Emotional Fatigue, Elevated Anxiety Symptoms, and Sustained Psychological Distress in Frontline Medical Staff and Nurses Working with COVID-19 Patients

ObjectiveThe COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA.DesignWe conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out).SettingThe questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey.ParticipantsUsing a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey.Primary outcomePrevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms.ResultsParticipants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71).ConclusionHCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being.

Download Full-text

Psychological Distress in Out-Patients Assessed for Chronic Pain Compared to Those with Rheumatoid Arthritis

Pain Research and Management ◽

10.1155/2016/7071907 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

D. Rice ◽

S. Mehta ◽

A. Shapiro ◽

J. Pope ◽

M. Harth ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Chronic Pain ◽

Psychological Distress ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Analysis Of Covariance ◽

Pain Clinic ◽

Cross Sectional ◽

Rheumatology Clinic ◽

Two Samples

Background. Patients diagnosed with chronic pain (CP) and rheumatoid arthritis (RA) represent two samples with overlapping symptoms, such as experiencing significant pain.Objectives. To compare the level of psychological distress among patients diagnosed CP attending a specialist pain clinic with those attending a specialist RA clinic.Measures. A cross-sectional study was conducted at an academic specialist chronic pain and rheumatology clinic.Participants. 330 participants included a CP group (n=167) and a RA group (n=163) completed a booklet of questionnaires regarding demographic characteristics, duration, and severity of their pain. Psychological and personality variables were compared between the CP and RA participants using a Multivariate Analysis of Covariance (MANCOVA).Results. Level of psychological distress based on the subscales of the DASS (depression, anxiety, and stress), PASS (escape avoidance, cognitive anxiety, fear of pain, and physiological anxiety), and PCS (rumination, magnification, and helplessness) was significantly higher in the CP group compared to the RA group. Categorization of individuals based on DASS severity resulted in significant differences in rates of depression and anxiety symptoms between groups, with a greater number of CP participants displaying more severe depressive and anxiety symptoms.Discussion and Conclusions. This study found greater levels of psychological distress among CP individuals referred to an academic pain clinic when compared to RA patients referred to an academic rheumatology clinic.

Download Full-text

Associations of psychological distress with positive psychological variables and activities of daily living among stroke patients: a cross-sectional study

BMC Psychiatry ◽

10.1186/s12888-019-2368-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Xiaoxi Wang ◽

Shengjie Shang ◽

Huazhe Yang ◽

Hua Ai ◽

Yin Wang ◽

...

Keyword(s):

Social Support ◽

Psychological Distress ◽

Activities Of Daily Living ◽

Self Efficacy ◽

Daily Living ◽

Anxiety Symptoms ◽

Stroke Survivors ◽

Stroke Patients ◽

Psychological Variables ◽

Negatively Associated

Abstract Background Depression and anxiety result in psychological distress, which can further affect mental status and quality of life in stroke patients. Exploring the associations between positive psychological variables and symptoms of psychological distress following stroke is of great significance for further psychological interventions. Methods A total of 710 stroke patients from the five largest cities in Liaoning Province in China were enrolled into the present study in July 2014. All patients independently completed the questionnaires with respect to psychological distress and positive psychological variables. Depressive and anxiety symptoms were evaluated using Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale, respectively. Positive psychological variables were evaluated using Perceived Social Support Scale, Adult Hope Scale (AHS), General Perceived Self-Efficacy Scale and Resilience Scale-14 (RS-14). Activities of Daily Living (ADL) was measured using Barthel Index. Factors associated with psychological variables and depressive and anxiety symptoms were identified using t-test, ANOVA, correlation and hierarchical linear regression analysis. Results Depressive and anxiety symptoms were present in 600 of 710 (84.51%) and 537 of 710 (75.63%) stroke patients enrolled, respectively. Social support (β = − 0.111, p < 0.001) and hope (β = − 0.120, p < 0.001) were negatively associated with both depressive and anxiety symptoms. Resilience (β = − 0.179, p < 0.001) was negatively associated with depressive symptoms. Self-efficacy (β = − 0.135, p < 0.001) was negatively associated with anxiety symptoms. Hierarchical regression analyses indicated that ADL accounted for 10.0 and 6.0% of the variance of depressive and anxiety symptoms, respectively. Social support, resilience, self-efficacy and hope as a whole accounted for 7.5 and 5.3% of the variance of depressive and anxiety symptoms. Conclusions The high frequency of depressive and anxiety symptoms among Chinese stroke survivors should receive attentions from all stakeholders. Findings suggested that intervention strategies on ADL, social support, hope, resilience and self-efficacy could be developed to improve psychosocial outcomes for stroke survivors.

