COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan

Abstract

Background COVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with anxiety/depression among frontline physicians of Pakistan. Methods Data were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22. Results A 43% prevalence of anxiety/depression among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as “essential” during aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient-care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected. In multivariable model, assessing more than five COVID suspects/day (aOR = 2.73, 95% CI: 1.65–4.52), working 20 h/week or less (aOR = 2.11, 1.27–3.49), having children among household members (aOR = 1.58, 95% CI: 1.00–2.50) and moderate to low knowledge of the infection (aOR = 2.69, 95% CI: 1.68–4.31) were found to be independent predictors of anxiety/depression among physicians. Conclusion Anxiety/depression among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.

Association Between Proportion of Workday Treating COVID-19 and Depression, Anxiety, and PTSD Outcomes in US Physicians

“… 1 , 33 , 34 Several systematic reviews have also indicated that numerous cross-sectional studies across the world have found a high prevalence of anxiety and depressive symptoms in healthcare workers during the pandemic as well as a correlation of worsening mental health symptoms with occupational exposure to patients infected with COVID-19. 32 , 35 – 38 Physicians specifically who treat COVID-19 patients in Turkey, 39 , 40 China, 1 and Pakistan 41 are similarly experiencing an increase in depression and anxiety symptoms. Furthermore, healthcare workers in Italy 42 and China 43 who treated patients with COVID-19 experienced an increase in PTSD symptomatology, with similar findings to our data.…”

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

“…Moreover, a meta-analytic review found that the prevalence of anxiety, depressive symptoms were 25.8% and 26.8%, respectively 36 . These syntheses of the previous research highlight that anxiety and depression have been highly prevalent in South Asia, which may have aggravated amid the COVID-19 pandemic due to the continued fear of infection, loss of socioeconomic opportunities, impaired the psychosocial processes, and lack of access to mental health resources and services 47,58,72 .…”

“…Pooled prevalence of anxietyA total of 31 studies reported the prevalence of anxiety during COVID-19 in different samples from South Asian countries[46][47][48][49][50][51][52][53][54][55][56]58,59,[61][62][63][64][65][66]68,69,[71][72][73][74][75][76][77][78][79][80] . These studies used different scales to measureanxiety in respective samples, including the Generalized Anxiety Disorder 7-item (GAD-7) scale (n = 16), Depression, Anxiety and Stress Scale -21 Items (DASS-21) scales (n = 9), Hospital Anxiety and Depression Scale (HADS) (n = 4), Patient Health Questionnaire-4 (PHQ-4) (n = 1), and Self Reporting Questionnaire 20-items (SRQ-20) scale (n = 1).…”

Anxiety amongst physicians during COVID-19: cross-sectional study in Pakistan

“…With regard to our second hypothesis, we were able to prove that greater exhaustion, greater family strain, and reduced feelings of protection impact on levels of anxiety among physicians. Other research from the developed world [ 29 ], developing countries [ 30 ], and Pakistan itself [ 31 ] corroborate that physicians are suffering from anxiety during the pandemic.…”