Prevalence Of Mental Health Outcomes Research Articles

Global prevalence of anxiety and depression among medical students during the COVID-19 pandemic: a systematic review and meta-analysis

PurposeAs future physicians, medical students have experienced tremendous pressure during the ongoing COVID-19 pandemic, which is associated with a high risk of depression and anxiety. We aimed to investigate an overview of the prevalence of anxiety and depression among medical students in various countries during the global COVID-19 pandemic, and discuss associated stressors.MethodsWe systematically searched CINAHL, EMBASE, MEDLINE, PubMed, and Web of Science for relevant articles from December 1, 2019 to March 15, 2023. We performed meta-analysis using a random-effects model with REML method to calculate the pooled prevalence of anxiety and depression. Begg’s and Egger’s tests were used to identify the potential risk of publication bias. Meta-regression was used to explore potential sources of heterogeneity.ResultsWe identified 130 studies reporting anxiety and depression among 132,068 medical students during the COVID-19 pandemic. Eight screening tools were identified for anxiety and six for depression. The pooled prevalence of mental health outcomes for anxiety and depression was 45% (95% confidence interval [CI], 40%–49%) and 48% (95% CI, 43%–52%), respectively. The pooled prevalence of mental health outcomes for moderate and severe anxiety and moderate and severe depression was 28% (95% CI, 24%–32%) and 30% (95% CI, 26%–35%), respectively. There was high heterogeneity between studies, with I2 ranging from 99.58%–99.66%. Continent and survey date were included in the meta-regression model. The results of meta-regression revealed that medical students in Asia had a lower prevalence of anxiety, and depression than those in other regions. The survey date (from February to June, 2020) showed a significantly positive correlation with the prevalence of anxiety and depression.ConclusionsWe demonstrated the global prevalence of anxiety and depression among medical students during the COVID-19 pandemic. The data highlight that medical students worldwide are at high risk of experiencing anxiety and depression. The reported stressors can be categorized into personal, academic, environmental and cultural, and pandemic factors. Schools and institutions should ensure optimal alternative learning environments for uninterrupted provision of medical education. The appropriate authorities should prioritize the provision of adequate protection for medical students and establish policies to promote new methods of training and education during a disaster, such as via distance learning.

FC44: Prevalence of mental health outcomes and the impact of sex and mood or cognitive comorbidity in older adults during the COVID-19 pandemic

Introduction:Older adults are at greater risk for developing severe illness from SARS-COV2 infection and may be more vulnerable to negative mental health outcomes as a result of public health guidelines that increase social isolation. We assessed mental health outcomes in older adults with normal cognition (NC), past history of major depressive disorder (i.e., remitted; rMDD), or mild cognitive impairment (MCI) to determine the prevalence of depression, anxiety, general stress, and post-traumatic stress during the COVID-19 pandemic and the impact of diagnosis and sex.Methods:The sample included 108 older adults (37 males, mean age=72.1 years): 71 older adults with normal cognition (NC) based on normal neuropsychological test performance and no psychiatric history, 21 rMDD participants based on DSM5 criteria, and 16 MCI participants based on NIA-AA criteria. Participants completed self-report measures of depression [Patient Health Questionnaire-9 (PHQ-9)], anxiety [Patient-Reported Outcomes Measurement Information System (PROMIS)], general stress [Perceived Stress Scale (PSS)] and post-traumatic stress [Impact of Events Scale Revised (IES-R)] through video- or teleconferencing. Prevalence rates of clinically significant psychiatric symptoms were expressed as the percentage of participants with total scores that exceed the normal cut-offs. Separate MANOVAs were used to examine the effects of diagnosis and sex. Non-normally distributed data (PHQ-9 and PROMIS total scores) were rank-transformed.Results:Approximately 1/3rd of participants endorsed clinically significant symptoms based on scores exceeding the cut-off for normal: 33.7% on PHQ-9, 31.3% on PROMIS-Anxiety, 35.5% on PSS, 38.3% on IES-R. rMDD participants scored higher on all measures compared to NC participants (p’s < .005) while MCI participants scored higher on the PSS compared to NC (p=.035). Women scored higher on all measures compared to men.Conclusions:These rates of approximately 1/3rd reporting clinically significant symptoms of depression, anxiety, general stress, and post-traumatic stress are higher than those described in population surveys of older adults but are comparable to prevalence rates of psychiatric symptoms in the general adult population. The effects of diagnosis and sex indicate that older adults with previous depression or current MCI, as well as women overall, are particularly vulnerable to developing clinically significant psychiatric

