Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic

Vilagut, Gemma; Alayo, Itxaso; Ferrer, M.; Aragonès, Enric; Barco, Ángel Asúnsolo del; Campos, Mireia; Espuga, Meritxell; González‐Pinto, Ana; Haro, Josep María; Fresneña, Nieves López; Salazar, Alma Martínez de; Molina, Juan D.; Ortí-Lucas, Rafael; Parellada, Mara; Pelayo-Terán, José María; Pérez‐Gómez, Beatriz; Pérez-Zapata, Aurora; Plana, N.; Polentinos-Castro, Elena; Diest, Ana Portillo-Van; Sanz, Ferrán; Urreta-Barallobre, I.; Kessler, R. C.; Bruffærts, Ronny; Vieta, Eduard; Pérez‐Solà, Víctor; Alonso, Jordi; Alonso, Manuel Francisco García; Álvarez, Mar; Amann, Benedikt L.; Amigo, Franco; Anmella, Gerard; Aragón, Andrés; Aragonés, Núria; Arizón, Ana Isabel; Asúnsolo, Ángel; Ayora, Alfons; Ballester, Laura; Barbas, Puri; Basora, Josep; Bereciartúa, Elena; Bolibar, Inés Bravo Ignasi; Bonfill, Xavier; Cotillas, Alberto; Cuartero, Andrés; Paz, Concha de; Cura, Isabel del; Yerro, María Jesús del; Diaz, Domingo; Domingo, José L.; Emparanza, José Ignacio; Espallargues, Mireia; Estevan, Patricia; Fernández, M. Isabel; Fernández, Tania Miñes; Ferreres, Yolanda; Fico, Giovanna; Forjaz, María João; Barranco, Rosa Garcia; Garcia-Ribera, J. Manuel Garcia TorrecillasC.; Garrido, Araceli; Gil, Elisa; Gómez, M del Olivo Valle; Gómez, J. J. Carrasco; Pinto, Ana González; Hernando, Margarita; Insigna, Maria Giola; Iriberri, Milagros; Jiménez, Nuria; Jimenez, Xavi; Larrauri, Amparo; Leon, Fernando; López‐Fresneña, Nieves; López, C.; López-Rodríguez, Juan A.; López-Cortacans, Germán; Marcos, Alba; Martin, Jesus; Martín, Vicente; Martínez-Cortés, Mercedes; Martinez-Martinez, Raquel; Martínez, Isabel; Buratto, Mattia; Mata, Nelva; Molina, Josep Maria; Molinero, Emilia; Mortier, Philippe; Muñoz, Carmen; Murru, Andréa; Olmedo, Jorge Andrés Izaguirre; Ortí, Rafael; Padrós, R.; Pallejà, Meritxell; Parra, R. Elizabeth Aguilar; Pascual, Julio; Pelayo, Jose Maria G.; Plá, Rosa Corcoy i; Aznar, C.; Gómez, Beatriz; Zapata, Aurora Pérez; Pijoán, José Ignacio; Polentinos, Elena; Puértolas, Beatriz; Puig, Maria Teresa; Quílez, Alex; Quintana, M. Jesus; Quiroga, Antonio; Rentero, David; Rey, Cristina Rodríguez; Rius, Cristina; Rodríguez‐Blázquez, Carmen; Rojas, Marianela; Romero, Yamina; Rubio, Gabriel; Rumayor, Mercedes; Ruiz, Pedro; Sáenz, Margarita; Sanchez, J. Ignacio; Sánchez-Arcilla, Ignacio; Serra, Consol; Serra-Sutton, Victoria; Serrano, Manuela; Sola, Silvia; Solera, Sara; Soto, Miguel; Tarrago, Alejandra; Tolosa, Natividad; Vázquez, Mireia; Viciola, Margarita; Yago, Sara; Yañez, Jesus; Zapico, Yolanda; Zorita, Luis Maria; Zorrilla, Iñaki; Zurbano, S. López

doi:10.1016/j.jpsychires.2022.02.009

Cited by 12 publications

(8 citation statements)

References 45 publications

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“…Workers completing the baseline interview (May 5th through September 7th, just after the peak of the first wave of the Covid-19 pandemic in Spain) and providing an e-mail address were re-contacted for the follow up interview approximately 4 months after, between October 9th and December 11th 2020, at the ascending curve of the pandemic's second wave (mean follow-up time of 120 days; median = 118; IQ range = 105–136 days). More information can be found elsewhere (Alonso et al ., 2021; Mortier et al ., 2022).…”

