Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20%−28%), 25% for nurses (95% CI: 18%−33%), 24% for medical doctors (95% CI: 16%−31%), and 43% for frontline professionals (95% CI: 28%−59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.

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Immediate Psychosocial Impact on Healthcare Workers During COVID-19 Pandemic in China: A Systematic Review and Meta-Analysis

Frontiers in Psychology ◽

10.3389/fpsyg.2021.645460 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fei Dong ◽

Hong-liang Liu ◽

Ming Yang ◽

Chun-li Lu ◽

Ning Dai ◽

...

Keyword(s):

Systematic Review ◽

Study Protocol ◽

Healthcare Workers ◽

Meta Analysis ◽

Hubei Province ◽

Psychosocial Impact ◽

Stress Disorders ◽

Pooled Prevalence ◽

Prevalence Of Depression ◽

Anxiety Depression

Objectives: The corona virus disease-2019 (COVID-19) pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers (HWs) in China during the pandemic.Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, depression, and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO (CRD42020195843).Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4% (29.5–39.4%), 31.1% (24.5–37.7%), and 29.1% (24.3–33.8%) for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4% (42.9–49.9%), significantly higher than those in mid-term February (28.0%, 23.9–32.1%) and after late February (27.6%, 16.0–39.2%). The pooled prevalence of depression disorders for HWs from late January to early February was 46.5% (38.8–54.2%), significantly higher than those in mid-term February (27.1%, 19.8–34.5%) and after late February (32.9%, 16.2–49.5%). HWs working in Hubei Province had a higher prevalence of anxiety (37.9 vs. 30.8%) and a lower prevalence of depression (27.5 vs. 34.7%) than those working in other regions. Nurses had a higher prevalence of anxiety (44.1 vs. 29.0%) and depression (34.1 vs. 29.2%) than other HWs.Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic.Systematic Review Registration: The study protocol was registered with PROSPERO (CRD42020195843).

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Prevalence of malaria and scrub typhus co-infection in febrile patients: a systematic review and meta-analysis

Parasites & Vectors ◽

10.1186/s13071-021-04969-y ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Polrat Wilairatana ◽

Saruda Kuraeiad ◽

Pongruj Rattaprasert ◽

Manas Kotepui

Keyword(s):

Systematic Review ◽

Scrub Typhus ◽

Meta Analysis ◽

Severe Disease ◽

Forest Plot ◽

Cross Sectional ◽

Random Effects Models ◽

Pooled Prevalence ◽

Study Results ◽

Endemic Areas

Abstract Background Little information is available about malaria and scrub typhus co-infection. This study aimed to investigate the pooled prevalence of malaria and scrub typhus co-infection in febrile patients. Further, it aimed to estimate the prevalence of scrub typhus infection among patients with malaria and the odds of co-infection. This will aid the diagnosis and management of co-infected patients in endemic areas. Methods We searched for relevant studies in three databases: PubMed, Scopus, and Web of Science. We assessed the quality of the included studies using the Joanna Briggs Institute checklist for analytical cross-sectional studies. We estimated (1) the pooled prevalence of malaria and scrub typhus co-infection, (2) the pooled prevalence of scrub typhus infection in malaria-positive patients, and (3) the pooled odds of co-infection using the DerSimonian–Laird method for random-effects models. The study results and summary estimates were visualized on a forest plot as point estimates (effect size, prevalence) and 95% confidence intervals (CI). We assessed the heterogeneity of the studies by Cochrane Q or I2 statistics. We performed subgroup analyses of countries and scrub typhus diagnostic tests to explore the sources of heterogeneity of the included studies. We assessed publication bias if more than 10 studies were used to estimate the outcome. All data analyses were conducted using Stata version 14 (StataCorp, College Station, TX, USA). Results Of the 542 studies retrieved from three databases, we included 14 meeting the inclusion criteria in the systematic review and meta-analysis. The pooled prevalence of malaria and scrub typhus co-infection (56 cases) among febrile patients (7920 cases) was 1% (95% CI: 0–1%, I2: 78.28%), while the pooled prevalence of scrub typhus infection (321 cases) in patients with malaria (1418 cases) was 21% (95% CI: 12–30%, I2: 98.15%). Subgroup analysis showed that the pooled prevalence of scrub typhus infection among patients with malaria in India was 8% (95% CI: 4–13%, I2: 85.87%, nine studies with 59/794 cases), while the pooled prevalence of scrub typhus infection among patients with malaria in Thailand was 35% (95% CI: 7–64%, I2: 98.9%, four studies with 262/624 cases). The co-infections did not occur by chance (P = 0.013, odds: 0.43, 95% CI: 0.22–0.84%, I2: 60.9%). In the sensitivity analysis, the pooled prevalence of malaria and scrub typhus co-infection among febrile patients was 0% (95% CI: 0–1%, I2: 59.91%). Conclusions The present study showed the pooled prevalence and a significant association between malaria and scrub typhus. The results show the status of co-infection. Further research into co-infection in endemic areas is needed, in particular, to determine whether co-infection can accelerate disease progression or protect against severe disease. Graphical abstract