Download Full-text

Psychological Distress and Weight Gain in Pregnancy: a Population-Based Study

International Journal of Behavioral Medicine ◽

10.1007/s12529-019-09832-0 ◽

2019 ◽

Vol 27 (1) ◽

pp. 30-38

Author(s):

Florianne O. L. Vehmeijer ◽

Sangeeta R. Balkaran ◽

Susana Santos ◽

Romy Gaillard ◽

Janine F. Felix ◽

...

Keyword(s):

Psychological Distress ◽

Weight Gain ◽

Population Based ◽

Brief Symptom Inventory ◽

Anxiety Symptoms ◽

Total Weight ◽

Excessive Weight Gain ◽

Excessive Weight ◽

Total Weight Gain ◽

In Pregnancy

Abstract Background Psychological distress and inappropriate or excessive weight gain are common in pregnancy and are associated with adverse maternal and offspring outcomes. Psychological well-being and weight status of women during pregnancy might be interrelated. We aimed to examine whether psychological distress during pregnancy is associated with gestational weight gain. Method In a population-based cohort of 3393 pregnant women, information about psychological distress, depressive and anxiety symptoms was assessed at 20 weeks of gestation using the Brief Symptom Inventory questionnaire. Weight was repeatedly measured during pregnancy and obtained by questionnaire before and after pregnancy. Linear regression and multinomial logistic regression models were used. Weight gain in the second half of pregnancy, total weight gain, and the risks of inadequate and excessive total weight gain were the main outcome measures. Results In total, 7.0% of all women experienced psychological distress. Overall psychological distress and anxiety were associated with lower weight gain in the second half of pregnancy (differences − 1.00 kg (95% confidence interval (CI) − 1.62, − 0.37) and − 0.68 kg (95% CI - 1.24, -0.11), respectively). These associations fully attenuated into non-significance after taking account for socio-demographic variables. Similar results were observed for total weight gain. Only women with anxiety symptoms had, independently of potential confounders, a lower risk of excessive weight gain (odds ratio (OR) 0.61 (95% CI 0.48, 0.91)). Conclusions In this large prospective cohort study, the observed associations of psychological distress with weight gain during pregnancy seem to be largely explained by common socio-demographic factors.

Download Full-text

A Study of Psychiatric Consequences following Road Traffic Accidents

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v9i2.5017 ◽

1970 ◽

Vol 9 (2) ◽

pp. 1-7

Author(s):

N Rawal ◽

P Thapa ◽

Y Bista

Keyword(s):

Psychological Distress ◽

Depressive Symptoms ◽

Traffic Accidents ◽

Road Traffic ◽

Psychiatric Symptoms ◽

Psychiatric Morbidity ◽

Anxiety Symptoms ◽

Ptsd Symptoms ◽

Road Traffic Accidents ◽

The Impact

Objectives: Psychiatric consequences are very common following RTA. The study is sought to identify the prevalence of psychiatric morbidity (e.g. depressive symptoms, anxiety symptoms and symptoms related to PTSD(Post Traumatic Stress Disorder) following injury sustained after road traffic accidents and to evaluate the relationshop between severity of injuries of victims and psychiatric symptoms. Methods: The 102 (male=83,female=19) patients were interviewed using a questionnaire to collect the socio- demographic data, the Self Rating Questionnaire (SRQ) -Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI) and the Impact of Event Scale -Revised (IES-R). Patients were prospectively followed up for 1 month. Patients were aged between 20-69 years. The impact of injury was assessed by ISS (Injury Severity Scale) and ABI (Abbreviated injury Scale). Results:The mean age was 33.93 years (range 20-69). Overall, the prevalence rate o of Anxiety symptoms-19.6%, depressive symptoms-21.6% and PTSD symptoms-35.3%. Females had a higher rate of PTSD symptoms 52.6% (n = 10), compared to the males 31.3% (n=26). The majority of those with PTSD (47.2%) were young, 20 - 29 years. The samples showed maximum symptoms of PTSD in first week 93.1% followed by depressive symptoms 51% and then anxiety symptoms30.4%. The symptoms gradually reduced in the fourth week to PTSD - 35.3%, depression- 21.6% and anxiety-19.6%. The study also showed higher scales of psychiatric symptoms in major injuries in comparison to minor injuries showing direct correlation of psychiatric morbidity with severity of injury. Conclusion: Psychiatric symptoms are frequent and severe after major injuries and less severe after minor RTA. Psychopathology following injury is a frequent and persistent occurrence. Early information and advice might reduce psychological distress and symptoms. Early information and advice might reduce psychological distress and symptoms. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5017 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 1-7

Download Full-text

Depression and anxiety symptoms in bereaved caregivers of patients with advanced cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.17 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 17-17

Author(s):

Areej El-Jawahri ◽

Joseph Greer ◽

Vicki A. Jackson ◽

Emily R. Gallagher ◽

Mihir Kamdar ◽

...

