COMVC-19: A Program to protect healthcare workers' mental health during the COVID-19 Pandemic. What we have learned

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

Depressão e comorbidades clínicas / Depression and medical comorbidity

A associação entre depressão e doenças clínicas é muito freqüente, levando a pior evolução tanto do quadro psiquiátrico como da doença clínica, com menor aderência às orientações terapêuticas, além de maior morbidade e mortalidade. A depressão muitas vezes é subdiagnosticada e subtratada, principalmente pela presença de sintomas depressivos, que também podem ocorrer em doenças crônicas, como fadiga e anorexia. Diversas doenças estão claramente associadas à depressão, com maior destaque para as doenças cardiovasculares, endocrinológicas, neurológicas, renais, oncológicas e outras síndromes dolorosas crônicas. Os autores discutem as evidências na literatura que demonstram essa associação, com enfoque nos avanços em fisiopatologia e terapêutica psiquiátrica.