One year facing Covid. Systematic evaluation of factors associated with mental distress among hospital workers in Italy

ABSTRACT

Introduction: Covid-19 pandemic is a severe challenge for healthcare workers (HCW) mental health. Several studies reported frequent adverse psychological outcomes in HCW. To identify risk factors of psychological impairment (PsI), we systematically examine workers in a University Hospital in Milan (Italy), using psychometric scales in the context of the occupational health surveillance. Methods: We enrolled 990 HCW (Jul20-Jul21), whose psychological wellbeing was screened by a 1st level questionnaire collecting individual/occupational data, personal/familiar/occupational Covid exposure, general psychological discomfort (GHQ-12), post-traumatic stress symptoms (IES-R), anxiety (GAD-7). HCW showing PsI (i.e. > cut-off in at least one among GAD-7, IES-r, GHQ-12) have been further investigated by a 2nd level questionnaire (psycho-diagnostic) composed by PHQ-9, DES-II and SCL-90. Results: 316 workers (32%) showed sign of PsI at the 1st screening. Women, nurses, younger workers, subjects working in Covid area and having an infected family member showed significantly higher PsI risk. PsI prevalence was strongly associated to the pandemic time trends but sensibly decreased after Jan 21, when HCW received vaccination. Only a proportion of subjects with PsI, presented clinically relevant symptoms (2nd level screening). Those symptoms weren’t associated to working in Covid area, with Covid infection in family, with pandemic waves or workers’ vaccination. Conclusions: To evaluate psychological wellbeing of HCW constitutes a unique condition to detect occupational, and non-occupational risk factors for PsI in high stress contexts.