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. 2020 Oct 1:275:210-215.
doi: 10.1016/j.jad.2020.06.031. Epub 2020 Jul 2.

The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study

Qi Cai  1 , Hongliang Feng  2 , Jing Huang  1 , Meiyao Wang  3 , Qunfeng Wang  4 , Xuanzhen Lu  1 , Yu Xie  1 , Xing Wang  5 , Zhenxing Liu  1 , Botong Hou  1 , Keni Ouyang  1 , Jing Pan  6 , Qin Li  7 , Beibei Fu  8 , Yongchao Deng  9 , Yumin Liu  10
Affiliations

The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study

Qi Cai et al. J Affect Disord. .

Abstract

Background and objective: Coronavirus disease 2019 (COVID-19) is a new infectious disease with high transmissibility and morbidity. It has caused substantial mental distress to medical professionals. We aimed to compare the psychological impact of the COVID-19 outbreak between frontline and non-frontline medical workers in China.

Methods: This case-control study recruited 1173 frontline and 1173 age- and sex-matched non-frontline medical workers during the COVID-19 outbreak (February 11 to 26, 2020). A set of online questionnaires were used to measure mental problems (i.e., anxiety, insomnia, and depressive symptoms), and help-seeking behavior and treatment for these mental problems.

Results: Frontline medical workers had higher rates of any mental problem (52.6% vs. 34.0%, adjusted OR=1.88, 95% CI=1.57-2.25), anxiety symptoms (15.7% vs. 7.4%, adjusted OR=1.95, 95% CI=1.46-2.61), depressed mood (marginally insignificant; 14.3% vs. 10.1%, adjusted OR=1.32, 95% CI=0.99-1.76) and insomnia (47.8% vs. 29.1%, adjusted OR=1.96, 95% CI=1.63-2.36) than non-frontline medical workers. No significant difference was observed in terms of suicidal ideation (12.0% vs. 9.0%, adjusted OR=1.25, 95% CI=0.92-1.71), help-seeking (4.5% vs. 4.5%, adjusted OR=1.00, 95% CI=0.53-1.87) or treatment (3.4% vs. 2.3%, adjusted OR=1.38, 95% CI=0.54-3.52) for mental problems.

Limitations: The case-control nature of the data precludes causal inferences, and there is a possibility of bias related to self-reports.

Conclusions: Frontline medical workers had more mental problems but comparable help-seeking behaviors and treatment for these problems than non-frontline medical workers. These findings highlight the timely mental support and intervention for medical workers, especially for those on the frontline.

Keywords: Coronavirus disease 2019; Help-seeking behavior; Medical workers; Mental health; Severe acute respiratory syndrome from coronavirus 2.

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Conflict of interest statement

Declaration of Competing Interest Dr. Hongliang Feng was supported by the Hong Kong Ph.D. Fellowship Scheme of the Research Grants Council (No.: PF16-05347). The other authors have nothing to declare.

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