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Prevalence of depression among school going adolescents in India: a systematic review and meta-analysis of cross-sectional studies

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210248 ◽

2021 ◽

Vol 8 (2) ◽

pp. 833

Author(s):

Prashanthi Kamath ◽

Sushma Marita Dsouza ◽

Subhransu Mahapatra ◽

Sruthi Jayakumar

Keyword(s):

Mental Health ◽

High School ◽

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Cochrane Library ◽

Cross Sectional ◽

School Based ◽

Pooled Prevalence ◽

Prevalence Of Depression

The objective of this systematic review was to estimate the pooled prevalence of depression among schoolgoing adolescents in India by using Beck’s Depression Inventory (BDI 1 or BDI 2). A systematic literature search was conducted in PubMed, Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, PsycINFO and Google Scholar to identify cross-sectional school-based studies published during 1990-2020. Studies with pre-identified mental illness were excluded. Heterogeneity between studies were examined and estimates were pooled using a random-effects model. Subgroup and sensitivity analysis were performed. Publication bias was evaluated using funnel plot and Egger’s test. We included 13 studies in the meta-analysis. The random effect meta-analysis revealed that the pooled prevalence of depression among school going adolescents was 53% (95% CI: 41% - 65%). By gender, the prevalence was 50% (95 % CI: 38%–62%) in males and 57% (95% CI: 46% - 69%) in females. The subgroup analysis revealed that the pooled prevalence increased with the education levels (High school: 42%; High school and pre-university: 55%; and Pre-university: 67%). In this review we found that more than half of the school going adolescents in India suffered from depression that ranged from mild to severe. These results draw attention to re-look at the mental health policy and newer public health approaches to address depression. Further, strengthening school-based mental health services, along with the community and center-based care is crucial to prevent and effective management of depression among adolescents.

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Prevalence and Risk Factors of Mental Health Problems Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.567381 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qinjian Hao ◽

Dahai Wang ◽

Min Xie ◽

Yiguo Tang ◽

Yikai Dou ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Systematic Review ◽

Healthcare Workers ◽

Mental Health Problems ◽

Meta Analysis ◽

Health Problems ◽

Post Traumatic Stress ◽

Obsessive Compulsive ◽

Prevalence Of Depression

Objective: The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic.Methods: We applied an optimized search strategy across the PubMed, EMBASE, Scopus, PsycINFO, and four Chinese databases, with hand searching supplemented to identify relevant surveys. Studies were eligible for inclusion if they were published in peer-reviewed literature and used a validated method to assess the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Heterogeneity was quantified using Q statistics and the I2 statistics. The potential causes of heterogeneity were investigated using subgroup analysis and meta-regression analysis. Sensitivity analysis was performed to examine the robustness of the results.Results: We pooled and analyzed data from 20 studies comprising 10,886 healthcare workers. The prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive–compulsive symptoms, and somatization symptoms was 24.1, 28.6, 44.1, 25.6, 35.0, 16.2, and 10.7%, respectively. Female and nurses had a high prevalence of depression and anxiety. Frontline healthcare workers had a higher prevalence of anxiety and a lower prevalence of depression than the those in the second-line. Furthermore, the proportion of moderate–severe depression and anxiety is higher in the frontline. Additionally, four studies reported on risk factors of mental health problems.Conclusions: In this systematic review, healthcare workers have a relatively high prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive–compulsive symptoms, and somatization symptoms during the COVID-19 pandemic, and focus should be on the healthcare workers at high risk of mental problems. Mental health problems in healthcare workers should be taken seriously, and timely screening and appropriate intervention for the high-risk group are highly recommended.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179189.

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Prevalence of Depression, Anxiety, and Insomnia Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3594632 ◽

2020 ◽

Cited By ~ 11

Author(s):

Sofia Pappa ◽

Vasiliki Ntella ◽

Timoleon Giannakas ◽

Vassilis G. Giannakoulis ◽

Eleni Papoutsi ◽

...

Keyword(s):

Systematic Review ◽

Healthcare Workers ◽

Meta Analysis ◽

Prevalence Of Depression

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Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0257983 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257983

Author(s):

Siew Mooi Ching ◽

Kar Yean Ng ◽

Kai Wei Lee ◽

Anne Yee ◽

Poh Ying Lim ◽

...

Keyword(s):

Meta Analysis ◽

Healthcare Providers ◽

Random Effects Model ◽

Depression And Anxiety ◽

Cross Sectional ◽

Funnel Plot ◽

Health And Wellbeing ◽

Pooled Prevalence ◽

Increased Risk ◽

Prevalence Of Depression

Introduction COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic. Material and methods We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI. Results We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8–41.3), anxiety 39.7(95%CI: 34.3–45.1), stress 36.4% (95%CI: 23.2–49.7), fear 71.3% (95%CI: 54.6–88.0), burnout 68.3% (95%CI: 54.0–82.5), and low resilience was 16.1% (95%CI: 12.8–19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30–1.68) and nurses (OR = 1.21; 95%CI = 1.02–1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49–1.85), (Nurse: OR = 1.36; 95%CI = 1.16–1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28–1.97). Conclusion In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

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Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Autism ◽

10.1177/13623613211045029 ◽

2021 ◽

pp. 136236132110450

Author(s):

Xian Liu ◽

Xin Sun ◽

Caihong Sun ◽

Mingyang Zou ◽

Yiru Chen ◽

...

