Mental health problems among healthcare workers involved with the COVID-19 outbreak

Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

Well-being status and post-traumatic stress symptoms in health workers attending mindfulness sessions during the early stage of the COVID-19 epidemic in Mexico / Alteraciones en el bienestar y síntomas de estrés postraumático en trabajadores de la salud mexicanos que participaron en sesiones virtuales de atención plena durante la etapa inicial de la epidemia de COVID-19

Abstract Introduction In Mexico, a National Mental Health Strategy was implemented to identify and attend the mental health repercussions of the COVID-19 pandemic. It included the creation of five virtual clinics for health workers, being the Burnout, Post-traumatic Stress and Compassion Fatigue clinic one of them. Objective To describe the basal sociodemographic and psychological characteristics of health workers attending online mindfulness sessions as part of the treatment of the aforementioned clinic. Method This is a cross-sectional report part of a major nationwide and longitudinal project. All attendants responded to digital sociodemographics and COVID-19 questionnaires, the Extended Physician Well-Being Index (EPWBI), and the Post-traumatic Stress Disorder (PTSD) TOP-8 index. Results Of the 507 health workers that participated, 70.02% of them were at risk of burnout according to the Extended Well-Being Index and 57.31, 7.91 and 2.77% had a mild, moderate, and severe risk of PTSD, respectively. The most affected were the female health workers, from metropolitan or central areas of the country, and those diagnosed with COVID-19 or exposed to a person with the diagnosis. Discussion and conclusion Mexican health workers attending mindfulness sessions presented high frequencies of PTSD symptoms and burnout. Female workers at urban hospitals could be at a special risk for developing PTSD or Well-ness alterations, and thus, they must be cared for closely, particularly those having direct contact with COVID 19 positive persons. The early participation in mental health strategies might lessen the immediate and long-term pandemic effects.

Resumen Introducción En México se crearon cinco clínicas virtuales de salud mental para los trabajadores de la salud como parte de la respuesta nacional de salud mental ante la pandemia por COVID-19. La clínica de desgaste, estrés postraumático y fatiga por compasión es una de ellas. Objetivo Describir las características sociodemográficas y psicológicas basales de los trabajadores de la salud que asistieron a las sesiones virtuales de atención plena, que constituyeron una de las estrategias de atención en la clínica. Método Estudio transversal, parte de un proyecto nacional y longitudinal. Los participantes contestaron un cuestionario digital con preguntas sociodemográficas y sobre la situación actual del COVID-19, el Índice Extendido de Bienestar Médico y la escala TOP-8 de estrés postraumático. Resultados De los 507 trabajadores de la salud que participaron, 70.02% presentaron riesgo de desgaste según el Índice de Bienestar Extendido, y 57.31, 7.91 y 2.77% de riesgo leve, moderado y grave en el TOP-8, respectivamente. Las mujeres, los habitantes de la zona metropolitana o del centro del país, aquellos con diagnóstico de COVID-19 y los expuestos a personas con dicho diagnóstico fueron los más afectados. Discusión y conclusión Los participantes de las sesiones de atención plena presentaron altas frecuencias de síntomas de estrés postraumático y desgaste (burnout). Como las trabajadoras de zonas urbanizadas podrían correr un riesgo especial, debería dárseles un seguimiento especial, en particular a aquellas en contacto directo con personas positivas al COVID-19. La participación temprana en estrategias de salud mental podría amortiguar los efectos inmediatos y de largo plazo de la pandemia.

Evaluation of mental health and occupational stress in Mexican medical residents / Evaluación de la salud mental y el estrés laboral en médicos residentes mexicanos

Abstract Introduction Since mental health disorders are an emerging problem in medical residents, its detection and attention must be a priority. Objetive To compare the frequency of psychopathology in residents according to sociodemographic and clinical characteristics. Method We conducted a cross-sectional study evaluating the presence of psychopathology, as well as sociodemographic and clinical characteristics in 644 residents through online questionnaires. Results Among participants, 55.7% reported a psychiatric disorder at some point and 29.2% a current one; only 41.5% were under treatment. Additionally, 8.1% had attempted suicide, of which 32.4% attempted it during residency. We found that 6.5% of women and 3.3% of men presented "risk of psychopathology," with a higher percentage of men presenting "severe psychopathology." Individuals with "risk of psychopathology" presented significantly higher scores on all of the questionnaires, compared to those with "absence of psychopathology." Discussion and conclusion Residents with occupational stress also presented higher risks of psychopathology, suicide, and substance use. Being under psychiatric treatment significantly improved the scores on the different scales. Because residency is a period that may increase the probability of suffering psychopathology, interventions should be aimed at reducing occupational stress and bringing specialized care.

Resumen Introducción Dado que los trastornos de salud mental son un problema emergente en los médicos residentes, su detección y atención deben ser una prioridad. Objetivo Comparar la frecuencia de psicopatología en médicos residentes de acuerdo con las características clínicas y sociodemográficas. Método Realizamos un estudio transversal donde evaluamos la presencia de psicopatología, así como características clínicas y sociodemográficas en 644 médicos residentes por medio de cuestionarios en línea. Resultados Entre los participantes, el 55.7% reportó haber tenido un trastorno psiquiátrico en algún momento de su vida y el 29.2% al momento del estudio, de los cuales solo el 41.5% estaba bajo tratamiento psiquiátrico. Asimismo, el 8.1% había intentado suicidarse a lo largo de su vida y el 32.4% lo intentó durante la residencia. Encontramos que el 6.5% de las mujeres y el 3.3% de los hombres presentaban "riesgo de psicopatología", y un mayor porcentaje de hombres presentaron "psicopatología grave". Las personas con "riesgo de psicopatología" contaron con puntuaciones significativamente más altas en todos los cuestionarios, en comparación con los individuos con "ausencia de psicopatología". Discusión y conclusión Los residentes con estrés laboral también presentaron mayor riesgo de psicopatología, suicidio y uso de sustancias. Estar bajo tratamiento psiquiátrico mejoró significativamente los puntajes en las diferentes escalas. Debido a que la residencia es un período que puede aumentar la probabilidad de sufrir psicopatología, las intervenciones deben estar dirigidas a reducir el estrés ocupacional y brindar atención especializada.