The association between lifetime trauma exposure typologies and mental health outcomes among veterans

We know little about veterans’ lifetime trauma exposure patterns and how such patterns are associated with mental health outcomes. This study sought to identify lifetime trauma exposure typologies among veterans and examine associations between these typologies and mental health outcomes. It used baseline data from a national longitudinal mail-based survey of 3,544 veterans and oversampled for women (51.6%) and veterans living in high crime areas (67.6%). Most veterans (94.2%) reported trauma exposure, and 80.1% reported exposure to two or more traumas. Prevalence of mental health outcomes was: 27.7% anxiety, 31.3% depression, 37.9% posttraumatic stress disorder, 44.4% alcohol use disorder, 10.4% suicide attempt, and 33.5% mental health comorbidity. Latent class analysis was used to identify patterns of lifetime trauma exposure and logistic regression was used to examine the odds of mental health outcomes as a function of class membership. Five lifetime trauma exposure typologies emerged: (1) low trauma; (2) high combat and community violence; (3) intimate partner violence trauma; (4) high global physical assault; and (5) high trauma. Classes showed differential associations with mental health outcomes. Findings have implications for clinical practice including informing providers’ mental health treatment plans to correspond to each veteran's trauma exposure typology.

Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil

BackgroundThe COVID-19 pandemic had a major impact on the mental health of healthcare workers (HCWs), especially in low and middle-income countries, which had to face additional political, social, and economic challenges. We thus aimed to assess the prevalence of mental health outcomes and the associated factors in HCWs treating COVID-19 patients in one of the most affected regions in Brazil.MethodsWe used the Respondent-Driven Sampling method to assess the risks of COVID-19 infection and symptoms of mental disorders in nurses, nursing technicians, and physicians who worked on the frontline in the metropolitan region of Recife. 865 healthcare workers completed a survey regarding sociodemographic data, work-related risks, and symptoms of mental disorders - SRQ-20 for common mental disorders (CMD); AUDIT-C for problematic alcohol use; GAD-7 for anxiety; PHQ-9 for depression; PCL-5 for post-traumatic stress disorder (PTSD). Gile’s successive sampling estimator was used to produce the weighted estimates by professional category. A Poisson regression model with robust variance was used to analyze factors associated with a positive screening for CMD. We will present the results of a cross-sectional analysis of the mental health outcomes after the first peak of COVID-19 – from August 2020 to February 2021.ResultsThe prevalence ratios for a positive screening for CMD were 34.9% (95% CI: 27.8–41.9) in nurses, 28.6% (95% CI: 21.3–36.0) in physicians, and 26.6% (95% CI: 16.8–36.5) in nursing technicians. Nurses presented a higher prevalence of depressive symptoms (23%). Positive screening for problematic alcohol use (10.5 to14.0%), anxiety (10.4 to 13.3%), and PTSD (3.3 to 4.4%) were similar between the professional categories. The main factors associated with CMD in nurses and physicians were related to an intrinsic susceptibility to mental illness, such as previous or family history of psychiatric disorder, and female sex. Among nurse technicians, work-related factors, such as accidents with biological material, presented the strongest association with CMD.ConclusionThe mental health of HCWs fighting COVID-19 in Recife was severely affected. It is crucial that healthcare services provide adequate working conditions and psychological support, investing in programs to promote and protect HCWs mental health.

Adolescents at risk of mental health problems in the COVID‐19 pandemic: A prospective population‐based study of the effects of government mandates and school closures

AbstractThere is increasing evidence that the COVID‐19 pandemic has had substantial mental health impacts for adolescents. Yet, few definitive studies have investigated which adolescents were at higher risk of poor mental health and well‐being during the pandemic. Data were drawn from the Childhood to Adolescence Transition Study, a prospective cohort study of students in Australia (N = 1211). Prevalence of mental health outcomes (depressive symptoms, anxiety symptoms, self‐harm and good subjective well‐being) was estimated in school Years 5–12, where Years 11 (2020) and 12 (2021) coincided with the pandemic. The age‐ and sex‐adjusted relative risk of each mental health outcome for each priority group during the pandemic were estimated. During the pandemic, over 50% of study participants reported depressive symptoms, and one quarter reported anxiety symptoms. There was a decrease in good subjective well‐being compared with pre‐pandemic years, while self‐harm prevalence remained similar. History of mental health problems, school disengagement and frequent peer victimisation increased the risk of experiencing mental health problems during the pandemic. Schools play a central role in maintaining the mental health and good subjective well‐being of students, and this is particularly important during periods of social disruption, such as the COVID‐19 pandemic.

