Contact: Runsen Chen, MBMS
For Release: Immediately
Anecdotes abound on how frontline healthcare professionals treating COVID-19 patients have endured a tsunami of stress. However, scientific evidence is just starting to emerge on what is happening to the mental and physical health of these essential medical workers.
A new, “advance scout” study from Wuhan, China—first site of the outbreak—reveals a severe toll, with many healthcare staff members suffering from Acute Stress Disorder (ASD), which can develop into Post-Traumatic Stress Disorder, as well as disturbing physical problems linked to their high stress levels. The study, published ahead of print, will appear in a forthcoming issue of Psychosomatic Medicine, journal of the American Psychosomatic Society.
Researchers surveyed 332 health professionals directly involved in treating patients with suspected or confirmed COVID-19—53% nurses, 36% physicians and 11% other health workers from 18 Wuhan hospitals. The anonymous surveys were filled out between January 28 and February 1, reports study leader Runsen Chen, MBMS, a Doctoral candidate in the Dept. of Psychiatry at the University of Oxford, UK.
One questionnaire asked about symptoms of ASD in the last seven days. ASD is a condition that can occur after experiencing a traumatic or highly stressful event, triggering feelings such as threat, fear and horror; flashbacks, nightmares, difficulty concentrating or sleeping are among common ASD symptoms, and PTSD can ultimately develop if the symptoms persist beyond a month. Scientists in the study also asked participants to fill out questionnaires on depression and anxiety symptoms, their hostility levels and conflicts with patients, and stress-related physical symptoms. The findings were quite concerning, says Chen:
** 38% had symptoms of ASD. About one out of four frontline workers also had symptoms of Generalized Anxiety Disorder, and one in five had symptoms of depression.
** Just over half of these workers, who were mostly in their 20s and 30s, reported chest pains in the last two weeks; 48%, significant weakness in parts of their body; 46%, nausea or upset stomach; and 41%, faintness or dizziness.
** About seven out of 10 said they’d been easily annoyed or irritated in the last week, and six in 10 said they’d had temper outbursts that were out of control.
** Both hostility and physical complaints were significantly associated with the stress symptoms, ASD.
** Compared to doctors, nurses had higher levels of anxiety, depression and troublesome body symptoms.
The worse impact for nurses is not surprising, Chen observes, since they spend more time than doctors in direct patient care and contacts. Also, studies done during the prior epidemic of Severe Acute Respiratory Syndrome (SARS) found that nurses suffered more severe mental health and physical symptoms than doctors.
Medical workers with untreated psychological stress during the SARS outbreak had higher levels of PTSD afterwards than workers who weren’t stressed or received treatment, notes Chen. He says that this underscores the need for greater support for frontline medical staff during the crisis, with treatments offered for lowering traumatic stress, and also the need to monitor these workers post-crisis for possible PTSD that warrants treatment.
Since the study covered a time span when the virus was at its peak, and all participants worked in Wuhan, that might limit how much the findings would hold during less peak infection times and for other locales, Chen points out. “But I think the basic findings would be quite similar all over the world,” he says. And the most severely affected may have chosen not to participate in the Wuhan survey, Chen adds, so the impact could be even more substantial then shown.
The health and mental health toll taken by COVID-19 on frontline medical professionals appears great in this early study, and the findings merit closely monitoring these essential workers world-wide, he concludes.
The American Psychosomatic Society (APS) (http://www.psychosomatic.org), founded in 1942, is an international multidisciplinary academic society that conducts an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the APS is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”