Section: Methodsmentioning

confidence: 99%

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey

Alonso

Vilagut

Alayo

et al. 2022

Epidemiol Psychiatr Sci

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Aims Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. Methods 8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. Results 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. Conclusions Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565

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Section: Methodsmentioning

confidence: 99%

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey

Alonso

Vilagut

Alayo

et al. 2022

Epidemiol Psychiatr Sci

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“…Finally, the survey was completed by less than a fifth of eligible HCWs. This is higher than the overall response rate of 11.7% reported in the repeated survey that investigated the four-month incidence of STB among HCWs in Spain [ 15 ]. Other UK studies of HCWs conducted during this time have not reported a response rate [ 49 ].…”

Section: Discussionmentioning

confidence: 67%

“…Globally, there is considerable variation in prevalence estimates of STB in HCWs during the pandemic [ 12 , 15 ]. In a rare follow-up study that provided data on first-time STB among 4,809 HCWs during the COVID-19 pandemic in Spain, the incidence risk of suicidal thoughts and behaviour combined was estimated to be 4% four months after initial data collection (May-September 2020 then October-December 2020) [ 15 ]. This study also investigated the relationship between risk factors and new cases of STB.…”

Section: Discussionmentioning

confidence: 99%

“…Since the publication of the review by Eyles et al (2021), several other studies have been published, which investigate the impact of the pandemic on STB among HCWs [ 13 ]. These have identified a broader range of potential sociodemographic, clinical and occupational risk factors for STB including a perception of poor working conditions [ 14 ] and re-deployment to a COVID-19 setting [ 15 ]. However, studies providing prospective follow-up data remain rare [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…These have identified a broader range of potential sociodemographic, clinical and occupational risk factors for STB including a perception of poor working conditions [ 14 ] and re-deployment to a COVID-19 setting [ 15 ]. However, studies providing prospective follow-up data remain rare [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Suicidal thoughts and behaviour among healthcare workers in England during the COVID-19 pandemic: A longitudinal study

et al. 2023

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Background During the COVID-19 pandemic, concern has been raised about suicide risk among healthcare workers (HCWs). We investigated the incidence risk and prevalence of suicidal thoughts and behaviour (STB), and their relationship with occupational risk factors, among National Health Service HCWs in England between April 2020 and August 2021. Methods In this longitudinal study, we analysed online survey data completed by 22,501 HCWs from 17 NHS Trusts at baseline (Time 1) and six months (Time 2). The primary outcome measures were suicidal ideation, suicide attempts, and non-suicidal self-injury. We used logistic regression to investigate the relationship between these outcomes and demographic characteristics and occupational factors. Results were stratified by occupational role (clinical/non-clinical). Results Time 1 and Time 2 surveys were completed by 12,514 and 7,160 HCWs, respectively. At baseline, 10.8% (95% CI = 10.1%, 11.6%) of participants reported having experienced suicidal thoughts in the previous two months, whilst 2.1% (95% CI = 1.8%, 2.5%) of participants reported having attempted suicide over the same period. Among HCWs who had not experienced suicidal thoughts at baseline (and who completed the Time 2 survey), 11.3% (95%CI = 10.4%, 12.3%) reported such thoughts six months later. Six months after baseline, 3.9% (95% CI = 3.4%, 4.4%) of HCWs reported attempting suicide for the first time. Exposure to potentially morally injurious events, lack of confidence about raising safety concerns and these concerns being addressed, feeling unsupported by managers, and providing a reduced standard of care were all associated with increased suicidal ideation among HCWs during the COVID-19 pandemic. At six months, among clinicians, a lack of confidence about safety concerns being addressed, independently predicted suicidal ideation. Conclusion Suicidal thoughts and behaviour among healthcare workers could be reduced by improving managerial support and enhancing the ability of staff to raise safety concerns.

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Do managers need to worry about employees' financial stress? A review of two decades of research

Rosso,

Muñoz-Pascual,

Galende

2024

Human Resource Management Review

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Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic

Cited by 12 publications

References 45 publications

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey

Suicidal thoughts and behaviour among healthcare workers in England during the COVID-19 pandemic: A longitudinal study

Do managers need to worry about employees' financial stress? A review of two decades of research

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