Anxiety, depression, and somatic symptom disorders in health care workers at high altitude during the rapid spread of the SARS-CoV-2 Omicron variant: A prospective cohort study.

The ongoing spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron variant and hypoxia exposure to high altitude are the susceptible factors of people's psychological abnormalities, especially the health care workers (HCWs) in the front line of the epidemic. There is no dynamic observation data on the prevalence of mental health disorders among HCWs at high altitude. The study is to assess the prevalence of mental health outcomes and its influencing factors among HCWs at high altitude exposed to the SARS-CoV-2 Omicron variant. This prospective cohort study collected sociodemographic data and mental health measurements from 647 HCWs in 3 hospitals in Xining, Qinghai province from 13 April to 4 May 2022. After the mental health intervention for the above-mentioned people in the Chengdong district, we collected mental health indicators on days 7 and 14, respectively. We used the generalized linear model and the generalized estimation equation and for further analysis. The baseline cross-sectional survey of 647 HCWs in the Chengdong and Chengbei districts of Xining, Qinghai province shows that the prevalence of depression, anxiety, and somatic disorders were 45.75, 46.52, and 52.55%, respectively. The multivariable model showed that chronic diseases and nucleic acid collection were associated with increased scores of GAD-7, PHQ-9, and PHQ-15. And the GAD-7 score of HCWs with elderly people at home increased by 0.92 points. Subsequent repeated measurements of the mental health of HCWs in Chengdong district in Xining, Qinghai province, showed that anxiety, depression, and somatic disorders were significantly relieved, and physical exercise showed a significant protective effect, while loans and nucleic acid collection showed an adverse effect after 2 weeks of intervention. Additionally, engaged in nucleic acid collection was the risk factor of anxiety and depression. In this survey of HCWs on frontline at high altitude during the rapid spread of the SARS-CoV-2 Omicron variant, participants reported experiencing mental health disorders, especially in those with chronic disease, loans, and those who worked with longer hours and engaged in nucleic acid collection in Xining, Qinghai province, China. Exercise may help to improve anxiety and physical disorders.

Teachers’ Mental Health During the COVID-19 Pandemic

With an emergence of research investigating the educational impacts of the COVID-19 pandemic, empirical studies assessing teachers’ mental health throughout the pandemic have been scarce. Using a large national data set, the current study compares mental health outcomes during the pandemic between pre-K–12 teachers and professionals in other occupations. Further, we compare the prevalence of mental health outcomes between in-person and remote teachers ( N = 134,693). Findings indicate that teachers reported a greater prevalence of anxiety symptoms than did those in other professions and that remote teachers reported significantly higher levels of distress than did those teaching in person. We summarize the policy implications of these results.

Prevalence and Correlates of Mental Health Symptoms and Well-Being Among Elite Sport Coaches and High-Performance Support Staff

BackgroundThere is growing understanding of mental health needs in elite athletes, but less is known about the mental health of coaches and support staff who work within elite sport settings. This study examined the prevalence and correlates of mental health symptoms in elite-level coaches and high-performance support staff (HPSS) and compared rates against published elite athlete samples. A cross-sectional, anonymous, online survey was administered to coaches and HPSS working in Australia’s high-performance sports system. Main outcomes were scores on validated measures of psychological distress, probable ‘caseness’ for a diagnosable psychological condition, alcohol consumption and sleep disturbance.ResultsData were provided by 78 coaches (mean age = 46.4 years, 23.8% female) and 174 HPSS (mean age = 40.0 years, 56.7% female). Overall, 41.2% of the sample met probable caseness criteria, 13.9% reported high to very high psychological distress, 41.8% reported potential risky alcohol consumption and 17.7% reported moderate to severe sleep disturbance, with no statistically significant differences between coaches and HPSS. The most robust correlates of psychological distress and probable caseness were dissatisfaction with social support and dissatisfaction with life balance, while poor life balance was also associated with increased alcohol consumption and poor social support with sleep disturbance. Coaches and HPSS reported similar prevalence of mental health outcomes compared to rates previously observed in elite athletes, with the exception of higher reporting of alcohol consumption among coaches and HPSS.ConclusionsElite-level coaches and HPSS reported levels of psychological distress and probable caseness similar to those previously reported among elite-level athletes, suggesting that these groups are also susceptible to the pressures of high-performance sporting environments. Screening for mental health symptoms in elite sport should be extended from athletes to all key stakeholders in the daily training environment, as should access to programs to support mental health and well-being.

