Document Type : Original Article
Authors
- . Bhuvan Jyoti
- . Manisha Kiran 1
- . Rahul Srivastava 2
- . Vikas Jaiswal 1
- . Swati Kumari 1
- . Amitabh K. Sinha 3
1 Department of Psychiatric Social Work, Ranchi Institute of Neuropsychiatry and Allied Sciences, Ranchi, Jharkhand, India
2 Department of Oral Medicine and Radiology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
3 Department of Oral Medicine and Radiology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
Abstract
BACKGROUND: Severe acute respiratory syndrome coronavirus 2, the virus that causes COVID‑19,
mainly spreads through respiratory droplets. The dental profession is particularly at risk. Routine
dental care was suspended after the announcement of the first lockdown in India. This makes the
group vulnerable to psychosocial consequences. The present study aims to evaluate the psychosocial
issues among dental professionals during COVID‑19 pandemic.
MATERIALS AND METHODS: Across‑sectional study was conducted among 627 dental professionals
of India, using online Google Forms from April 23, 2020, through April 30, 2020. Participants were
evaluated using self‑constructed and self‑administered personal and professional hardship and fear
checklist specifically developed for this study. The 9‑item Patient Health Questionnaire (PHQ‑9)
Depression Scale and 7‑item Generalized Anxiety Disorder Scale and PHQ‑15 were used to assess
the depression, anxiety, and somatic symptoms.
RESULTS: Fear had a remarkable impact on 80.7% of responders. Among the participants, 40.5%,
24.5%, and 30.6% reported symptoms of depression, anxiety, and somatic symptoms, respectively.
Somatic symptoms were significantly associated with gender (P = 0.000). Work setting was significantly
associated with depression (P = 0.011) and anxiety symptoms (P = 0.001). Concern, worry, and fear
due to COVID‑19 were significantly associated with depression (P = 0.000), anxiety (P = 0.033), and
somatic symptoms (P = 0.009). There was a positive correlation between depression and anxiety
symptoms (P = 0.01) and between age and somatic symptoms (P = 0.5).
CONCLUSIONS: This group reported a high level of depression, anxiety, and somatic symptoms.
Female dental professionals and private practitioners had more depression, anxiety, and somatic
symptoms. Immediate and special intervention is needed for this group. Further exploration into the
nature and its effects of the psychological symptoms may be required.
Keywords
the novel coronavirus disease. Int J Occup Environ Med
2020;11:1977‑08.
2. Gralinski LE, Menachery VD. Return of the coronavirus:
2019‑nCoV. Viruses 2020;12:135.
3. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel
coronavirus from patients with pneumonia in China, 2019. N Engl
J Med 2020;382:727‑33.
4. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019‑nCoV epidemic: Address
mental health care to empower society. Lancet 2020;395:e37‑8.
5. World Health Organisation. WHO Director‑General’s
Opening Remarks at the Media Briefing on COVID19 ‑March
2020; 2020. Available from: https://silverbelt.com/article/
who‑director‑generals‑opening‑remarks‑at‑the‑media
‑briefing‑on‑covid‑19. [Last acessed on 2020 Sep 09].
6. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C,
Gulyaeva AA et al. Severe acute respiratory syndrome‑related
coronavirus – The species and its viruses, a statement of the
Coronavirus Study Group. Nat Microbiol 2020;5:536‑44.
7. PengX, XuX, LiY, Cheng L, ZhouX, Ren B. Transmission routes of
2019‑nCoV and controls in dental practice. Int J Oral Sci 2020;12:9.
8. Lu CW, LiuXF, JiaZF. 2019‑nCoV transmission through the ocular
surface must not be ignored. Lancet 2020;395:e39.
9. Times of India/Times News Network. How Asymptomatic Cases
Fuelled Spread of Coronavirus; 2020 Apr 23. Available from:
http://timesofindia.indiatimes.com/articleshow/75292506.
cms?utm_source=contentofinterest and utm_medium=text and
utm_campaign=cppst_prime.
10. Wax RS, Christian MD. Practical recommendations for
critical care and anesthesiology teams caring for novel
coronavirus (2019‑nCoV) patients. Can J Anaesth 2020;67:568‑76.
11. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG,
Gamble A, Williamson BN, et al. Aerosol and surface stability
of SARS‑CoV‑2 as compared with SARS‑CoV‑1. N Engl J Med
2020;382:1564‑7.
12. Alkrisat M. The Impact of Workplace Stress and Stress of
Conscience on the Moral Distress of Nurses in Acute Care
Settings. Azusa, CA, USA: Ph.D. Thesis, Azusa Pacific University;
2011.
13. Russell H, Maître B, Watson D, Fahey É. Job stress and Working
Conditions: Ireland in Comparative Perspective. In: An Analysis
of the European Working Conditions Survey. The Economic and
Social Research Institute.Whitaker Square, Sir John Rogerson’s
Quay, Dublin 2: Research Series; 2018.
14. Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D,
Hayes SN, et al. Longitudinal study evaluating the association
between physician burnout and changes in professional work
effort. Mayo Clin Proc 2016;91:422‑31.
15. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al.
Timely mental health care for the 2019 novel coronavirus outbreak
is urgently needed. Lancet Psychiatry 2020;7:228‑9.
16. Tam CW, Pang EP, Lam LC, Chiu HF. Severe acute respiratory
syndrome (SARS) in Hong Kong in 2003: Stress and psychological
impact among frontline healthcare workers. Psychol Med
2004;34:1197‑204.
17. MaunderRG, LanceeWJ, BaldersonKE, BennettJP, BorgundvaagB,
Evans S, et al. Long‑term psychological and occupational effects
of providing hospital healthcare during SARS outbreak. Emerg
Infect Dis 2006;12:1924‑32.
