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      Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study

      research-article
      a , 1 , a , 1 , b , b , a , a , a , a , c , d , e , f , a , g , * , a , *
      Brain, Behavior, and Immunity
      Elsevier Inc.
      COVID-19, novel coronavirus disease, SARS, severe acute respiratory syndrome, MERS, Middle East respiratory syndrome, PHQ-9, 9-item Patient Health Questionnaire, GAD-7, 7-item Generalized Anxiety Disorder, ISI, Insomnia Severity Index, IES-R, Impact of Event Scale-Revised, SEM, structural equation model, RMSEA, root mean square error of approximation, CFI, comparative fit index, TLI, Tucker-Lewis index, 2019 novel coronavirus disease, Medical and nursing staff, Mental healthcare, Mental health, Exposure

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          Highlights

          • Medical staff experience mental health disturb during the COVID-19 pandemic.

          • Direct and indirect exposure to COVID-19 affects the mental health profoundly.

          • Psychological materials and resources provide some protection.

          • Interventions with appropriate level are urgent.

          Abstract

          The severe 2019 outbreak of novel coronavirus disease (COVID-19), which was first reported in Wuhan, would be expected to impact the mental health of local medical and nursing staff and thus lead them to seek help. However, those outcomes have yet to be established using epidemiological data. To explore the mental health status of medical and nursing staff and the efficacy, or lack thereof, of critically connecting psychological needs to receiving psychological care, we conducted a quantitative study. This is the first paper on the mental health of medical and nursing staff in Wuhan. Notably, among 994 medical and nursing staff working in Wuhan, 36.9% had subthreshold mental health disturbances (mean PHQ-9: 2.4), 34.4% had mild disturbances (mean PHQ-9: 5.4), 22.4% had moderate disturbances (mean PHQ-9: 9.0), and 6.2% had severe disturbance (mean PHQ-9: 15.1) in the immediate wake of the viral epidemic. The noted burden fell particularly heavily on young women. Of all participants, 36.3% had accessed psychological materials (such as books on mental health), 50.4% had accessed psychological resources available through media (such as online push messages on mental health self-help coping methods), and 17.5% had participated in counseling or psychotherapy. Trends in levels of psychological distress and factors such as exposure to infected people and psychological assistance were identified. Although staff accessed limited mental healthcare services, distressed staff nonetheless saw these services as important resources to alleviate acute mental health disturbances and improve their physical health perceptions. These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis.

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          Most cited references14

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          A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

          Summary Background An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36–66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3–6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6–10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
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            Presumed Asymptomatic Carrier Transmission of COVID-19

            This study describes possible transmission of novel coronavirus disease 2019 (COVID-19) from an asymptomatic Wuhan resident to 5 family members in Anyang, a Chinese city in the neighboring province of Hubei.
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              The Lancet Commission on global mental health and sustainable development

              The Lancet, 392(10157), 1553-1598
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                Author and article information

                Contributors
                Journal
                Brain Behav Immun
                Brain Behav. Immun
                Brain, Behavior, and Immunity
                Elsevier Inc.
                0889-1591
                1090-2139
                30 March 2020
                30 March 2020
                :
                Affiliations
                [a ]Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
                [b ]Computer Science and Technology, Huazhong University of Science and Technology, Wuhan 430030, China
                [c ]Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
                [d ]School of Health Sciences, Wuhan University, Wuhan 430000, China
                [e ]Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
                [f ]Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, China
                [g ]Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, United States
                Author notes
                [1]

                These authors contributed equally.

                Article
                S0889-1591(20)30348-2
                10.1016/j.bbi.2020.03.028
                7118532
                32240764
                0fdc75a2-b2fb-4c7c-9c2f-1629adc1ee55
                © 2020 Elsevier Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 15 March 2020
                : 27 March 2020
                : 28 March 2020
                Categories
                Article

                Neurosciences
                covid-19, novel coronavirus disease,sars, severe acute respiratory syndrome,mers, middle east respiratory syndrome,phq-9, 9-item patient health questionnaire,gad-7, 7-item generalized anxiety disorder,isi, insomnia severity index,ies-r, impact of event scale-revised,sem, structural equation model,rmsea, root mean square error of approximation,cfi, comparative fit index,tli, tucker-lewis index,2019 novel coronavirus disease,medical and nursing staff,mental healthcare,mental health,exposure

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