Mental health and protective strategies among community-based health workers in region 3, Philippines during COVID-19 pandemic

The COVID-19 crisis in the Philippines posed both physical and psychological threats to health workers. It is vital to determine practices to protect them. This study determined the prevalence of mental health outcomes among community-based health workers during the COVID-19 pandemic and examined the association of protective strategies with symptoms of mental health outcomes. A cross-sectional study design was applied to the records of community-based health workers conducted through online psychological assessment by Department of Health - Central Luzon between September 1-30, 2020. Respondents’ age, sex, mental health status, and protective strategies were extracted using ion Form, and analyses were done using OpenEpi. A total of 324 records of community-based health workers were included in the analysis. Ten percent of the respondents present symptoms of stress, 26% anxiety symptoms, and 18% depressive symptoms. The majority of the respondents were using deep breathing techniques, having a constant social connection with family and friends, and engaging in their regular spiritual/religious activities as protective strategies during the pandemic. Engagement in regular spiritual/religious practices was found associated with symptoms of stress through Fisher’s exact test. Participants who engaged in religious/spiritual practices were less likely to report symptoms of stress. Community-based health workers showed evident rates of symptoms of stress, anxiety, and depression. The majority of the participants engaged in various protective strategies but only engagement in regular religious/spiritual practices was found associated with symptoms of stress.

Problematic Social Media Use in Adolescents and Young Adults: Systematic Review and Meta-analysis.

BackgroundTechnology is ever evolving, with more and more diverse activities becoming possible on screen-based devices. However, participating in a heavy screen-based lifestyle may come at a cost. Our hypothesis was that problematic social media use increased the prevalence of mental health outcomes.ObjectiveThis study seeks to systematically examine problematic social media use in youth and its association with symptoms of depression, anxiety, and stress.MethodsA systematic search was conducted to identify studies in adolescents and young adults, using the databases Engineering Village, Psycinfo, Pubmed, and Web of Science. A total of 18 studies were identified, with a total of 9269 participants in our review and included in the meta-analysis.ResultsOur metaregression shows moderate but statistically significant correlations between problematic social media use and depression (r=0.273, P<.001), anxiety (r=0.348, P<.001), and stress (r=0.313, P<.001). We did not find evidence of heterogeneity of these summary correlations by age, gender, or year of publication.ConclusionsThis study provides further evidence of the association between problematic social media use and negative mental health among adolescents and young adults and supports future research to focus on the underlying mechanisms of problematic use of social media.Trial RegistrationPROSPERO CRD42021222309; https://tinyurl.com/2p9y4bjx

Psychological Symptom Progression in School-Aged Children After COVID-19 Home Confinement: A Longitudinal Study.

BackgroundThe long-term mental health effects of coronavirus disease 2019 (COVID-19) in children are rarely reported. We aimed to investigate the progression of depressive and anxiety symptoms among a cohort of children in the initial epicenter of COVID-19 in China.MethodsTwo waves of surveys were conducted in the same two primary schools in Wuhan and Huangshi, Hubei province: Wave 1 from 28 February to 5 March, 2020 (children had been confined to home for 30–40 days) and Wave 2 from 27 November to 9 December, 2020 (schools had reopened for nearly 3 months). Depressive and anxiety symptoms were estimated using the Children's Depression Inventory – Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. ΔCDI-S and ΔSCARED scores between Wave 2 and Wave 1 were calculated and further categorized into tertiles. Multivariable linear regression and multinomial logistic regression models were then applied.ResultsA total of 1,224 children completed both surveys. The prevalence of mental health outcomes at Wave 2 increased significantly compared to Wave 1, specifically depressive symptoms (age-standardized prevalence rates: 37.5 vs. 21.8%) and anxiety symptoms (age-standardized prevalence rates: 24.0 vs. 19.6%). Higher ΔSCARED scores were observed in females and children in Wuhan, and children with experience of neglect had higher ΔCDI-S (β = 1.12; 95% CI = 0.67–1.58) and ΔSCARED (β = 6.46; 95% CI = 4.73–8.19) scores compared with those without experience of neglect. When the Δ scores were further categorized into tertiles, similar results were found.ConclusionsThe prevalence of depressive and anxiety symptoms after schools resumed was increased compared with that during the home quarantine period, even though the COVID-19 pandemic was under control. Females and children in Wuhan, and also children with experience of neglect were at increased risk of mental health disorders.

