scholarly journals Psychological distress and trauma in doctors providing frontline care during the COVID-19 pandemic in the United Kingdom and Ireland: a prospective longitudinal survey cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049680
Author(s):  
Tom Roberts ◽  
Jo Daniels ◽  
William Hulme ◽  
Robert Hirst ◽  
Daniel Horner ◽  
...  

ObjectivesThe psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of multiple pandemic waves, longitudinal data on the impact of COVID-19 are vital to ensure an adequate psychological care response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in frontline doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.DesignA prospective online three-part longitudinal survey.SettingAcute hospitals in the UK and Ireland.ParticipantsFrontline doctors working in emergency medicine, anaesthetics and intensive care medicine during the first wave of the COVID-19 pandemic in March 2020.Primary outcome measuresPsychological distress and trauma measured using the General Health Questionnaire-12 and the Impact of Events-Revised.ResultsThe initial acceleration survey distributed across networks generated a sample of 5440 doctors. Peak and deceleration response rates from the original sample were 71.6% (n=3896) and 56.6% (n=3079), respectively. Prevalence of psychological distress was 44.7% (n=1334) during the acceleration, 36.9% (n=1098) at peak and 31.5% (n=918) at the deceleration phase. The prevalence of trauma was 23.7% (n=647) at peak and 17.7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12.6% (n=343) at peak and 10.1% (n=276) at deceleration. Worry of family infection due to clinical work was the factor most strongly associated with both distress (R2=0.06) and trauma (R2=0.10).ConclusionFindings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a) provision of vital equipment to mitigate physical and psychological harm, (b) increased awareness and recognition of signs of psychological distress and (c) the development of clear pathways to effective psychological care.Trial registration numberISRCTN10666798.

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039851
Author(s):  
Tom Roberts ◽  
Jo Daniels ◽  
William Hulme ◽  
Daniel Horner ◽  
Mark David Lyttle ◽  
...  

IntroductionThe COVID-19 pandemic is putting an unprecedented strain on healthcare systems globally. The psychological impact on frontline doctors of dealing with the COVID-19 pandemic is currently unknown. This longitudinal professional survey aims to understand the evolving and cumulative effects of working during the COVID-19 outbreak on the psychological well-being of doctors working in emergency departments (ED), intensive care units (ICU) and anaesthetics during the pandemic.Methods and analysisThis study is a longitudinal questionnaire-based study with three predefined time points spanning the acceleration, peak and deceleration phases of the COVID-19 pandemic.The primary outcomes are psychological distress and post-trauma stress as measured by the General Health Questionnaire-12 (GHQ-12) and Impact of Events Scale-Revised (IES-R). Data related to personal and professional characteristics will also be collected. Questionnaires will be administered prospectively to all doctors working in ED, ICU and anaesthetics in the UK and Ireland via existing research networks during the sampling period. Data from the questionnaires will be analysed to assess the prevalence and degree of psychological distress and trauma, and the nature of the relationship between personal and professional characteristics and the primary outcomes. Data will be described, analysed and disseminated at each time point; however, the primary endpoint will be psychological distress and trauma at the final time point.Ethics and disseminationEthical approval was obtained from the University of Bath, UK (ref: 4421), and Children’s Health Ireland at Crumlin, Ethics Committee. Regulatory approval from the Health Regulation Authority (UK), Health and Care Research Wales (IRAS: 281944).This study is limited by the fact that it focuses on doctors only and is survey based without further qualitative interviews of participants. It is expected this study will provide clear evidence of the psychological impact of COVID-19 on doctors and will allow present and future planning to mitigate against any psychological impact.Trial registration numberISRCTN10666798.


2007 ◽  
Vol 136 (7) ◽  
pp. 997-1007 ◽  
Author(s):  
D. L. REYNOLDS ◽  
J. R. GARAY ◽  
S. L. DEAMOND ◽  
M. K. MORAN ◽  
W. GOLD ◽  
...  

SUMMARYThis study examines a cohort of persons quarantined during the 2003 SARS outbreak in Canada and describes their understanding of, difficulties and compliance with, and the psychological impact of the quarantine experience. A mailed questionnaire was administered to 1912 eligible adults and included the Impact of Events Scale – Revised (IES-R) to assess symptoms of post-traumatic stress disorder (PTSD). Self-reported compliance with all required quarantine measures was low (15·8±2·3%), although significantly higher when the rationale for quarantine was understood (P=0·018). Health-care workers (HCW) experienced greater psychological distress, including symptoms of PTSD (P<0·001). Increasing perceived difficulty with compliance, HCW, longer quarantine and compliance with quarantine requirements were significant contributors to higher IES-R scores. The low compliance with quarantine requirements introduces concerns about the effectiveness of quarantine as a public health measure. Improvements in compliance and reduced psychological distress may be possible by minimizing duration, revising requirements, and providing enhanced education and support.


