Factors associated with burnout in Polish healthcare workers during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has placed the healthcare system under substantial strain that has caused elevated psychological distress among healthcare workers (HCWs). Previous studies have found a high prevalence of burnout among HCWs exacerbated by the COVID-19 pandemic and have delineated some associated factors, but further research is needed. Little is known, for example, whether the economic status of HCWs or experiencing negative and positive emotions contribute to burnout. The present study was meant to fill this gap. Methods: A total of 412 HCWs (i.e.: nurses - 47%, physicians-28%, psychologists-14%, and other healthcare professionals-11%), aged 21-69 years (M = 36.63; SD = 11.76) participated in a web-based cross-sectional study. Data was collected from June to November 2020. The participants filled out measures assessing two dimensions of burnout (Exhaustion and Disengagement), depression, generalized anxiety, positive and negative emotions, along with the survey evaluating organizational aspects of their work during the pandemic. Results: Burnout thresholds were met by 54 and 66% of respondents for Disengagement and Exhaustion, respectively, which is high but comparable to levels found in other countries during the pandemic. Similarly to previous work, depression and anxiety were high in HCWs, with 24 % of them being in the risk group for clinical severity of depression and 34% in the risk group for a clinical generalized anxiety disorder (GAD). Regression analysis showed that the intensity of negative emotions was the strongest predictor of Exhaustion, whereas the intensity of positive emotions was the strongest predictor of Disengagement. Depression and GAD symptoms were positively related to Exhaustion, and economic status was inversely related to Disengagement. Discussion: These results suggest that distress in HCWs during the pandemic was related to symptoms of burnout, whereas higher income and experiencing positive emotions were associated with reduced burnout levels. Our findings call for the development of burnout intervention programs that could build capacities for dealing with depression and other negative emotions and at the same time teach skills on how to increase positive emotions in HCWs.

Assessment of Neurocognitive Functions, Olfaction, Taste, Mental, and Psychosocial Health in COVID-19 in Adults: Recommendations for Harmonization of Research and Implications for Clinical Practice.

OBJECTIVE: To propose a set of internationally harmonized procedures and methods for assessing neurocognitive functions, smell, taste, mental, and psychosocial health, and other factors in adults formally diagnosed with COVID-19 (confirmed as SARS-CoV-2 + WHO definition). METHODS: We formed an international and cross-disciplinary NeuroCOVID Neuropsychology Taskforce in April 2020. Seven criteria were used to guide the selection of the recommendations' methods and procedures: (i) Relevance to all COVID-19 illness stages and longitudinal study design; (ii) Standard, cross-culturally valid or widely available instruments; (iii) Coverage of both direct and indirect causes of COVID-19-associated neurological and psychiatric symptoms; (iv) Control of factors specifically pertinent to COVID-19 that may affect neuropsychological performance; (v) Flexibility of administration (telehealth, computerized, remote/online, face to face); (vi) Harmonization for facilitating international research; (vii) Ease of translation to clinical practice. RESULTS: The three proposed levels of harmonization include a screening strategy with telehealth option, a medium-size computerized assessment with an online/remote option, and a comprehensive evaluation with flexible administration. The context in which each harmonization level might be used is described. Issues of assessment timelines, guidance for home/remote assessment to support data fidelity and telehealth considerations, cross-cultural adequacy, norms, and impairment definitions are also described. CONCLUSIONS: The proposed recommendations provide rationale and methodological guidance for neuropsychological research studies and clinical assessment in adults with COVID-19. We expect that the use of the recommendations will facilitate data harmonization and global research. Research implementing the recommendations will be crucial to determine their acceptability, usability, and validity.

Prevalence of adjustment disorder in Poland during the COVID-19 pandemic and its association with symptoms of anxiety and depression.

Purpose: Due to the current COVID-19 pandemic, many new stressors have arisen, which is associated with an increased risk of mental disorders. The purpose of this article is to assess the prevalence of adjustment disorder and symptoms of anxiety and depression in the Polish population, on the basis of two studies conducted during the pandemic. Methods: Two online survey studies were conducted at different time points: the first in March 2020 on a N = 1742 sample, the second in June 2020, on the sample of N = 567. In both cases, the same self-description questionnaires were used to measure adjustment disorder, depression and generalized anxiety. Results: In Study I, 75% of participants considered the COVID-19 pandemic to be highly stressful and 43% declared they met the criteria for adjustment disorder. When anxiety and depression were excluded 8.4% of participants met the criteria. On the other hand, in Study II, the criteria for this disorder (without the exclusion of other disorders) were met by 52%. In both studies, significant positive correlations were observed between the symptoms of adjustment disorder and those of anxiety and depression. Conclusions: The research provides important data on the mental health of Poles during the pandemic. The proportion of people who have potentially met the criteria for adjustment disorder, as well as for depression and anxiety, seems very high. It is advisable to continue monitoring the occurrence of these disorders, depending on developments in the changing context of the pandemic.