Prevalence of mental health outcomes and effects of sex and mood or cognitive comorbidity in older adults during the COVID-19 pandemic

IntroductionOlder adults are at greater risk for developing severe illness from SARS-COV2 infection and may be more vulnerable to negative mental health outcomes as a result of public health guidelines that increase social isolation. In the current study, we assessed mental health outcomes in a cohort of older adults with normal cognition (NC), past history of major depressive disorder (i.e., remitted; rMDD), or mild cognitive impairment (MCI) to determine the prevalence of clinically significant symptoms of depression, anxiety, general stress, and post-traumatic stress. Additionally, we assessed the effects of mood or cognitive diagnosis and sex on symptom severity. Based on the pre-pandemic literature, we predicted that the presence of rMDD or MCI diagnosis would be associated with increased severity of psychiatric symptoms during the COVID-19 pandemic. We also predicted that women would experience greater severity of psychiatric symptoms compared to men.MethodsThe study included 108 older adults (37 males, mean age=72.1 years) who were participating in existing longitudinal studies. The sample included 71 older adults with normal cognition (NC) based on normal neuropsychological test performance and who were free of lifetime history of psychiatric illness, 21 rMDD participants based on DSM5 criteria, and 16 MCI participants based on the presence of memory concerns, impaired performance on neuropsychological assessments, and intact functional independence. Participants completed self-report measures of depression, anxiety, and stress through video- or teleconferencing with a research assistant. Measures included the Patient Health Questionnaire-9 (PHQ-9) to assess depression, the Patient-Reported Outcomes Measurement Information System (PROMIS) to measure anxiety, the Perceived Stress Scale (PSS) to measure stress, and the Impact of Events Scale-Revised (IES-R) to assess post-traumatic stress symptoms. Prevalence rates of clinically significant psychiatric symptoms were expressed as the percentage of participants with total scores that exceed the normal cut-offs for each respective measure. Separate MANOVAs were used to examine the effects of diagnosis and sex. Non-normally distributed data (PHQ-9 and PROMIS total scores) were rank-transformed and entered into MANOVA.ResultsWithin the sample of 108 participants, 33.7% exceeded the normal cut-off on the PHQ-9, 31.3% had clinically significant anxiety symptoms on the PROMIS-Anxiety, 35.5% had clinically significant stress scores on the PSS, and 38.3% had clinically significant post-traumatic stress scores on the IES-R. MANOVA showed statistically significant effects of diagnosis on all measures: PHQ-9 [F(2,90)=5.380, p=.006], PROMIS-Anxiety [F(2,90)=11.687, p<.001], PSS [F(2,90)=8.480, p<.001], and IES-R [F(2,90)=5.027, p=.009]. MDD participants scored higher on all measures compared to NC participants: PHQ-9 (p=.005), PROMIS-Anxiety (p<.001), PSS (p<.001), and IES-R (p=.004). In addition, MCI participants scored higher on the PSS compared to NC participants (p=.035). MANOVA showed significant effects of sex on all measures: PHQ-9 [F(1,91)=7.046, p=.009], PROMIS-Anxiety [F(1,91)=8.623, p=.004], PSS [F(1,91)=12.553, p<.001], and IES-R [F(1,91)=10.529, p=.002] such that women scored higher on all measures compared to men.ConclusionsOverall, over one-third of study participants reported clinically significant symptoms of depression, anxiety, general stress, and post-traumatic stress during the COVID-19 pandemic. These rates are higher than those described in population studies of older adults based on anonymous online surveys, which are reported to be 24.9% for depression, 19.4% for anxiety, 10.3% for stress, and 28.3% for post-traumatic stress; but are comparable to the prevalence rates of psychiatric symptoms in the general adult population. As predicted, presence of rMDD increased the severity of all psychiatric symptoms. However, MCI was also associated with increased stress compared to those with normal cognition, despite absence of current or past psychiatric illness. These findings suggest that older adults with previous depression or current MCI, as well as women overall, are particularly vulnerable to developing clinically significant psychiatric symptomatology during the COVID-19 pandemic. Limitations of the current study are the inclusion of participants in existing studies, as opposed to sampling from the general population and the relatively small sample size. Nevertheless, the current findings suggest that some clinical populations, including those with rMDD and MCI, as well as women overall, may benefit from receiving interventions for mental health during the current and future pandemics.This research was funded byThis study was funded by the Ontario Ministry of Health and Long-Term Care Alternative Funding Plan. The funders had no role in the design of the study, analysis, or preparation of the manuscript.