2021 ◽  
Vol 11 (8) ◽  
pp. 44-54
Author(s):  
Julia Budzyńska ◽  
Magdalena Leśniewska ◽  
Ilona Kozioł ◽  
Joanna Milanowska

BACKGROUND: The outbreak of a coronavirus pandemic in 2019 posed a serious threat to the global population. Coronavirus Disease 2019 (COVID-19) has not only been a public health emergency, but has also affected mental health worldwide. Patients were exposed to a number of significant stressors during COVID-19 infection by which it appears that it may have had a major impact on mental health. Little is known about changes in levels of psychological affect, stress, anxiety and depression during this pandemic.AIM OF THE STUDY: The purpose of this study was to analyze the most recent available literature on the association of pandemic COVID-19 with psychiatric disorders occurring both as a result of past infection and in response to stress associated with the new situation of a global epidemic of Sars-CoV-2 virus.RESULTS: The psychological effects of the epidemic are clearly noticeable. The study identified groups particularly vulnerable to developing symptoms of anxiety, depression and post-traumatic stress disorder. Risk factors were also identified in people working in health care as having direct contact with the effects of infection with the new virus.SUMMARY AND CONCLUSIONS: Key elements of preventing psychological impact are the creation of a mental health organization. Another important task for governments is to create the conditions for economic security, as financial problems or job losses can also be the cause of mental crises.


Author(s):  
Bruce P. Dohrenwend ◽  
Nick Turse ◽  
Thomas J. Yager ◽  
Melanie M. Wall

Surviving Vietnam: Psychological Consequences of the War for U.S. Veterans presents a unique combination of historical material, military records of combat exposure, clinical diagnoses of post-traumatic stress disorder (PTSD), and interviews with representative samples of veterans surveyed both a little over decade after the war’s conclusion in the National Vietnam Veterans Readjustment Study (NVVRS), and again nearly four decades after the war’s conclusion in the National Vietnam Veterans Longitudinal Study (Longitudinal Study). It focuses specifically on veterans’ war-zone experiences and the development in some of PTSD, a relatively new and controversial diagnosis. The monograph begins with a brief history of the Vietnam war that provides context for the discussions of the relevance to their mental health outcomes of the severity of veterans’ exposure to combat, their personal involvement in harm to civilians and prisoners, their race/ethnicity, and their military assignments. It discusses nurses’ experiences in Vietnam and the psychological impact on families of veterans’ chronic war-related PTSD. The monograph then examines factors affecting surveyed veterans’ post-war readjustment, including the effects of changing public attitudes toward the war and the veterans’ own appraisals of the impact of the war on their lives after the war. It concludes by discussing the policy implications of its research findings.


2020 ◽  
pp. 1-12 ◽  
Author(s):  
Yiqun Gan ◽  
Jinjin Ma ◽  
Jianhui Wu ◽  
Yidi Chen ◽  
Huanya Zhu ◽  
...  

Abstract Background The COVID-19 pandemic has greatly affected public health and wellbeing. In response to the pandemic threat of the coronavirus epidemic, several countries, including China, adopted lockdown and quarantine policies, which may cause psychological distress. This study aimed to explore the psychological impact of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China as well as the corresponding risk factors and protective factors. Methods We examined the immediate (2-week) and delayed (2-month) impact of province-wide lockdown and personal quarantine on psychological distress in a national sample of 1390 Chinese residents. Results No immediate impact of province-wide lockdown on psychological distress was observed, whereas personal quarantine increased individuals’ anxiety, fear, and anger. Despite the lack of initial association, psychological distress increased among those in province-wide lockdown. Self-stigma and personal control both significantly moderated the association between lockdown and psychological distress, but in different directions. Those with higher self-stigma and lower personal control were more impacted by the lockdown. Government support moderated the impact of quarantine on psychological distress, but not that of lockdown. Conclusions The delayed effects of lockdown and quarantine on psychological distress were observed, and self-stigma, social support, and perceived control moderate the relationships. This study is the first to demonstrate the psychological costs of province-wide lockdowns on individuals’ mental health, providing evidence of the need for mitigation strategies and timely public mental health preparedness in countries with recent outbreaks of COVID-19.


2021 ◽  
Author(s):  
Valentina Delle Donne ◽  
Nicoletta Ciccarelli ◽  
Valentina Massaroni ◽  
Francesca Lombardi ◽  
Silvia Lamonica ◽  
...  

