Medical ICU, St. Louis University Hospital, Public Assistance Hospitals of Paris, Paris, France.
Medical ICU, Cochin University Hospital, University of Paris, Public Assistance Hospitals of Paris Center, Paris, France.
Am J Respir Crit Care Med. 2020 Nov 15;202(10):1388-1398. doi: 10.1164/rccm.202006-2568OC.
Frontline healthcare providers (HCPs) during the coronavirus disease (COVID-19) pandemic are at high risk of mental morbidity. To assess the prevalence of symptoms of anxiety, depression, and peritraumatic dissociation in HCPs. This was a cross-sectional study in 21 ICUs in France between April 20, 2020, and May 21, 2020. The Hospital Anxiety and Depression Scale and the Peritraumatic Dissociative Experience Questionnaire were used. Factors independently associated with reported symptoms of mental health disorders were identified. The response rate was 67%, with 1,058 respondents (median age 33 yr; 71% women; 68% nursing staff). The prevalence of symptoms of anxiety, depression, and peritraumatic dissociation was 50.4%, 30.4%, and 32%, respectively, with the highest rates in nurses. By multivariable analysis, male sex was independently associated with lower prevalence of symptoms of anxiety, depression, and peritraumatic dissociation (odds ratio of 0.58 [95% confidence interval, 0.42-0.79], 0.57 [95% confidence interval, 0.39-0.82], and 0.49 [95% confidence interval, 0.34-0.72], respectively). HCPs working in non-university-affiliated hospitals and nursing assistants were at high risk of symptoms of anxiety and peritraumatic dissociation. Importantly, we identified the following six modifiable determinants of symptoms of mental health disorders: fear of being infected, inability to rest, inability to care for family, struggling with difficult emotions, regret about the restrictions in visitation policies, and witnessing hasty end-of-life decisions. HCPs experience high levels of psychological burden during the COVID-19 pandemic. Hospitals, ICU directors, and ICU staff must devise strategies to overcome the modifiable determinants of adverse mental illness symptoms.
在冠状病毒病（COVID-19）大流行期间，一线医疗保健提供者（HCP）面临较高的精神发病风险。评估 HCP 中焦虑、抑郁和创伤前解离症状的患病率。这是 2020 年 4 月 20 日至 5 月 21 日在法国 21 个 ICU 进行的一项横断面研究。使用医院焦虑和抑郁量表和创伤前解离体验问卷。确定与报告的心理健康障碍症状相关的独立因素。响应率为 67%，有 1058 名受访者（中位数年龄 33 岁；71%为女性；68%为护理人员）。焦虑、抑郁和创伤前解离症状的患病率分别为 50.4%、30.4%和 32%，护士的患病率最高。通过多变量分析，男性与焦虑、抑郁和创伤前解离症状的患病率较低独立相关（比值比分别为 0.58 [95%置信区间，0.42-0.79]、0.57 [95%置信区间，0.39-0.82]和 0.49 [95%置信区间，0.34-0.72]）。在非大学附属医院工作的 HCP 和助理护士有焦虑和创伤前解离症状的高风险。重要的是，我们确定了以下六个可改变的心理健康障碍症状决定因素：担心被感染、无法休息、无法照顾家人、与困难情绪作斗争、对探视政策限制感到遗憾以及目睹仓促的临终决策。HCP 在 COVID-19 大流行期间经历了较高的心理负担。医院、重症监护室主任和重症监护室工作人员必须制定策略来克服不良精神疾病症状的可改变决定因素。