Mental health consequences of COVID-19 in house staff physicians

Background: A new coronavirus, SARS-CoV-2, was associated with a newly identified respiratory syndrome, COVID-19 in Wuhan, China, in early December 2019. SARS-CoV-2 rapidly spread across the globe, imposing increased working hours and workloads for healthcare workers. We have evaluated the prevalence of mental health outcomes and associated factors in house staff physicians in Panama. Methods: A cross-sectional study was undertaken from July 23, 2020, to August 13, 2020. Snowball sampling was used to recruit participants. Then, an electronic questionnaire with scales to evaluate anxiety disorders (GAD-7), depression (PHQ-9) and post-traumatic stress (IES-R) was administered. In addition, socio-demographic variables, clinical history of mental disorders and COVID-19 exposure were evaluated. Independent analyses for each mental health outcome were undertaken using a logistic regression analysis. Results: A total of 517/1,205 (42.9%) interns and residents were recruited nationwide. The overall prevalence of depression symptoms was 25.3%, 13.7% for anxiety and 12.2% for post-traumatic stress. At least 9.3% participants reported having suicidal ideation. The most parsimonious model showed females had a higher prevalence of mental health disorders across results, and married participants were more likely to present depression (OR, 1.73; 95% CI, 1.03-2.91; P = 0.039) or at least one mental health disorder (OR, 1.66; 95% CI, 1.03-2.68; P = 0.039). Conclusions: A high prevalence of mental health disorders was found, showing the need to mitigate this emotional burden among healthcare workers in the current context of the COVID-19 pandemic.

The prevalence of mental health outcomes among eating disorder patients during the COVID-19 pandemic: A meta-analysis.

Background & aimsPatients with eating disorders (ED) are known to suffer from various psychological morbidities thus they are expected to be negatively impacted due to the COVID-19 pandemic. Our meta-analysis aims to evaluate the effect of the COVID-19 pandemic on the pooled prevalence of psychological comorbidities in ED patients.MethodsPubmed, Scopus, GoogleScholar, and medRxiv were searched using the keywords COVID19 and Eating Disorders and their related MeSH terms. The articles were included if they contained patients with diagnosed EDs and having evaluated their mental health disturbances during the COVID-19 pandemic. The quality of the included studies was assessed using the “assessing risk of bias in prevalence studies” tool. The heterogeneity was assessed using Cochrane Q and I2 heterogeneity statistics.ResultsA total of 13 articles have been included in this meta-analysis with a sample size of 3056. The pooled prevalence of ED patients who experienced worsening of ED symptoms was 57% (95%CI: 36%–76%), anxiety was 64% (95%CI: 39%–78%), and depression was 55% (95%CI: 12%–87%) during the pandemic.ConclusionsThis meta-analysis provides evidence supporting an increase in the pooled prevalence of mental health disorders among patients suffering from EDs during the COVID-19 pandemic.

Mental health risk factors during the first wave of the COVID-19 pandemic.

During the first wave of the COVID-19 pandemic, distancing measures were enforced to reduce virus spread, which likely had an impact on the overall mental health of the population. To investigate the prevalence of mental health outcomes (depression, anxiety and insomnia), and associated risk factors, during a physical distancing period imposed in the first wave of COVID-19. During the first month of Portugal's state of emergency, an online survey was created and disseminated through social media channels. Sociodemographic and clinical variables were assessed via self-reported questionnaires. Univariate linear regressions were used to identify associations between the collected variables and mental health outcomes. Multivariate regression analyses were performed to identify independent risk factors for clinical outcomes, with adjustment for potential confounders. We analysed data from 1626 participants: a significant proportion showed depression (30.2%), anxiety (53.1%) and insomnia (36.3%) symptoms. Multivariate regression models showed that being male and working from home were protective for all mental health outcomes analysed, whereas the perception of infection, being under psychiatric care and taking medication were risk factors (P < 0.05). Days in isolation and being unemployed were risk factors for depression and insomnia (P < 0.05). Younger age and being a student were risk factors for depression, whereas being a healthcare professional was protective (P < 0.05). Indirect contact with COVID-19 was a risk factor for anxiety (P < 0.05). COVID-19-related distancing measures were associated with high levels of adverse mental health symptoms. Several risk factors were associated with these symptoms, which highlight the importance of identifying vulnerable groups during physical distancing periods.