Abstract Our aim was to explore the psychological impact of the initial 2019 Coronavirus (COVID-19) pandemic in a cohort of people living with HIV (PLWH), a population at increased risk of psychological distress. PLWH, treated at our unit, responded an online survey. Data on demographics, clinical and physical symptoms, contact history, as well as knowledge, concerns, precautionary measures and additional information required with respect to COVID-19 during the first phase of the pandemic in Italy were collected. Additionally, the Impact of Event Scale-Revised (IES-R) (identifying COVID-19 pandemic as specific traumatic life event) and the Depression, Anxiety and Stress Scale (DASS-21) were also administered. Out of 98 participants, 44 (45%) revealed from mild to severe psychological impact distress from COVID-19 according to IES-R. According to DASS-21, a lower percentage of significant levels of depression (14%), anxiety (11%) or stress (6%) were reported. Higher education, unemployment, number of perceived physical COVID-19 symptoms, concerns contracting COVID-19 and the situation regarding the pandemic in Italy, and the need of additional information to prevent COVID-19 infection were positively associated to psychological distress. Moreover, female gender, older age, recent HIV diagnosis and unawareness of own viremia were associated to a higher psychological distress. Almost half of our cohort experienced significant levels of distress related to the COVID-19 pandemic. Women, elderly patients and those with recent HIV diagnosis resulted to be the more psychological fragile subgroup. Our findings could help to identify patients in need of psychological interventions to improve wellbeing of PLWH.


2021 ◽  
Author(s):  
Musheer A. Aljaberi ◽  
Naser A. Alareqe ◽  
Mousa A. Qasem ◽  
Abdulsamad Alsalahi ◽  
Sarah Noman ◽  
...  

Abstract Background: Due to the limited research examining the psychological impact of coronavirus disease 2019 (COVID-19), our study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes and assess the differences between participants with and without post-traumatic stress disorder (PTSD) on the psychological outcomes as latent factors and items. Methods: An online survey was conducted on 999 participants. The Impact of Event Scale-Revised (IES-R) assessed the psychological impact, while outcomes were measured by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). A series of Confirmatory Factor Analysis (CFA), structural equation model (SEM), Multiple Indicators and Multiple Causes (MIMIC), and Differential Item Functioning (DIF) were conducted. Results: The IES-R has significant effects on the psychological outcomes. Participants with PTSD have a higher impact on latent factors (depression, anxiety, and insomnia) than those without PTSD. Among participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. For anxiety, 23.7% of respondents experienced moderate to severe anxiety symptoms, and 33.1% had mild symptoms of anxiety. For the ISI, 51.5% of participants experienced symptoms of insomnia. Conclusion: the IES-R for COVID-19 has a significant impact on depression, anxiety, and insomnia at the level of latent constructs and observed variables.


2021 ◽  
Vol 12 ◽  
Author(s):  
Dóra Révész ◽  
Genís Ona ◽  
Giordano N. Rossi ◽  
Juliana M. Rocha ◽  
Rafael G. dos Santos ◽  
...  

Background: One of the main public health strategies adopted at the beginning of the COVID-19 pandemic consisted of implementing strict lockdowns to stop the transmission of the virus. Despite being an effective measure, the confinement and the associated social isolation create a stressful, potentially lengthy situations that has been proven to have several psychological consequences. Given the potential benefits that certain psychedelic drugs have shown for the treatment of psychological disorders, this study aimed to assess the impact of lifetime psychedelic drug use on mental health in relation to the first strict lockdown adopted by various countries (April-July 2020).Methods: Subjects completed an online survey that inquired about sociodemographic factors, activities, and lifestyle factors during confinement, as well as health and mental health related factors. Subjects were asked about their lifetime use of psychedelic drugs (MDMA, ayahuasca, psilocybin-containing mushrooms, LSD, peyote, San Pedro, Bufo alvarius or 5-MeO-DMT, and others), being classified as regular users (more than once per 6 months), occasional users, or non-users. The survey included psychometric tests used to assess psychological distress, peritraumatic stress, social support, psychopathological symptoms, and personality. Linear regressions were performed with psychedelic drug users as the independent variable and psychometric factors as the outcomes, while correcting for age, gender, language, religion, spirituality, and use of non-psychedelic drugs.Results: The study included 2,974 English, Portuguese, and Spanish speakers (497 regular users of psychedelic drugs, 606 occasional users, and 1,968 non-users). On average, respondents were 36 years old and 70% were female. Psychedelic drug users, especially regular ones, reported less psychological distress, less peritraumatic stress, and more social support. Regarding personality measures, psychedelic drug users scored higher on the novelty-seeking and self-transcendence scales, and lower on cooperativeness.Conclusion: Our findings showed that regular users of psychedelic drugs had less psychological stress and some personality differences when compared to occasional users and non-users. This suggests that either the use of psychedelics might be a protective factor itself or people with certain previous traits are more prone to frequently using psychedelic drugs. Future prospective longitudinal research should investigate the underlying processes observed in this study to develop consistent hypotheses.