Neuropsychological disorders after COVID-19. Urgent need for research and clinical practice.

Purpose: Numerous studies suggest that infection with coronavirus SARS-CoV-2, which causes acute respiratory distress syndrome and COVID-19 illness, can lead to changes in the central nervous system (CNS). Consequently, some individuals with SARS-CoV-2 infection may also present the symptoms of neuropsychological disorders. The goals of this literature review is the synthesis of various perspectives and up-to-date scientific knowledge as well as the formulation of initial recommendations for clinical practice. Views: According to current state of knowledge, numerous SARS-CoV-2 infection-specific and nonspecific risk factors exist for brain damage, which might lead to neuropsychological impairments in individuals who have recovered from COVID-19. The emerging evidence suggests significant behavioral and cognitive deficits in COVID-19 survivors, which are present in the early phase after recovery and persist for several months. Neuropsychological disturbances can potentially include a wide spectrum of disorders, yet deficits of attention, memory, executive functions, language and visuospatial orientation are among most commonly identified. The relationship between cognitive impairment, emotional disturbances and severity of COVID-19 symptoms needs to be submitted to further research. Conclusions: The scientific knowledge resulting from neuropsychological empirical studies during the COVID-19 pandemic allows for a postulate of an urgent evidence-based systematic neuropsychological research to be conducted among COVID-19 survivors. More than anything, the recovered individuals must be provided with adequate neuropsychological help in the form of neuropsychological diagnosis, monitoring and rehabilitation.

Risk of Developing Post-traumatic Stress Disorder in Severe COVID-19 Survivors, Their Families and Frontline Healthcare Workers: What Should Mental Health Specialists Prepare For?

Given the high mortality of the coronavirus disease 2019 (COVID-19), having severe COVID-19 may be a life-threatening event, especially for individuals at high risk of complications. Therefore, in the article we try to answer two questions that are relevant to public mental health: Can we define groups who are at higher risk of developing pandemic-related PTSD? How can health specialists prepare for it? Given the results of previous research on PTSD in epidemic (e.g., SARS) survivors, we suggest that mental health professionals in countries touched by the pandemic should prepare for an increase in the PTSD prevalence, specifically in: individuals who have had severe COVID-19; family members of these patients and of patients who have died; and frontline healthcare workers witnessing COVID-19 patients' sudden deaths, or numerous life-threatening situations. We postulate that these groups at risk should be routinely screened for PTSD in primary medical and pediatric care. Mental health services should prepare for providing therapeutic interventions for individuals with PTSD in the vulnerable groups, and support to their families, especially children.

Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity.

BACKGROUND: Previous studies carried out in different countries have indicated that young adults experienced higher levels of emotional distress, in the form of depressive and anxiety symptoms, than older age groups during the COVID-19 pandemic. However, little is known about which pandemic-related difficulties and factors may contribute to these forms of emotional distress in various age groups. PURPOSE: The aim of the current study was to investigate: (i) differences in levels of depressive and generalized anxiety symptoms in four age groups in the Polish population during the COVID-19 lockdown; (ii) differences in perceived difficulties related to the pandemic in these groups; and (iii) which factors and difficulties related to the pandemic are the best predictors of generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown. METHOD: A total of 1115 participants (aged 18-85) took part in the study. The sample was representative of the Polish population in terms of sex, age, and place of residence. Participants completed the following online: the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, a Scale of Perceived Health and Life Risk of COVID-19, a Social Support Scale, and a Scale of Pandemic-Related Difficulties. RESULTS: Younger age groups (18-29 and 30-44) experienced higher levels of depressive and generalized anxiety symptoms than older adults (45-59 and 60-85 years). Household relationship difficulties were among the most significant predictors of depressive and generalized anxiety symptoms in all age groups. Fear and uncertainty related to the spread of the virus was one of the most important predictors of emotional distress in all the groups apart from the adults between 18 and 29 years, whereas difficulties related to external restrictions were one of the most significant predictors of depressive and anxiety symptoms exclusively in the youngest group. CONCLUSIONS: The youngest adults and those experiencing difficulties in relationships among household members are the most vulnerable to depressive and generalized anxiety symptoms during the COVID-19 lockdown. It is important to plan preventive and therapeutic interventions to support these at-risk individuals in dealing with the various challenges related to the COVID-19 pandemic.