Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 (COVID-19) are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: (1) whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; (2) the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; and (3) factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic.

Background:The term of suicide is too broad and too vague. The definition and risk for suicide-related behaviors, that including self-harm, threats, attempts and suicide, remain unclear. In addition, whether paternal or maternal bonding plays an important role in suicidal attempt and threat is unknown in Taiwan. Hence, this study aimed to find out the relationship between different parental bonding styles and suicidal attempt and threat, and the predictive index for suicidality was also investigated.Method: Total of 422 participants with suicidal attempt and 356 who's with suicidal threat, which referred from all Health Department clinics and hospitals in 33 townships of Pingtung County in southern Taiwan, were recruited. In addition, 299 controls were random sampling from the community in 33 townships of Pingtung County, and who's without any psychiatric diagnosis history.Results: After adjustment for socio-demographics, both paternal and maternal "affectionless control" had significant associations with suicidality. When demographics and depression was adjusted, only the paternal "affectionless control" remained significantly associated with the suicidality. Furthermore, personality characteristics, alexithymia, and mental disorders as the mediating factors between parental affectionless control and suicidal attempt or threat are shown. Conclusion:In conclusion, paternal and maternal "affectionless control" might be used as the predictors for suicidal attempt and threat in Taiwan. Particularly, the impact of paternal affectionless has contributed to suicidal attempt through neuroticism than threat. These models may provide the references for clinical implication. Different preventive program and model might be considered in different type of suicide behaviors.