Document Type : Original Article

Authors

1 Department of Psychiatry, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

2 Department of TB and Chest, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

3 Department of Medicine, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

4 Department of Anesthesia, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Abstract

BACKGROUND: The spread of novel coronavirus diseases‑2019 (COVID‑19) across the world and
its associated morbidity and mortality confronted the nations by various means. COVID19 pandemic
had significant psychological effects not only on the general population but also on health‑care
workers (HCWs). Hence, we aimed to found the level of anxiety and depression among health‑care
professionals amidst coronavirus.
MATERIALS AND METHODS: This is a cross‑sectional study conducted on 829 participants including
doctors and nurses and other medical staff who were posted in the COVID ward and COVID intensive
care unit using a well‑structured questionnaire through the Google Forms. The two scales used to
measure anxiety and depression among the HCWs were the Hamilton anxiety scale (HAM‑A) and the
Patient Health Questionnaire (PHQ‑9), Cronbach’s alpha of HAM A is 0.921 and Cronbach’s alpha
of PHQ 9 is 0.851. Data analysis was done using SPSS 26, Chi‑square test and Fisher’s exact test
were used to establish the association between categorical independent and dependent variables.
RESULTS: The results of this study demonstrate that anxiety and depression were significantly
higher in doctors and staff nurses as compared to other medical staff. According to HAM‑A, 65.1% of
respondents were in the mild category, 22.0% mild to moderate, and 12.9% moderate to severe. The
HAM‑A (P = 0.022) and PHQ‑9 (P = 0.001) for anxiety and depression respectively were significantly
higher in females. The means of the scales got increased after postings in the corona wards.
CONCLUSION: Concerning the high occurrence of anxiety and fear among health‑care professionals,
appropriate psychological/psychiatric intervention necessitates and emphasizes the need to implement
urgent measures to prevent further progress to severe mental health disorder.

