Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19

Abstract

Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant psychological distress, including PTSD, depression, and/or anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of PTSD, depression and anxiety across different groups of HCSWs. Design: An online survey was conducted in the weeks following the initial peak in cases (27 May to 23 July 2020). Setting: The participants worked in a variety of healthcare roles UK hospitals, nursing or care homes and community settings. Participants: A convenience sample (n=1194) of frontline UK health and social care workers completed the survey (including allied healthcare professionals, carers, clinical support staff, nurses and midwives, and other health and social care roles). Main outcome measures: PTSD was assessed using the PTSD subscale of the International Trauma Questionnaire (ITQ); Depression assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Logistic regression analyses examined predictors for depression, anxiety and PTSD separately, and also investigated the predictors of meeting the criteria for at least one of the three conditions. Over 57% of respondents met the threshold for clinically significant PTSD, anxiety or depression, and symptom levels were reasonably high and comparable across occupational groups. Participants who were more concerned about infecting others, who felt they could not talk with their managers, who reported feeling stigmatised due to their role and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with a higher likelihood of meeting criteria for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identifies predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE. Further research should investigate mental disorders in under-represented HSCW groups and examine barriers to communication between managers and staff. Identifying risk factors for PTSD, depression and anxiety among HSCWs, and providing treatment for those who need it, is critical given that subsequent waves of COVID-19 and other healthcare crises are inevitable.

Psychological Distress and Post-Traumatic Symptomatology among Dental Healthcare Workers in Russia: Results of a Pilot Study

“…Emerging evidence from research on the COVID-19 pandemic indicates high rates of mental disorders among HSCWs in most countries, including China, the U.S.A., India, and Italy [ 2 , 3 , 16 , 18 , 23 , 24 , 44 , 45 ].…”

“…Notably, an examination of the levels of PTSD, anxiety, and depression symptoms among the study groups have revealed that dentists (who hold MD degrees), in contrast to other dental HCWs, had significantly higher PSS-SR re-experiencing, arousal, intrusions, and total scores, while dental assistants (persons without an MD degree), in contrast to other participants, had significantly higher IES-R avoidance scores. This is somewhat interesting, because nurses (which is the closest analog to dental assistant in general medicine) typically reported higher levels of symptoms and distress than doctors [ 3 , 6 , 8 , 52 ], with a few studies reporting no difference [ 53 , 54 ] and only one study reporting higher rates in doctors [ 30 ].…”

“…The global spread of SARS-CoV-2 infection has deeply affected the world. The increasing numbers of patients and outbreak-affected countries have elicited public worry and thus increased the risk of mental health problems (insomnia, anxiety, depression, and stress-related disorders, including the post-traumatic stress disorder (PTSD)) [ 1 , 2 , 3 , 4 , 5 , 6 ].…”

“…The psychological burden of healthcare workers (HCWs) has received heightened awareness, with research continuing to show high rates of mental disorders among them in most countries, including China, the U.K., U.S.A., India, and Italy [ 3 , 4 , 5 , 6 ]. Thus, nearly 58% of HCWs in the U.K. met the threshold for clinically significant PTSD, anxiety, or depression [ 3 ]; in China, the prevalence rates of these conditions were estimated at 9.8–50.4%, 27.1–44.6%, and 15.0–25.0%, respectively [ 7 , 8 ]; and in Italy, about 22% and 40% of HCWs reported moderate-to-severe symptoms of anxiety and PTSD, respectively [ 5 ]. In the U.S.A. and Australia, more than half of HCWs screened positive for PTSD symptoms, almost half screened positive for depression, and one-third screened positive for anxiety [ 9 , 10 ].…”

What support do frontline workers want? A qualitative study of health and social care workers’ experiences and views of psychosocial support during the COVID-19 pandemic

“…Early quantitative research emerging from around the world has demonstrated a significant mental health burden experienced by frontline workers in response to COVID -19, with elevated rates of depression, anxiety, post-traumatic stress disorder (PTSD) and suicidality reported [2][3][4][5]. This is amongst a workforce already under considerable strain pre-COVID-19, as evidenced by the growing incidence of stress, burnout, depression, drug and alcohol dependence and suicide across all groups of health professionals, worldwide [6].…”