Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review

Abstract

BackgroundCOVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors.ObjectivesThe aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic.MethodsA systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732.ResultsA total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies.ConclusionOrganizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload.Systematic review registrationPROSPERO, identifier CRD42022340732.

Levels of Anxiety and Fear among Nurses During the COVID-19 Pandemic: A Systematic Review

“…Similarly, a study by Gasteiger et al [49] found that depression and anxiety had been most negatively afected during the frst ten weeks of social distancing during the COVID-19 pandemic. All these negative emotions can cause problems at the psychological level and, of course, in work carried out by the nursing staf, bringing about errors, and malpractice, which would also infuence patient safety [50,51].…”

Impact of Unexpected In-House Major COVID-19 Outbreaks on Depressive Symptoms among Healthcare Workers: A Retrospective Multi-Institutional Study

“…Furthermore, in a systematic review of suicidal ideation among HCWs during the COVID-19 pandemic, 11 studies assessed suicide attempts using the same criteria as in the present study (i.e., item nine scores of PHQ-9 ≥ 1). The proportion of HCWs at high risk of suicidal ideation ranged from 2.4% to 18.6% [ 6 ]. These results indicate psychological impacts and burdens among HCWs unexpectedly exposed to major COVID-19 outbreaks at workplace.…”

“…Previous studies have reported that the COVID-19 pandemic has worsened the mental health of healthcare workers (HCWs) [ 4 , 5 , 6 , 7 , 8 ]. HCWs, such as nurses and nursing home staff, were essential to the COVID-19 public health response.…”

“…Furthermore, they were burdened with work during the pandemic [ 10 , 11 ]. Major depressive symptoms in HCWs have been associated with suicidal ideation and the ‘moral injury’ of failing to provide adequate care, which violated core moral beliefs in the course of their work and during the COVID-19 pandemic [ 6 , 12 , 13 ]. For example, a meta-analysis of 57 studies conducted in 17 countries estimated that 24% (95% confidence interval [CI]:20–28%) of HCWs overall and 25% (95% CI:18–33%) of nurses were at high risk for depressive symptoms [ 7 ].…”

“…For example, a meta-analysis of 57 studies conducted in 17 countries estimated that 24% (95% confidence interval [CI]:20–28%) of HCWs overall and 25% (95% CI:18–33%) of nurses were at high risk for depressive symptoms [ 7 ]. Moreover, a systematic review of suicidal ideation among HCWs during the COVID-19 pandemic reported suicidal ideation in 2.4–21.7% of HCWs [ 6 ]. HCWs have been reported to be at a higher risk for depressive symptoms than the general population and those employed in other sectors [ 4 , 5 ].…”