Keyword(s):

Psychological Distress ◽

Advanced Cancer ◽

Depression Scale ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

Cancer Type ◽

Depression And Anxiety ◽

Oncology Care ◽

Caregiver Rating ◽

Cancer Experience

17 Background: Caregivers of patients with advanced cancer experience substantial caregiving burden and psychological distress during the illness course. However, data on depression and anxiety symptoms in bereaved caregivers and factors associated with their psychological distress are lacking. Methods: We conducted a secondary analysis of 168 caregivers enrolled in a randomized trial of early palliative care integrated with oncology care versus oncology care alone for patients newly-diagnosed with incurable lung and non-colorectal gastrointestinal cancers and their caregivers who completed bereavement assessments at 3 months after their loved one’s death. We used the Hospital Anxiety and Depression Scale (HADS) to assess patients’ and caregivers’ depression and anxiety symptoms at baseline within 8 weeks of diagnosis, and at 3-4 months after the patient’s death (for caregivers). We asked caregivers to rate patient’s physical and psychological distress in the last week of life on a 10-point scale. We used linear regression adjusting for randomization and cancer type to explore associations between patient and caregiver factors and bereaved caregivers’ depression and anxiety. Results: 30.4% (51/168) and 43.4% (73/168) of bereaved caregivers reported clinically significant depression and anxiety symptoms, respectively. Younger patient age (B = -0.06, P = 0.041), higher patient baseline anxiety (B = 0.28, P = 0.002), and caregiver rating of worse physical (B = 0.28, P = 0.035) and psychological (B = 0.41, P < 0.001) distress experienced by the patient at the end of life (EOL) were associated with worse depression symptoms in bereaved caregivers. Only caregiver factors, including age (B = -0.07, P = 0.004), female sex (B = 1.60, P = 0.024), and rating of worse psychological distress experienced by the patient at the EOL (B = 0.42, P < 0.001) were associated with worse bereaved caregivers’ anxiety symptoms. Conclusions: Bereaved caregivers of patients with advanced cancer experience substantial psychological distress which is associated with their perceptions of their loved one’s distress at the EOL. Interventions to optimize EOL care for patients and reduce bereaved caregivers’ psychological distress are needed.

Download Full-text

Sustained Psychological Distress, Acute Depression, and Emotional Exhaustion in Frontline Medical Staff and Nurses Working with COVID-19 Patients

Psychosociological Issues in Human Resource Management ◽

10.22381/pihrm91202110 ◽

2021 ◽

Vol 9 (1) ◽

pp. 99

Keyword(s):

Psychological Distress ◽

Emotional Exhaustion ◽

Medical Staff

Download Full-text

There’s no sugar-coating psychological distress and illness perceptions in gestational diabetes mellitus: depression and anxiety are associated with negative illness perceptions

Australasian Psychiatry ◽

10.1177/10398562211038910 ◽

2021 ◽

pp. 103985622110389

Author(s):

Paul A Maguire ◽

Jasmine Cummings ◽

Rebecca E Reay ◽

Christopher Nolan ◽

Jeffrey C L Looi

Keyword(s):

Psychological Distress ◽

Gestational Diabetes ◽

Pregnant Women ◽

Illness Perceptions ◽

Illness Perception ◽

Depression Scale ◽

Anxiety Symptoms ◽

Strong Positive Correlation ◽

Distress Scale ◽

Anxiety Subscale

Objective: To gain an understanding of how women with gestational diabetes perceive their illness, and whether depressive/anxiety symptoms and/or psychological distress influence these illness perceptions. Method: A cross-sectional study was conducted with 159 pregnant women aged 18–44 attending gestational diabetes clinics. Participants completed a questionnaire, which included the Edinburgh Depression Scale (EDS), Kessler 10-item Psychological Distress Scale (K-10), Brief Illness Perception Questionnaire (BIPQ), and psychiatric/general health items. Multiple regression was used to explore the relationship between EDS (total and anxiety subscale) scores and BIPQ scores, as well as between K-10 (total and anxiety subscale) scores and BIPQ scores. Results: Regression analysis revealed a positive association between EDS total/anxiety subscale scores and BIPQ total score, as well as between K-10 total/anxiety subscale scores and BIPQ total score, controlling for potentially confounding variables. There was a strong positive correlation between EDS total score and K-10 total score. The most frequently expressed concern about GDM was an adverse effect on their baby’s health. A poor diet was the most frequently reported perceived ‘cause’ of GDM. Conclusion: Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women.

Download Full-text