A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak
•Commonly reported symptoms are headache, throat pain and lethargy.•A large number of healthcare workers report more than four symptoms.•Those with physical symptoms had higher rates of depression, anxiety, stress, PTSD.•Those with physical symptoms had higher mean scores in the IES-R, DASS subscale...
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| Published in | Brain, behavior, and immunity Vol. 88; pp. 559 - 565 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier Inc
01.08.2020
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| Subjects | |
| Online Access | Get full text |
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| Abstract | •Commonly reported symptoms are headache, throat pain and lethargy.•A large number of healthcare workers report more than four symptoms.•Those with physical symptoms had higher rates of depression, anxiety, stress, PTSD.•Those with physical symptoms had higher mean scores in the IES-R, DASS subscales.•Association between physical symptoms and psychological outcomes may be bidirectional.
Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.
Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.
Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54–5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36–3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27–7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12–4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.
Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded. |
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| AbstractList | •Commonly reported symptoms are headache, throat pain and lethargy.•A large number of healthcare workers report more than four symptoms.•Those with physical symptoms had higher rates of depression, anxiety, stress, PTSD.•Those with physical symptoms had higher mean scores in the IES-R, DASS subscales.•Association between physical symptoms and psychological outcomes may be bidirectional.
Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.
Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.
Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54–5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36–3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27–7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12–4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.
Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded. Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers. Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated. Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales. Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded. • Commonly reported symptoms are headache, throat pain and lethargy. • A large number of healthcare workers report more than four symptoms. • Those with physical symptoms had higher rates of depression, anxiety, stress, PTSD. • Those with physical symptoms had higher mean scores in the IES-R, DASS subscales. • Association between physical symptoms and psychological outcomes may be bidirectional. Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.OBJECTIVESince the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.METHODSHealthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.RESULTSOut of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded.CONCLUSIONSOur study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded. |
| Author | Ho, Cyrus S. Jing, Mingxue Ho, Roger C. Chandra, Bharatendu Tan, Benjamin Y.Q. Sharma, Vijay K. Ong, Jonathan J.Y. Chen, Jin Tao Komalkumar, R.N. Sunny, Sibi Ahmed Khan, Faheem Ngiam, Nicholas J.H. Patel, Bhargesh Chew, Nicholas W.S. Sagayanathan, Renarebecca Ying Ng, Alison Ying Ahmad, Aftab Paliwal, Prakash R. Meenakshi, P.V. Goh, Yihui Shah, Kenam Chan, Bernard P.L. Lee, Grace K.H. Yeo, Leonard L.L. Teoh, Hock Luen Sharma, Arvind K. Tsivgoulis, Georgios Wong, Lily Y.H. Napolean Shanmugam, Ganesh |
| Author_xml | – sequence: 1 givenname: Nicholas W.S. surname: Chew fullname: Chew, Nicholas W.S. organization: Department of Medicine, National University Health System, Singapore – sequence: 2 givenname: Grace K.H. surname: Lee fullname: Lee, Grace K.H. organization: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 3 givenname: Benjamin Y.Q. surname: Tan fullname: Tan, Benjamin Y.Q. organization: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 4 givenname: Mingxue surname: Jing fullname: Jing, Mingxue organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 5 givenname: Yihui surname: Goh fullname: Goh, Yihui organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 6 givenname: Nicholas J.H. surname: Ngiam fullname: Ngiam, Nicholas J.H. organization: Department of Medicine, National University Health System, Singapore – sequence: 7 givenname: Leonard L.L. surname: Yeo fullname: Yeo, Leonard L.L. organization: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 8 givenname: Aftab surname: Ahmad fullname: Ahmad, Aftab organization: Department of Neurology, Ng Teng Fong General Hospital, Singapore – sequence: 9 givenname: Faheem surname: Ahmed Khan fullname: Ahmed Khan, Faheem organization: Department of Intensive Care Medicine, Ng Teng Fong General Hospital, Singapore – sequence: 10 givenname: Ganesh surname: Napolean Shanmugam fullname: Napolean Shanmugam, Ganesh organization: Department of Neurology, Ng Teng Fong General Hospital, Singapore – sequence: 11 givenname: Arvind K. surname: Sharma fullname: Sharma, Arvind K. organization: Department of Neurology, Zydus Hospital and BJ Hospital, Ahmedabad, India – sequence: 12 givenname: R.N. surname: Komalkumar fullname: Komalkumar, R.N. organization: Department of Neurology, Yashoda Hospital, Secunderabad, India – sequence: 13 givenname: P.V. surname: Meenakshi fullname: Meenakshi, P.V. organization: Department of Neurology, SMS Hospital, Erode, India – sequence: 14 givenname: Kenam surname: Shah fullname: Shah, Kenam organization: Department of Neurology, Zydus Hospital and BJ Hospital, Ahmedabad, India – sequence: 15 givenname: Bhargesh surname: Patel fullname: Patel, Bhargesh organization: Department of Neurology, Zydus Hospital and BJ Hospital, Ahmedabad, India – sequence: 16 givenname: Bernard P.L. surname: Chan fullname: Chan, Bernard P.L. organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 17 givenname: Sibi surname: Sunny fullname: Sunny, Sibi organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 18 givenname: Bharatendu surname: Chandra fullname: Chandra, Bharatendu organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 19 givenname: Jonathan J.Y. surname: Ong fullname: Ong, Jonathan J.Y. organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 20 givenname: Prakash R. surname: Paliwal fullname: Paliwal, Prakash R. organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 21 givenname: Lily Y.H. surname: Wong fullname: Wong, Lily Y.H. organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 22 givenname: Renarebecca surname: Sagayanathan fullname: Sagayanathan, Renarebecca organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 23 givenname: Jin Tao surname: Chen fullname: Chen, Jin Tao organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 24 givenname: Alison Ying surname: Ying Ng fullname: Ying Ng, Alison Ying organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 25 givenname: Hock Luen surname: Teoh fullname: Teoh, Hock Luen organization: Division of Neurology, Department of Medicine, National University Health System, Singapore – sequence: 26 givenname: Georgios surname: Tsivgoulis fullname: Tsivgoulis, Georgios organization: Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, “Attikon” University Hospital, Athens, Greece and The University of Tennessee Health Science Center, Memphis, TN, United States – sequence: 27 givenname: Cyrus S. surname: Ho fullname: Ho, Cyrus S. organization: Department of Psychological Medicine, National University of Singapore, Singapore – sequence: 28 givenname: Roger C. surname: Ho fullname: Ho, Roger C. organization: Department of Psychological Medicine, National University of Singapore, Singapore – sequence: 29 givenname: Vijay K. surname: Sharma fullname: Sharma, Vijay K. email: Vijay_Kumar_SHARMA@nuhs.edu.sg organization: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32330593$$D View this record in MEDLINE/PubMed |
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| Title | A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak |
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