University of Utah School of Medicine, USA.
Central Arkansas VA Health Care System, USA; University of Arkansas for Medical Sciences, USA.
J Psychiatr Res. 2021 May;137:673-680. doi: 10.1016/j.jpsychires.2020.10.045. Epub 2020 Nov 4.
The mental health of frontline workers is critical to a community's ability to manage crises and disasters. This study assessed risks for mental health problems (traumatic stress, depression, anxiety, alcohol use, insomnia) in association with pandemic-related stressors in a sample of emergency and hospital personnel (N = 571). Respondents completed self-report surveys online from April 1st to May 7th, 2020 in the Rocky Mountain region of the United States. Results showed that roughly fifteen to thirty percent of respondents screened positive for each disorder. Odds of screening positive were similar between groups for probable acute traumatic stress, depressive disorder, anxiety disorder, and alcohol use disorder; emergency personnel reported significantly higher rates of insufficient sleep than healthcare workers. Logistic regressions showed that respondents who reported having an immunocompromised condition had higher odds of acute traumatic stress, anxiety, and depression. Having an immunocompromised household member was associated with higher odds of insufficient sleep and anxiety. Being in a direct care provision role was associated with higher odds of screening positive for risky alcohol use. Being in a management role over direct care providers was associated with higher odds of screening positive for anxiety, risky alcohol use, and insufficient sleep. There was an inverse relationship between number of positive COVID-19 cases and anxiety, such that as positive cases went up, anxiety decreased. Overall, the mental health risks that we observed early in the COVID-19 pandemic are elevated above previous viral outbreaks (SARS) and comparable to rates shown in disasters (9/11 attacks; Hurricane Katrina).
一线工作人员的心理健康对于社区应对危机和灾难的能力至关重要。本研究评估了与大流行相关压力源相关的心理健康问题(创伤后应激、抑郁、焦虑、酒精使用、失眠)风险,研究对象为急救和医院工作人员(N=571)。受访者于 2020 年 4 月 1 日至 5 月 7 日期间通过网络完成了自我报告调查,调查地点在美国落基山脉地区。结果表明,大约有 15%到 30%的受访者对每种疾病的筛查呈阳性。在可能的急性创伤后应激、抑郁障碍、焦虑障碍和酒精使用障碍方面,各群体之间的筛查阳性几率相似;急救人员报告的睡眠不足率明显高于医护人员。逻辑回归显示,报告存在免疫功能低下情况的受访者发生急性创伤后应激、焦虑和抑郁的几率更高。有免疫功能低下的家庭成员与睡眠不足和焦虑的几率增加有关。提供直接护理服务的角色与更高的风险酒精使用筛查阳性几率有关。管理角色相对于直接护理提供者与更高的焦虑、风险酒精使用和睡眠不足筛查阳性几率有关。阳性 COVID-19 病例数量与焦虑之间呈反比关系,即阳性病例越多,焦虑程度越低。总的来说,我们在 COVID-19 大流行早期观察到的心理健康风险高于之前的病毒爆发(SARS),与灾难中的发病率相当(9/11 袭击;卡特里娜飓风)。