Mental Health Outcomes among Frontline Health-Care Workers at Eka Kotebe National COVID-19 Treatment Center, Addis Ababa, Ethiopia, 2020: A Cross-Sectional Study.

BackgroundThe COVID-19 pandemic has resulted in many frontline health-care workers vulnerable to developing various mental health conditions. This study aimed to determine prevalence and associated factors of such conditions among frontline workers at Eka Kotebe National COVID-19 Treatment Center in Addis Ababa, Ethiopia.MethodsThis institution-based cross-sectional study was conducted between May and June 2020 on 280 frontline workers. Mental health outcomes (depression, anxiety, insomnia, and posttraumatic stress disorder) were assessed using the Patient Health Questionnaire9, Generalized Anxiety Disorder 7 questionnaire, PTSD Checklist — civilian version, and Pittsburgh Sleep Quality Index. Responses were coded, entered into EpiData 3.1 and analyzed using SPSS 20. Associations between outcomes and independent variables were identified using bivariate and multivariate logistic regressions, statistical significance set at p<0.05.ResultsA total of 238 subjects participated in the study, with a response rate of 85%. Estimated prevalence was 31.1% (95% CI 24.8%–37%) for anxiety, 27.3% (95% CI 21.8%–32.4%) for depression, 16% (95% CI 11.3%–21%) for PTSD, and 40.8% (95% CI 33.6%–47.5%) for insomnia. Female sex (AOR 2.99, 95% CI 1.49–5.97), being married, (AOR 13.2, 95% CI 3.42–50.7), being single (AOR 11.5, 95% CI 3.38–39.8), duration of exposure 1–2 hours (AOR 0.29, 95% CI 0.14–0.64), and assigned place of work (critical ward —AOR 2.26, 95% CI 1.03–4.97; ICU — AOR 4.44, 95% CI 1.51–13.05) were found to be significant predictors of depression.ConclusionWe found a high estimated prevalence of mental health outcomes. Sex, marital status, duration of exposure, and assigned place of work were found to be associated with depression.

Mental health outcomes of ICU and non-ICU healthcare workers during the COVID-19 outbreak: a cross-sectional study

BackgroundIntensive care workers are known for their stressful work environment and for a high prevalence of mental health outcomes. The aim of this study was to evaluate the mental health, well-being and changes in lifestyle among intensive care unit (ICU) healthcare workers (HCW) during the first wave of the COVID-19 pandemic and to compare these results with those of HCW in other hospital units. Another objective was to understand which associated factors aggravate their mental health during the COVID-19 outbreak.MethodsThis cross-sectional survey collected socio-demographic data, lifestyle changes and mental health evaluations as assessed by the Generalized Anxiety Disorder 7 items (GAD-7), the Patient Health Questionnaire 9 items (PHQ-9), the Peritraumatic Distress Inventory (PDI) and the World Health Organization Well-Being Index (WHO-5) from the 28th May to 7th July 2020. The study was carried out at Geneva University Hospitals, a group of eight public hospitals in Switzerland. ICU HCW were analyzed for mental health outcomes and lifestyles changes and then compared to non-ICU HCW. A series of linear regression analyses were performed to assess factors associated with mental health scores.ResultsA total of 3461 HCW were included in the study, with 352 ICU HCW. Among ICU HCW, 145 (41%) showed low well-being, 162 (46%) symptoms of anxiety, 163 (46%) symptoms of depression and 76 (22%) had peritraumatic distress. The mean scores of GAD-7, PHQ-9 and WHO-5 were worse in ICU HCW than in non-ICU HCW (p < 0.01). Working in the ICU rather than in other departments resulted in a change of eating habits, sleeping patterns and alcohol consumption (p < 0.01). Being a woman, the fear of catching and transmitting COVID-19, anxiety of working with COVID-19 patients, work overload, eating and sleeping disorders as well as increased alcohol consumption were associated with worse mental health outcomes.ConclusionThis study confirms the suspicion of a high prevalence of anxiety, depression, peritraumatic distress and low well-being during the first COVID-19 wave among HCW, especially among ICU HCW. This allows for the identification of associated risk factors. Long-term psychological follow-up should be considered for HCW.