2021 ◽  
Vol 12 ◽  
Author(s):  
Marta Ciułkowicz ◽  
Julian Maciaszek ◽  
Błażej Misiak ◽  
Anna Pałȩga ◽  
Joanna Rymaszewska ◽  
...  

Background: The SARS-CoV-2 pandemic was announced on March 11th, 2020, due to a surge of newly confirmed cases that significantly impacted populations worldwide, both directly and indirectly. Based on past epidemics research, the mental health implications of introduced restrictions should be expected and adequately addressed irrespective of the practiced profession.Objective: The study aimed to explore psychopathological responses, including post-traumatic stress disorder (PTSD), concerning coping strategy clusters during the COVID-19 pandemic among medical and non-medical workers.Methods: A cross-sectional web survey of the general population of internet users was performed from March 16th to April 26th, 2020, in Poland during the first peak of COVID-19 cases. A sample of 1,831 professionally active respondents, 64.0% of which pursuing a medical career, filled out General Health Questionnaire-28 (GHQ-28), The Impact of Event Scale-Revised (IES-R), and MiniCOPE, along with the socio-demographic questionnaire exploring personal as well as the work-related possibility of direct exposure to contagion and availability of proper protection, contact with the infected without accurate protective measures as well as the adequacy of workers when compared settings.Results: Individuals labeled with specific clusters had significantly different psychopathological manifestations. Irrespective of performed job maladaptive cluster was associated with significantly higher GHQ-28 and IES-R scores on total subscales and all subscales compared to those representing the non-specific and adaptive cluster. Similar findings were observed concerning the frequency of the GHQ-28 positive score. Moreover, the non-specific cluster was associated with significantly higher GHQ-28 total scores among medical professionals. However, GHQ-28 positive scores were significantly more frequent in medical workers using adaptive clusters when compared to non-specific. Such relations were not observed in the non-medical group.IES-R total and subscales' scores did not significantly vary within medical and non-medical groups when adaptive and non-specific clusters were compared. Pursuing a non-medical career was found to be a determinant of lower scores, while female sex was observed to be determinant of higher scores in both GHQ-28 and IES-R scales.Conclusions: Positive screening for psychopathological and PTSD symptoms was expected regardless of the analyzed groups' coping strategies. Given the dramatically developing situation of the COVID-19 pandemic, support initiatives grounded in research evidence may be essential for maintaining the mental well-being and resilience of both the medical and non-medical workforce.


2021 ◽  
Vol 10 (34) ◽  
pp. 2884-2887
Author(s):  
Ajay Kumar Joopaka ◽  
Molanguri Umashankar ◽  
Pingali Srilakshmi ◽  
Pradeep Sharma Telkapalli ◽  
Chinni Krishna Banoth ◽  
...  

BACKGROUND Corona virus disease or the (COVID 19) has caused mental health problems in the general population, in people infected and hospitalised for the disease and in patients who have recovered from the disease physically but continue to suffer from lingering mental health problems. Studies have shown stress, depression, and anxiety in one third of the survivors. Similarly post-traumatic stress disorder has been reported to be around 13 % in the survivors of COVID 19. In this study, we wanted to assess the psychological symptoms in the survivors of Covid 19 patients, one month post discharge and also assess various factors associated with the same. METHODS A cross sectional telephonic survey of the patients one month following discharge was done to understand the psychological problems. Sociodemographic data was recorded on a semi structured proforma, whereas psychological distress was recorded on patient health questionnaire - 4 (PHQ - 4) and the post-traumatic stress disorder (PTSD) was screened for by the impact of event scale revised (IES - R). RESULTS Of the 200 patients evaluated, 46.8 % scored above 20 on the impact of event scale which was considered to be a positive screen for post-traumatic stress disorder. Moderate psychological distress was reported by 10.5 % and severe by 7.5 % as measured by PHQ - 4. Being married, having other family members effected by the infection and deaths in the family were some of the factors that were significantly associated with psychological distress and symptoms of post-traumatic stress disorder. CONCLUSIONS Continued mental health support needs to be extended to members who are considered to have recovered and discharged from the hospital following the COVID 19 infection. KEY WORDS COVID 19, Psychological Symptoms, Post-Traumatic Stress Disorder


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