Mental health symptoms in a cohort of hospital healthcare workers following the first peak of the COVID-19 pandemic in the UK

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic is likely to lead to a significant increase in mental health disorders among healthcare workers (HCW).

Aims

We evaluated the rates of anxiety, depressive and post-traumatic stress disorder (PTSD) symptoms in a population of HCW in the UK.

Method

An electronic survey was conducted between the 5 June 2020 and 31 July 2020 of all hospital HCW in the West Midlands, UK using clinically validated questionnaires: the 4-item Patient Health Questionnaire(PHQ-4) and the Impact of Event Scale-Revised (IES-R). Univariate analyses and adjusted logistic regression analyses were performed to estimate the strengths in associations between 24 independent variables and anxiety, depressive or PTSD symptoms.

Results

There were 2638 eligible participants who completed the survey (female: 79.5%, median age: 42 years, interquartile range: 32–51). The rates of clinically significant symptoms of anxiety, depression and PTSD were 34.3%, 31.2% and 24.5%, respectively. In adjusted analysis a history of mental health conditions was associated with clinically significant symptoms of anxiety (odds ratio (OR) = 2.3, 95% CI 1.9–2.7, P < 0.001), depression (OR = 2.5, 95% CI 2.1–3.0, P < 0.001) and PTSD (OR = 2.1, 95% CI 1.7–2.5, P < 0.001). The availability of adequate personal protective equipment (PPE), well-being support and lower exposure to moral dilemmas at work demonstrated significant negative associations with these symptoms ( P ≤ 0.001).

Conclusions

We report higher rates of clinically significant mental health symptoms among hospital HCW following the initial COVID-19 pandemic peak in the UK. Those with a history of mental health conditions were most at risk. Adequate PPE availability, access to well-being support and reduced exposure to moral dilemmas may protect hospital HCW from mental health symptoms.

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  1. SciScore for 10.1101/2020.10.02.20205674: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Informed consent was obtained from all participants and recorded electronically at the start of the study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data analysis: Data were collated using Microsoft Excel (Redmond, Washington, USA) and summarised as median (interquartile range) for non-normal data, and as proportions (percentage) for categorical data.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    Statistical analysis was performed using SPSS V.25 (IBM, New York, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There were some limitations in our study. The time elapsed between traumatic exposure and the onset of symptoms is key to making a diagnosis of PTSD. However, the aim of the study was not to make diagnoses of mental health disorders but to screen the target population for the presence of clinically concerning symptoms. The survey was conducted relatively close to the duration of the UK’s Covid-19 pandemic peak. The elevated scores on the IES-R may be representative of an acute stress reaction which usually resolves within a few months. Further follow-up of these participants is required to ascertain the persistence of symptoms—a planned analysis by our study group. Our data is from a cross-sectional survey. Therefore, causal inferences cannot be made. Furthermore, the data were collected through a self-report questionnaire which is at risk of responder bias. There were also several strengths. This study is one of the first in the UK to report on the mental health impact of working during the Covid-19 pandemic on hospital staff. These findings may be generalisable to the wider UK population of hospital employees given the relatively large sample size and representative demographic sample (supplementary Table 3). During the Covid-19 pandemic, there were high prevalence rates of common mental health symptoms in hospital HCW in the UK, especially amongst those with a past history of mental health conditions. Occupational interventions such as adequate PPE and wellbeing support av...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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