Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey

Abstract

Introduction: Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain.

Methods: All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 - September 7, 2020). We report: probable current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder -PTSD- [PCL-5≥7]; and Substance Use Disorder -SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify probable "disabling" current mental disorders.

Results: 9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Workers with pre-pandemic lifetime mental disorders had almost twice the prevalence than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring "all of the time" for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95).

Conclusions: One in seven Spanish healthcare workers screened positive for a disabling mental disorder during the first wave of the COVID-19 pandemic. Workers reporting pre-pandemic lifetime mental disorders, those frequently exposed to COVID-19 patients, infected or quarantined/isolated, female workers, and auxiliary nurses should be considered groups in need of mental health monitoring and support.

Keywords: Adverse Mental Health; COVID-19 pandemic; Disability; Discapacidad; Healthcare Workers; Mental Disorders; Necesidad de atención; Need for Care; Pandemia de COVID-19; Salud mental adversa; Trabajadores de la salud; Trastornos mentales.

Figure 1

Current prevalence of probable mental disorders among Spanish healthcare workers during the first wave of the COVID-19 pandemic, according to pre-pandemic lifetime mental disorders. MINDCOVID study (n = 9138). Green bar: workers with no pre-pandemic mental disorders (new onset); Red Bar: workers with lifetime history of mental disorders (persistence/recurrence). MDD: Major Depressive Disorder; GAD: Generalized Anxiety Disorder; PTSD: Post-Stress Traumatic Disorder; SUB: Substance Use Disorder.

Figure 2

Current prevalence of any probable mental disorders (disabling and non-disabling) among Spanish healthcare workers during the first wave of the COVID-19 pandemic, according the pre-pandemic lifetime mental disorders and individual characteristics. MINDCOVID study (n = 9138).