Keyword(s):

Systematic Review ◽

Intellectual Disability ◽

Human Development ◽

Human Development Index ◽

Clinical Sample ◽

Meta Analysis ◽

Population Based ◽

Cross Sectional ◽

Development Index ◽

Pooled Prevalence

The literature from inception to 2020 on the prevalence of epilepsy in autistic individuals was systematically reviewed and further explored by subgroup analyses and meta-regression models. This systematic review is registered with PROSPERO (CRD42020179725). A total of 66 studies from 53 articles were included. The updated pooled prevalence of epilepsy in autistic individuals was 10% (95% CI: 6–14). The respective prevalence estimate of epilepsy was 19% (95% CI: 6–35) in the clinical sample-based cross-sectional study, 7% (95% CI: 3–11) in the cohort study, and 9% (95% CI: 5–15) in the population-based cross-sectional study. The pooled prevalence of epilepsy was 7% (95% CI: 4–11) in autistic children and 19% (95% CI: 14–24) in autistic adults. Compared to the school-aged group, the adolescence group (OR: 1.15, 95% CI: 1.06–1.25) and the pre-school group (OR: 1.06, 95% CI: 0.94–1.19) were positively associated with the prevalence of epilepsy. The moderators of age, human development index of the country, gender, and intellectual function accounted for most of the heterogeneity. The prevalence estimates were associated with age, female gender, intellectual disability rate, and the human development index of countries. About 1/10 autistic individuals co-occurred with epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability, and less common in the country with high human development index. Lay abstract Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11–17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7–10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.

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Prevalence of smoking in adults with spinal cord stimulators: a systematic review and meta-analysis

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2019-100996 ◽

2020 ◽

Vol 45 (3) ◽

pp. 214-218

Author(s):

W Michael Hooten ◽

Rajat N Moman ◽

Jodie Dvorkin ◽

E Morgan Pollard ◽

Robalee Wonderman ◽

...

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Smoking Status ◽

Meta Analysis ◽

Vascular Diseases ◽

Risk Of Bias ◽

Future Research ◽

Cross Sectional ◽

Prevalence Studies ◽

Pooled Prevalence

BackgroundSmoking adversely impacts pain-related outcomes of spinal cord stimulation (SCS). However, the proportion of SCS patients at risk of worse outcomes is limited by an incomplete knowledge of smoking prevalence in this population. Thus, the primary aim of this systematic review is to determine the prevalence of smoking in adults with chronic pain treated with SCS.MethodsA comprehensive search of databases from 1 January 1980 to 3 January 2019 was conducted. Eligible study designs included (1) randomized trials; (2) prospective and retrospective cohort studies; and (3) cross-sectional studies. The risk of bias was assessed using a tool specifically developed for prevalence studies. A total of 1619 records were screened, 19 studies met inclusion criteria, and the total number of participants was 10 838.ResultsThirteen studies had low or moderate risk of bias, and six had a high risk of bias. All 19 studies reported smoking status and the pooled prevalence was 38% (95% CI 30% to 47%). The pooled prevalence in 6 studies of peripheral vascular diseases was 56% (95% CI 42% to 69%), the pooled prevalence of smoking in 11 studies of lumbar spine diagnoses was 28% (95% CI 20% to 36%) and the pooled prevalence in 2 studies of refractory angina was 44% (95% CI 31% to 58%).ConclusionsThe estimated prevalence of smoking in SCS patients is 2.5 times greater than the general population. Future research should focus on development, testing and deployment of tailored smoking cessation treatments for SCS patients.

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The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression

Human Resources for Health ◽

10.1186/s12960-020-00544-1 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Nader Salari ◽

Habibolah Khazaie ◽

Amin Hosseinian-Far ◽

Behnam Khaledi-Paveh ◽

Mohsen Kazeminia ◽

...

Keyword(s):

Systematic Review ◽

Sample Size ◽

Healthcare Workers ◽

Meta Analysis ◽

Research Work ◽

Hospital Staff ◽

Anxiety And Depression ◽

Front Line ◽

Prevalence Of Depression ◽

Meta Regression

Abstract Background Stress, anxiety, and depression are some of the most important research and practice challenges for psychologists, psychiatrists, and behavioral scientists. Due to the importance of issue and the lack of general statistics on these disorders among the Hospital staff treating the COVID-19 patients, this study aims to systematically review and determine the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. Methods In this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I2 index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software. Results Of the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2–31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5–31.9%), and the prevalence of stress is 45% (95% CI 24.3–67.5%) among the hospitals’ Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P < 0.05), however, the prevalence of stress increased with increasing the sample size, yet this was not statistically significant (P = 0.829). Conclusion The results of this study clearly demonstrate that the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients is high. Therefore, the health policy-makers should take measures to control and prevent mental disorders in the Hospital staff.

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