Keywords

1. Nishiura H, Jung S, Linton NM, Kinoshita R, Yang Y, Hayashi K,
et al. The extent of transmission of novel coronavirus in Wuhan,
China, 2020. J Clin Med 2020;9:330.
2. C o r o n a v i r u s C a s e s : S t a t i s t i c s a n d
Charts – Worldometer; 2020. Available from: http://
srv1.worldometers.info/coronavirus/coronavirus
‑cases. [Last accessed on 2020 Sep 19].
3. World Health Organization. WHO Director‑General’s Opening
Remarks at the Media Briefing on COVID‑19–11 March 2020.
Geneva, Switzerland: World Health Organization; 2020. Available
from: https://www.who.int/dg/speeches/detail/who-directorgeneral-s-opening-remarks-at‑the‑media‑briefing‑oncovid‑19‑11
‑march‑2020. [Last accessed on 2020 Apr 18].
4. Coronavirus Disease (COVID‑19): Situation Report – 138.
Geneva, Switzerland: World Health Organization; 2020.
Available from: https://www.who.int/docs/default‑source/
coronaviruse/situation‑reports/20200606‑covid‑19‑sitrep‑138.
pdf?sfvrsn=c8abfb17_4. [Last accessed on 2020 Jun 07].
5. Islam MA, Barna SD, Raihan H, Khan MN, Hossain MT.
Depression and anxiety among university students during the
COVID‑19 pandemic in Bangladesh: A web‑based crosssectional
survey. PLoS One 2020;15:E0238162.
6. Chew NW, Lee GK, Tan BY, Jing M, Goh Y, Ngiam NJ, et al.
A multinational, multicentre study on the psychological outcomes
and associated physical symptoms amongst healthcare workers
during COVID‑19 outbreak. Brain Behav Immun 2020;88:559‑65.
7. Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, et al. The
prevalence and influencing factors in anxiety in medical workers
fighting COVID‑19 in China: A cross‑sectional survey. Epidemiol
Infect 2020;148:e98.
8. Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression,
anxiety, stress levels of physicians and associated factors in
COVID‑19 pandemics. Psychiatry Res 2020 Aug; 2020;290:113130..
9. Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, et al.
Mention six authors. Psychological distress, coping behaviors,
and preferences for support among New York healthcare
workers during the COVID‑19 pandemic. Gen Hosp Psychiatry
2020;66:1‑8.
10. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self‑report version of PRIMEMD: The PHQ primary care study.
JAMA 1999;282:1737‑44.
11. Levis B, Benedetti A, Thombs BD; Depression Screening
Data (DEPRESSD) Collaboration. Accuracy of Patient Health
Questionnaire‑9 (PHQ‑9) for screening to detect major depression:
Individual participant data meta‑analysis. BMJ 2019;365:l1476.
12. Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety
Scale: Reliability, validity and sensitivity to change in anxiety and
depressive disorders. J Affect Disord 1988;14:61‑8.
13. Khanal P, Devkota N, Dahal M, Paudel K, Joshi D. Mental health
impacts among health workers during COVID‑19 in a low
resource setting: A cross‑sectional survey from Nepal. Global
Health 2020;16:89.
14. Vahedian‑Azimi A, Moayed MS, Rahimibashar F, Shojaei S,
Ashtari S, Pourhoseingholi MA. Comparison of the severity
of psychological distress among four groups of an Iranian
population regarding COVID‑19 pandemic. BMC Psychiatry
2020;20:402.
15. Jain A, Singariya G, Kamal M, Kumar M, Jain A, Solanki RK.
COVID‑19 pandemic: Psychological impact on anaesthesiologists.
Indian J Anaesth 2020;64:774‑83.
16. Saleem Z, Majeed MM, Rafique S, Siddiqui Z, Gandhi D,
Tariq H. COVID‑19 pandemic fear and anxiety among healthcare
professionals in Pakistan. Research square 2020 preprint version,
CC BY 4.0 License; [doi: 10.21203/rs. 3.rs‑37608/v2].
17. Bai Y, Lin CC, Lin CY, Chen JY, Chue CM, Chou P. Survey of
stress reactions among health care workers involved with the
SARS outbreak. Psychiatr Serv 2004;55:1055‑7.
18. Nickell LA, Crighton EJ, Tracy CS, Al‑Enazy H, Bolaji Y,
Hanjrah S, et al. Psychosocial effects of SARS on hospital staff:
Survey of a large tertiary care institution. CMAJ 2004;170:793‑8.
19. Sigdel A, Bista A, Bhattarai N, Poon BC, Giri G, Marqusee H.
Depression, anxiety and depression‑anxiety comorbidity amid
COVID‑19 pandemic: An online survey conducted during
lockdown in Nepal. medRxiv 2020 preprint version; doi: https://
doi.org/10.1101/2020.04.30.20086926. CC‑BY‑NC‑ND 4.0
International license.
20. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated
with mental health outcomes among health care workers exposed
to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
21. Suryavanshi N, Kadam A, Dhumal G, Nimkar S, Mave V,
Gupta A, et al. Mental health and quality of life among healthcare
professionals during the COVID‑19 pandemic in India. Brain
Behav 2020;10:e01837.
22. Lai J, Ma S, Wang Y. Factors associated with mental health
outcomes among health care workers exposed to corona virus
disease 2019. JAMA Network Open 2020;3:E203976.
23. Kluger MT, Townend K, Laidlaw T. Job satisfaction, stress and
burnout in Australian specialist anaesthetists. Anaesthesia
2003;58:339‑45.
24. Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of
insomnia and related social psychological factors among medical
staff involved in the 2019 novel coronavirus disease outbreak.
Front Psychiatry 2020;11:306.
25. Al‑Hanawi MK, Mwale ML, Alshareef N, Qattan AM, Angawi K,
Almubark R, et al. Psychological distress amongst health workers
and the general public during the COVID‑19 pandemic in Saudi
Arabia. Risk Manag Healthc Policy 2020;13:733‑42.
26. Ahmed I, AsgharMS, IqbalS, SalmanS, Hassan M, Rasheed U. Levels
of anxiety and depression amongst the frontline healthcare workers
of COVID‑19: A cross‑sectional survey with follow‑up. J Psychiatry
Psychiatr Dis 2020;4:270‑84. J Psychiatry Psychiatr Dis 2020;4:270-84.