Factors associated with work performance and mental health of healthcare workers during pandemics: a systematic review and meta-analysis.

Introduction Healthcare workers’ work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study’s quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted.

Decline in the mental health of nurses across the globe during COVID-19: A systematic review and meta-analysis.

BackgroundNurses represent the major proportion of frontline health care professionals delivering 24/7 services to patients with an increased vulnerability towards COVID-19 infection. Mental health issues among nurses during the COVID-19 pandemic are poorly reported across the globe. Henceforth, a systematic review and meta-analysis was performed to explore the prevalence and determinants of mental health outcomes (anxiety, stress, depression, PTSD, insomnia) among nurses across the globe due to the COVID-19.MethodsA PRISMA compliant systematic review (PROSPERO-CRD 42020204120) was carried out to identify articles from multiple databases reporting the prevalence of mental health outcomes among nurses. Proportion random effect analysis, I2 statistic, quality assessment, and sensitivity analysis were carried out.ResultsPooled data on mental health outcomes were generated from 25 cross-sectional studies: 32% anxiety (95% confidence interval (CI) = 21%-44%, n (number of studies) = 21, N (sample size) = 13 641), 40.6% stress (95% CI = 25.4%-56.8%, n = 10, N = 4204), 32% depression (95% CI = 21%-44%, n = 17, N = 12 294), 18.6% PTSD (95% CI = 4.8%-38%, n = 3, N = 638), 38.3% insomnia (95% CI = 5.8%-78.6%, n = 2, N = 261) and significant risk factors for mental ailments includes; caring for COVID-19 patients, being a female, low self-efficacy, resilience, social support and having physical symptoms (sore-throat, breathlessness, cough, lethargy, myalgia, fever).ConclusionThe study results highlighted a higher proportion of poor mental health outcomes namely, anxiety, stress, depression, PTSD and insomnia among nurses from different parts of the world. Poor mental health outcomes among nurses warrants the need to implement proactive psychological interventions to deter the collapse of health care systems in responding to the pandemic and in particular all possible efforts should be undertaken to mitigate the risk factors. Health care organizations should provide support to nurses with sufficient flexibility. The disaster preparedness plan envisaged by nations should have provisions to address the mental health of nurses. Greater investment in addressing the global shortage of nurses should be given priority in national health policies. Attractive salary packages should be offered to nurses to prevent their emigration from low- and middle-income countries (LMICs).RegistrationPROSPERO (CRD42020204120)

Impact of COVID-19 on mental health of healthcare professionals working in COVID-19 designated clinical areas in India

Background: In the wake of the pandemic of coronavirus disease 2019, there are reports of its impact on psychological wellbeing of the health care workers.Methods: This cross-sectional survey was conducted in June 2020 in a tertiary care hospital in Delhi, India among conveniently sampled 93 participants i.e. doctors and nurses directly engaged in clinical activities in COVID-19 designated areas. A self-administered questionnaire through Google forms elicited symptoms of depression, anxiety, insomnia, and distress measured using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale, 7-item insomnia severity index, and 22-item impact of event scale-revised respectively.Results: Majority (53.8%) of the participants were male and their mean age was 30.2 years. Most (72%) were nurses, the rest being doctors. A substantial proportion of the participants had depression (47.4% of the sample), anxiety (29.0%), insomnia (32.3%) and distress (22.6%). Symptoms were disproportionately higher in female and single participants, nurses; those with history of chronic illness, staying in institute provided temporary accommodation, working on regular basis and perceiving lack of adequate personal protective equipment. Taking prophylactic hydroxychloroquine was associated with lower symptom rates.Conclusions: This survey revealed a considerable prevalence of mental health outcomes in HCWs demonstrating an association with age, gender; marital, professional and employment status, history of chronic illness, access to PPE, stay at institute provided temporary accommodation and prophylactic hydroxychloroquine use.