The psychological impact of anxiety and depression on Chinese medical staff during the outbreak of the COVID-19 pandemic: a cross-sectional study

Ann Palliat Med. 2021 Jul;10(7):7759-7774. doi: 10.21037/apm-21-1261.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health emergency that began in late 2019 and is still ongoing. Medical staff are at a particularly high risk of mental stress due to their close contact with infected patients. This study aimed to assess medical staff anxiety and depression levels from different risk-level areas in China during the early period of the COVID-19 outbreak and identify the main factors that might affect their mental health.

Methods: From February 22 to March 9, 2020, we conducted a 4-part online questionnaire to survey medical staff across different Chinese provinces about their anxiety and depression levels during the initial COVID-19 outbreak. The survey considered different demographic characteristics, anxiety (General Anxiety Disorder-7) scores, depression (Patient Health Questionnaire-9) scores, and occupational protection scores. Snowball sampling via a WeChatTM group was performed to collect the data.

Results: Among the 7,413 respondents, the rates of anxiety and depression reported among medical staff were 33.74% [2,501] and 27.65% [2,050], respectively. The odds of being assessed with severe anxiety were higher among nurses, those who were widowed, those in poor physical health, those working in COVID-19 designated facilities, and those receiving more than 50% negative/false information every day; the odds decreased by 5.8% with every 1-point increase in occupational protection. The odds of being assessed with moderate to severe depression or above were higher for the 18-30-year-old group, divorcees, those in poor physical health, and those receiving more than 50% of negative/false information every day; these odds decreased by 4.5% with every 1-point increase in occupational protection. Medical staff working in areas with a low exposure risk were at high risk of both anxiety and depression.

Conclusions: During the outbreak of COVID-19 in China, a significant proportion of medical staff faced psychological problems, even those in areas with a low exposure risk. Targeted interventions should focus more on nurses, widowed /divorced, and medical staff with poor physical health, less clinical experience, or insufficient occupational protection. The authenticity and orientation of media also showed a correlation with the mental state of medical staff.

Keywords: Coronavirus 2019 (COVID-19); media orientation; medical staff; mental health; occupation protection.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology
  • Anxiety Disorders / epidemiology
  • COVID-19*
  • China / epidemiology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Disease Outbreaks
  • Humans
  • Medical Staff
  • Pandemics*
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Young Adult