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. 2021 May;38(5):528-544.
doi: 10.1002/da.23129. Epub 2021 Jan 4.

Thirty-day suicidal thoughts and behaviors among hospital workers during the first wave of the Spain COVID-19 outbreak

Philippe Mortier  1   2 , Gemma Vilagut  1   2 , Montse Ferrer  1   2   3 , Consol Serra  2   4   5 , Juan D Molina  6   7   8   9 , Nieves López-Fresneña  10 , Teresa Puig  3   11   12   13 , José M Pelayo-Terán  14 , José I Pijoan  2   15 , José I Emparanza  2   16 , Meritxell Espuga  17 , Nieves Plana  2   18 , Ana González-Pinto  9   19 , Rafael M Ortí-Lucas  9   20 , Alma M de Salázar  21 , Cristina Rius  9   22 , Enric Aragonès  23   24 , Isabel Del Cura-González  25   26   27 , Andrés Aragón-Peña  27   28 , Mireia Campos  29 , Mara Parellada  9   10 , Aurora Pérez-Zapata  18 , Maria João Forjaz  30   31 , Ferran Sanz  32   33   34 , Josep M Haro  3   9   35 , Eduard Vieta  9   36 , Víctor Pérez-Solà  3   4   9 , Ronald C Kessler  37 , Ronny Bruffaerts  38 , Jordi Alonso  1   2   33 ; MINDCOVID Working Group
Affiliations

Thirty-day suicidal thoughts and behaviors among hospital workers during the first wave of the Spain COVID-19 outbreak

Philippe Mortier et al. Depress Anxiety. 2021 May.

Abstract

Background: Healthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID-19 outbreak (March-July 2020).

Methods: Data come from the baseline assessment of a cohort of Spanish hospital workers (n = 5450), recruited from 10 hospitals just after the height of the coronavirus disease 2019 (COVID-19) outbreak (May 5-July 23, 2020). Web-based self-report surveys assessed 30-day STB, individual characteristics, and potentially modifiable contextual factors related to hospital workers' work and financial situation.

Results: Thirty-day STB prevalence was estimated at 8.4% (4.9% passive ideation only, 3.5% active ideation with or without a plan or attempt). A total of n = 6 professionals attempted suicide in the past 30 days. In adjusted models, 30-day STB remained significantly associated with pre-pandemic lifetime mood (odds ratio [OR] = 2.92) and anxiety disorder (OR = 1.90). Significant modifiable factors included a perceived lack of coordination, communication, personnel, or supervision at work (population-attributable risk proportion [PARP] = 50.5%), and financial stress (PARP = 44.1%).

Conclusions and relevance: Thirty-day STB among hospital workers during the first wave of the Spain COVID-19 outbreak was high. Hospital preparedness for virus outbreaks should be increased, and strong governmental policy response is needed to increase financial security among hospital workers.

Keywords: COVID-19 outbreak; hospital workers; suicidal thoughts and behaviors.

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Conflict of interest statement

Eduard Vieta reports personal fees from Abbott, personal fees from Allergan, personal fees from Angelini, grants from Novartis, grants from Ferrer, grants and personal fees from Janssen, personal fees from Lundbeck, personal fees from Sage, personal fees from Sanofi, outside the submitted work. Juan D. Molina reports personal fees from Janssen, personal fees and nonfinancial support from Otsuka, personal fees and nonfinancial support from Lundbeck, personal fees from Angelini, personal fees and nonfinancial support from Accord, outside the submitted work. In the past 3 years, Ronald C. Kessler was a consultant for Datastat, Inc., Sage Pharmaceuticals, and Takeda. All other authors reported no conflict of interest.

Figures

Figure 1
Figure 1
Multivariable PARPs (All analyses adjust for time of survey [weeks], hospital membership, age, gender, marital status, having children in care, frequency of direct exposure to COVID‐19 patients, frequency of working at home, perceived inefficiency of protective equipment, and the predictors shown in the figure.) for 30‐day suicidal thoughts and behaviors (STB; n = 5164). Individual characteristics and potentially modifiable contextual factors included in the final multivariable models are selected using the lasso shrinkage method, optimizing the Bayesian Information Criterion. Variables included for PARP analysis are potentially modifiable contextual factors, and lifetime mental disorders before the onset of the COVID‐19 outbreak; only PARPs that are statistically different from zero are shown. See Tables S7 and S8 for more details on PARP analysis. PARP of individual risk factors do not sum to 100% because of the multifactorial etiology of STB, that is, one risk factor can be part of multiple risk factor constellations leading to STB. COVID‐19, coronavirus disease 2019; PARP, population‐attributable risk proportion; STB, suicidal thoughts and behavior
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