18. Ho SM, Kwong‑Lo RS, Mak CW, Wong JS. Fear of severe acute
respiratory syndrome (SARS) among health care workers.
J Consult Clin Psychol 2005;73:344‑9.
19. Wong TW, Yau JK, Chan CL, Kwong RS, Ho SM, Lau CC, et al.
The psychological impact of severe acute respiratory syndrome
outbreak on healthcare workers in emergency departments and
how they cope. Eur J Emerg Med 2005;12:13‑8.
20. Shacham M, Hamama‑Raz Y, Kolerman R, Mijiritsky O,
Ben‑Ezra M, Mijiritsky E. COVID‑19 factors and psychological
factors associated with elevated psychological distress among
dentists and dental hygienists in Israel. Int J Environ Res Public
Health 2020;17:2900.
21. Ahmed MA, Jouhar R, Ahmed N, Adnan S, Aftab M, Zafar MS,
et al. Fear and practice modifications among dentists to combat
novel coronavirus disease (COVID‑19) outbreak. Int J Environ
Res Public Health 2020;17:2821.
22. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID‑19):
Emerging and future challenges for dental and oral medicine.
J Dent Res 2020;99:481‑7.
23. Booth J. Be Prepared for COVID‑19, but Don’t Panic, Says
Indian Dental Association. Dental Tribune; 2020 Mar 25.
Available from: https://www.dental‑tribune.com/
news/be‑prepared‑for‑covid‑19‑but‑dont‑panic‑says‑
indian‑dental‑association/. [Last accessed on 2020 May 22].
24. Li RW, Leung KW, Sun FC, Samaranayake LP. Severe acute
respiratory syndrome (SARS) and the GDP. Part II: Implications
for GDPs. Br Dent J 2004;197:130‑4.
25. Gamio L. The Workers Who Face the Greatest Coronavirus Risk. The New York Times; 2020 Mar 15. Available from: https://www.
nytimes.com/interactive/2020/03/15/business/economy/
coronavirus‑worker‑risk.html. [Last accessed on 2020 Sep 10].
26. Mishra P, Bhadauria US, Dasar PL, N S, Kumar S, Lalani A, et al.
Knowledge, attitude and anxiety towards pandemic flu a potential
bio weapon among health professionals in Indore City. Przegl
Epidemiol 2016;70:41‑5, 125‑7.
27. Nair AK, Chellaswamy KS, Kattula D, Thavarajah R,
Mohandoss AA. Perceived stress and psychological (Dis) stress
among Indian endodontists during COVID19 pandemic lock
down. medRxiv 2020 Jan 1. DOI: 10.1101/2020.05.06.20092601.
Available from: https://www.medrxiv.org/
content/10.1101/2020.05.06.2009 2601v1.full.pdf. [Last accessed
on 2020 Sep 10].
28. Kroenke K, Spitzer R. “The PHQ‑9: A new depression diagnostic
and severity measure.” Psychiatr Ann 2002;32:509‑15.
29. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for
assessing generalized anxiety disorder: The GAD‑7. Arch Intern
Med 2006;166:1092‑7.
30. Kroenke K, Spitzer RL, Williams JB. The PHQ‑15: Validity of a
new measure for evaluating the severity of somatic symptoms.
Psychosom Med 2002;64:258‑66.
31. Fiorillo A, Gorwood P. The consequences of the COVID‑19
pandemic on mental health and implications for clinical practice.
Eur Psychiatry 2020;63:e32.
32. McKee M, Stuckler D. If the world fails to protect the economy,
COVID‑19 will damage health not just now but also in the future.
Nat Med 2020;26:640‑2.
33. Goulia P, Mantas C, DimitroulaD, MantisD, HyphantisT. General
hospital staff worries, perceived sufficiency of information and
associated psychological distress during the A/H1N1 influenza
pandemic. BMC Infect Dis 2010;10:322.
34. Chong MY, Wang WC, Hsieh WC, Lee CY, Chiu NM, Yeh WC,
et al. Psychological impact of severe acute respiratory syndrome
on health workers in a tertiary hospital. Br J Psychiatry
2004;185:127‑33.
35. 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.
36. Shultz JM, Cooper JL, Baingana F, Oquendo MA, Espinel Z,
Althouse BM, et al. The role of fear‑related behaviors in the
2013‑2016 West Africa Ebola virus disease outbreak. Curr
Psychiatry Rep 2016;18:104.
37. Chen Y, Zhou H, Zhou Y, Zhou F. Prevalence of self‑reported
depression and anxiety among pediatric medical staff members
during the COVID‑19 outbreak in Guiyang, China. Psychiatry
Res 2020;288:113005.
38. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate
psychological responses and associated factors during the initial
stage of the 2019 coronavirus disease (COVID‑19) epidemic
among the general population in China. Int J Environ Res Public
Health 2020;17:1729.
39. Xie J, Bi Q, Li W, Shang W, Yan M, Yang Y, et al. Positive and
negative relationship between anxiety and depression of patients
in pain: A bifactor model analysis. PLoS One 2012;7:e47577.
40. Beutel ME, Wiltink J, Ghaemi Kerahrodi J, Tibubos AN, Brähler E,
Schulz A, et al. Somatic symptom load in men and women from
middle to high age in the Gutenberg Health Study – Association
with psychosocial and somatic factors. Sci Rep 2019;9:4610.
41. Basudan S, Binanzan N, Alhassan A. Depression, anxiety and
stress in dental students. Int J Med Educ 2017;8:179‑86.
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