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      Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

      research-article
      1 , , 2 , 3 , 4 , 5 , 2 , 6 , 7 , 1 , 4 , 8 , 4 , 9 , 9 , 9 , 3 , 4 , 8 , 9 , 4 , 10 , 11 , 9 , 3 , 12 , 13 , 14 , 8 , 15 , 16 , 3 , 4 , 4
      Occupational and Environmental Medicine
      BMJ Publishing Group
      psychiatry, stress disorders, post-traumatic, mental health, psychology, health personnel

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          Abstract

          Objectives

          This study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April–June) of the COVID-19 pandemic in the UK.

          Methods

          Preliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale.

          Results

          Analyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse.

          Conclusions

          Our findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.

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          Most cited references45

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9

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              Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

              Highlights • At least one in five healthcare professionals report symptoms of depression and anxiety. • Almost four in 10 healthcare workers experience sleeping difficulties and/or insomnia. • Rates of anxiety and depression were higher for female healthcare workers and nursing staff. • Milder mood symptoms are common and screening should aim to identify mild and sub-threshold syndromes.
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                Author and article information

                Journal
                Occup Environ Med
                Occup Environ Med
                oemed
                oem
                Occupational and Environmental Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1351-0711
                1470-7926
                June 2021
                27 June 2021
                27 June 2021
                : oemed-2020-107276
                Affiliations
                [1 ]departmentDepartment of Applied Health Research , University College London , London, UK
                [2 ]Maudsley NHS Foundation Trust , London, UK
                [3 ]departmentAcademic Department of Military Mental Health , King's College London , London, UK
                [4 ]departmentDepartment of Psychological Medicine , King's College London , London, UK
                [5 ]departmentDepartment of Biostatistics and Health Informatics , King's College London , London, UK
                [6 ]National Institute of Health Research Biomedical Research Centre , London, UK
                [7 ]departmentLife Sciences and Medicine , King's College London , London, UK
                [8 ]Guy's and St Thomas' NHS Foundation Trust , London, UK
                [9 ]departmentInstitute of Psychiatry, Psychology & Neuroscience , King's College London , London, UK
                [10 ]departmentAdult Nursing , King's College London , London, UK
                [11 ]departmentMental Health Liaison Team , King's College London , London, UK
                [12 ]University Hospitals of Leicester NHS Trust , Leicester, UK
                [13 ]Devon Partnership NHS Trust , Exeter, UK
                [14 ]Avon & Wiltshire Mental Health Partnership NHS Trust , Bristol, UK
                [15 ]Nottinghamshire Healthcare NHS Foundation Trust , Nottingham, UK
                [16 ]Cornwall Partnership Foundation NHS Trust , Cornwall, UK
                Author notes
                [Correspondence to ] Dr Danielle Lamb, University College London, London, UK; d.lamb@ 123456ucl.ac.uk

                DL and SG are joint first authors.

                Author information
                http://orcid.org/0000-0003-1526-9793
                http://orcid.org/0000-0002-1146-4922
                http://orcid.org/0000-0002-6462-1880
                http://orcid.org/0000-0003-2200-7329
                http://orcid.org/0000-0002-7655-7986
                http://orcid.org/0000-0002-6743-9929
                Article
                oemed-2020-107276
                10.1136/oemed-2020-107276
                8245285
                34183447
                d103af68-a6f1-4f75-a07a-72576d279b10
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 01 December 2020
                : 12 March 2021
                : 29 March 2021
                Funding
                Funded by: NIHR Applied Research Collaborative North Thames;
                Award ID: N/A
                Funded by: National Institute for Health Research Maudsley Biomedical Research Centre, King’s College London;
                Award ID: N/A
                Funded by: FundRef http://dx.doi.org/10.13039/501100000833, Rosetrees Trust;
                Award ID: N/A
                Funded by: National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King’s College London;
                Award ID: N/A
                Categories
                Workplace
                1506
                2474
                Original research
                Custom metadata
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                Occupational & Environmental medicine
                psychiatry,stress disorders,post-traumatic,mental health,psychology,health personnel

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