ABSTRACT
Introduction: Health student's mental health is considered a public health issue that dramatically increased with COVID 19's pandemic. However, very few studies assessed the prevalence of mental health in medical, pharmacist, and dental students. Objective(s): Our goal was to assess mental health in health students from the same university one year after pandemic's beginning and look at for associated factors. Method(s): An online survey was realized in Paris university which has the 3 specialties (medicine, pharmacy, and dental). We used the Hospitalization Anxiety and Depression scale, Composite International Diagnostic Interview - Short Form questionnaire, Maslach Burnout Inventory (with 2 versions (Student survey and Human Services Survey). We also asked for 12 months of suicidal ideation, humiliation, sexual harassment, and sexual aggression. We did multivariable logistic regression analyses to identify Major Depressive Episode (MDE) associated factors. Result(s): We included 1925 students: 95 dental, 233 pharmacists, 541 medical preclinic, 587 medical clinic and 469 residents. Overall prevalence of 7- days anxiety symptoms, 7- days depressive symptoms, 12-month MDE, 12-month suicidal ideation, humiliation, sexual harassment and sexual aggression were 55%, 23%, 26%, 19%, 19%, 22% and 6% respectively. There were significative differences between groups for anxiety and depressive symptoms and MDE (p<0.001 for all). Associated factors to MDE in multivariable logistic regression were humiliation (OR=1.71, IC95[1.28-2.28]), sexual harassment (OR=1.60, IC95[1.19-2.16]), sexual abuse (OR=1.65, IC95[1.04-2.60])) and moderate (OR=1.49, IC95 [1.17-1.90]) or important (OR=2.32, IC95[1.68-3.20]) subjective financial difficulties. Conclusion(s): Health student's prevalence of psychiatric symptoms is significant, but it seems possible to intervene on several risk factors.
ABSTRACT
OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms. RESULTS: The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications. CONCLUSIONS: In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management.