ABSTRACT
The mental health of healthcare workers during epidemics is a complex topic. The outbreak of coronavirus disease 2019 (COVID-19) that occurred in late 2019 has become a global public health threat and provides an opportunity to investigate this topic. Based on a large-scale investigation of Chinese healthcare workers during the COVID-19 epidemic, the article tests the assumption that the socioeconomic level of a city affects the mental health status of healthcare workers. The result is interesting and important: the mental health status of this population differs based on the city level. Hospital level, hospital type and departments risk level were investigated separately. With regard to the degree of anxiety, depression and post-traumatic stress disorder (PTSD), there were obvious differences based on the city level: the negative mental health impacts increase with increasing city level, such that healthcare workers in first-tier cities have the least negative mental health impacts, while those in third-tier cities have the most. City level reflects the degree of urban development, resource richness, resident satisfaction, and positive social atmosphere. Urban prosperity may affect mental health.
ABSTRACT
BACKGROUND: Reliable and detailed nationwide data on the prevalence and distribution of mental disorders among healthcare workers in China during the coronavirus disease 2019 (COVID-19) outbreak are scarce. METHODS: We did a cross-sectional online survey from March 2 to 2 April 2020 and a total of 19,379 healthcare workers from 25 provinces participated. Depression, anxiety and post-traumatic stress disorder (PTSD) were assessed by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and PTSD Checklist for DSM-5 (PCL-5), respectively. RESULTS: The age-standardized prevalence of depression, anxiety and PTSD was 15.5%, 12.7% and 5.2%, respectively. Frontline workers had higher prevalence estimates than non-frontline workers (depression: 18.2% vs. 13.9%; anxiety: 14.7% vs. 11.6%; PTSD: 6.1% vs. 4.6%). Subgroups who were nurses, were married or had dependent children reported higher prevalence of depression, anxiety and PTSD. Despite of the large variations, the prevalence of mental disorders was lowest in East China, followed by Middle China, and highest in West China. CONCLUSION: Healthcare workers faced enormous stress not only from the direct risk presented by the COVID-19 outbreak, but also from the profound changes in their professional practice. Prevalence of adverse psychological outcomes has a significant association with geographically distribution of health resources and regional economic level. Sufficient medical resource may be a protective factor to mental health condition of healthcare personnel when such a public health emergency happened.