenarios using as a base line the National Mental Health Survey and estimated the prevalence of depression and anxiety for female and male adults and adolescents, we found that the prevalence of depression and anxiety has had an important increase in the last five years for all groups and had an important increase during 2020. This increase was greater for women compared to men, and adolescents than adults. Our results show the number of people who need potential attention from the health system in Colombia and highlight the importance to think about how to avoid and detect potential cases of anxiety and depression especially in female adolescents.

BackgroundAs some countries announced to remove Coronavirus Disease 2019 (COVID-19) border, it indicates that the COVID-19 may have entered its terminal stage. In this COVID-19 pandemic, the mental health of frontline healthcare workers (HCWs) experienced unprecedented challenges. However, the impact of the COVID-19 pandemic on mental health among frontline HCWs lacks a high-quality and long-term systematic review and meta-analysis.MethodsWe conducted a systematic review and meta-analysis according to PRISMA guidelines. The system searches EMBASE, MEDLINE, PsycINFO, Cochrane Library, ScienceNet, and ERIC. Analyze the mental health problems of frontline HCWs in different regions and periods, including insomnia, stress, anxiety and depression. This study was registered in PROSPERO under the number CRD42021253821.ResultsA total of 19 studies on the effects of COVID-19 pandemic on mental health among frontline HCWs were included in this study. The overall prevalence of insomnia was 42.9% (95% CI, 33.9–51.9%, I2 = 99.0%) extracted from data from 14 cross-sectional studies (n = 10 127), 1 cohort study (n = 4,804), and 1 randomized controlled trial (RCT; n = 482) in 10 countries. The overall prevalence of stress was 53.0% (95% CI, 41.1–64.9%, I2 = 78.3%) extracted from data from nine cross-sectional studies (n = 5,494) and 1 RCT study (n = 482) from eight countries. The overall prevalence of anxiety and depression was 43.0% (95% CI, 33.8–52.3%, I2 = 99.0%) and 44.6% (95% CI, 36.1–53.1%, I2 = 99.0%) extracted from data from 17 cross-sectional studies (n = 11,727), one cohort study (n = 4,804), and one RCT study (n = 482) from 12 countries. The prevalence of stress and depression was higher in 2020, while the prevalence of insomnia and anxiety was higher in 2021. The prevalence of mental health problems among physicians was higher than that of other frontline HCWs. The prevalence of mental health problems among frontline HCWs is higher in South America and lower in North America.ConclusionsThis systematic review and meta-analysis showed that the COVID-19 pandemic have significant effects on mental health among frontline HCWs. The overall prevalence of insomnia, stress, anxiety and depression among frontline HCWs is high. Therefore, the health policy-makers should pay attention to and respond to the mental health problems of frontline HCWs in the context of public health emergencies.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/.

Citation:Li Y, Qin Q, Sun Q, Sanford LD, Vgontzas AN, Tang X. Insomnia and psychological reactions during the COVID-19 outbreak in China. J Clin Sleep Med. 2020;16(8):1417–1418.

Background:Since December 2019, countries experienced different numbers of COVID-19 pandemic waves. The COVID-19 pandemic led to adverse psychologic problems in the communities and among healthcare workers (HCWs), but the dynamic of these problems through different waves needs to be established more.Materials and Methods:This cross-sectional study was conducted in October 2020, through the third wave of the COVID-19 pandemic, in Isfahan, Iran. We studied HCWs’ depression, anxiety, and stress using Depression, Anxiety, Stress Scale-21 (DASS-21) and insomnia using Insomnia Severity Index (ISI) questionnaires. Multiple linear regression was used to evaluate the association of some characteristic factors with different psychologic symptoms.Results:Our results showed that about 80% of HCWs had one or more psychological problems. The prevalence of depression, anxiety, stress, and insomnia was 46.0%, 50.2%, 44.6%, and 66.5%, respectively. Female sex, working in ICU, and having a history of chronic disease were predictors of psychological symptoms in our participants.Conclusion:HCWs’ mental health state could be underestimated or neglected. The third pandemic wave negatively affected the mental health of the HCWs. Since mental health problems of HCWs may reduce the quality of care, the potential impact of not addressing this issue should be highlighted.

The COVID-19 pandemic caused significant stress and anxiety among the general population and healthcare workers (HCWs) worldwide. India is one of the countries severely impacted by the pandemic. This review explores the gender perspective of mental health conditions among HCWs and job loss during the pandemic in India. Electronic databases (PubMed, Scopus, and Web of Science) were searched for articles published till March 2021. Studies that reported the prevalence of depression, anxiety, stress, and worry among HCWs in India during the pandemic and job loss in both males and females due to COVID-19 were included. We used a random-effects model to estimate pooled prevalence rates with 95% CIs. We assessed heterogeneity using the I2 statistic. The meta-analysis included 11 studies; the pooled prevalence of depression, anxiety, stress, and worry among HCWs was 34.9% (95%CI 27.33, 42.47), 35.4% (95%CI 24.46, 46.33), 32.9% (95%CI 25.43, 40.37), and 42.87% (95%CI 25.83, 59.91), respectively. The pooled prevalence of job loss due to COVID-19 was 16.6% (95%CI 8.34, 19.66). We employed meta-regression and Egger's regression for publication bias. The meta-analysis findings suggest that the prevalence of depression, anxiety, stress, and worry among HCWs in India during COVID-19 was high. Furthermore, job loss due to COVID-19 has also been prevalent in India. These findings emphasize the need for mental health support for HCWs and those who have lost their jobs during the pandemic. It is essential to prioritize mental health and job creation policies in India to support individuals affected by COVID-19.

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.

AB0357 CORRELATION BETWEEN DISEASE ACTIVITY AND MENTAL HEALTH OF RA PATIENTS- ASSESSMENT WITH SMART SYSTEM OF DISEASE MANAGEMENT (SSDM) MOBILE TOOLS