Healthcare workers’ depression increased in second year of pandemic (By: Stephanie Soucheray, MA)
A study today of 2,564 Czech healthcare workers finds that their prevalence of depression increased twice during the pandemic. The study is published in Scientific Reports.
The study was based on the results from an online survey administered to healthcare workers (HCWs) in summer 2020 (referred to as wave 0 of the pandemic) and spring 2021 (wave 1) in the Czech arm of the HEROES study, a prospective cohort study evaluating the impact of the COVID-19 pandemic on the mental health of HCWs in 26 countries. Depression was defined by reaching 10 or more points on the Patient Health Questionnaire.
In wave 0, among 1,413 participants (76% women), 11% had moderate to severe depression; in wave 1, among 1,620 respondents (75% women), 22% had moderate to severe depression.
Stress, COVID care, patient death tied to depression
“This change was explained the most by increased stress, contact with COVID-19 patients, and experience of death due to COVID-19,” wrote the authors, who employed a number of models to show how and why participants saw increased rates of depression. “Perceived stress has been consistently found to be a risk factor for depression in HCWs over the course of [the] COVID-19 pandemic.”
Perceived stress has been consistently found to be a risk factor for depression in HCWs over the course of the COVID-19 pandemic.
Increased stress accounted for at least half of the difference. According to the authors, the participants in wave 1 reported more frequently experiencing stress (54% vs 25%), chronic physical illness (31% vs 23%), contact with COVID-19 patients (69% vs 17%), patient prioritization (20% vs 8%), and patient death due to COVID-19 (52% vs 12%).
In a multivariate analysis, being a woman (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.16 to 1.88) was associated with almost 50% higher odds of moderate to severe depression. But women who had protective factors for mental health showed no increased risk.
The effect of sex, however, did not stand up in subsequent models, when protective factors against depression were included in the analysis. Protective factors included having access to personal protective equipment and a personal sense of resilience.
Low trust in workplace linked to depression
Similarly, before protective measures were factored into the analysis, physicians had higher odds of moderate to severe depression (OR, 1.42; 95% CI ,1.03 to,1.96) than nurses and other medical staff.
“However, after the risk and protective factors were entered into the model, the association of being a physician to moderate to severe depression became close to unity,” the authors said.
Independent of all other risk factors, low trust in the workplace was related to greater odds of depression (OR, 1.42; 95% CI, 1.03 to 1.95).
The authors concluded by saying their findings were buttressed by similar findings among HCWs in China, studies of the general population that showed higher rates of depression during the second year of the pandemic, and perceived stress as a strong predictor of depression.
“The finding of a great increase in the burden of depression among HCWs is in line with research on community-dwelling individuals showing a rise in depression, anxiety, and stress between the first and the second wave of the pandemic,” they wrote.
