Objective: We explored whether medical health workers had more psychosocial problems than nonmedical health workers during the COVID-19 outbreak. Methods: An online survey was run from February 19 to March 6, 2020; a total of 2,182 Chinese subjects participated. Mental health variables were assessed via the Insomnia Severity Index (ISI), the Symptom Check List-revised (SCL-90-R), and the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). Results: Compared with nonmedical health workers (n = 1,255), medical health workers (n = 927) had a higher prevalence of insomnia (38.4 vs. 30.5%, p < 0.01), anxiety (13.0 vs. 8.5%, p < 0.01), depression (12.2 vs. 9.5%; p< 0.04), somatization (1.6 vs. 0.4%; p < 0.01), and obsessive-compulsive symptoms (5.3 vs. 2.2%; p < 0.01). They also had higher total scores of ISI, GAD-2, PHQ-2, and SCL-90-R obsessive-compulsive symptoms (p ≤ 0.01). Among medical health workers, having organic disease was an independent factor for insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms (p < 0.05 or 0.01). Living in rural areas, being female, and being at risk of contact with COVID-19 patients were the most common risk factors for insomnia, anxiety, obsessive-compulsive symptoms, and depression (p < 0.01 or 0.05). Among nonmedical health workers, having organic disease was a risk factor for insomnia, depression, and obsessive-compulsive symptoms (p < 0.01 or 0.05). Conclusions: During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They were in need of attention and recovery programs.

1.
World Health Organization [Internet]. Geneva: WHO characterizes COVID-19 as a pandemic. [cited 2020 March 11]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
2.
Li
Q
,
Guan
X
,
Wu
P
,
Wang
X
,
Zhou
L
,
Tong
Y
, et al.
Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia
.
N Engl J Med
.
2020
Mar
;
382
(
13
):
1199
207
.
[PubMed]
0028-4793
3.
Lancet
T.
COVID-19: too little, too late? . Lancet. 2020 07 March
2020
;395(10226):755.
4.
Day
M
.
Covid-19: surge in cases in Italy and South Korea makes pandemic look more likely
.
BMJ
.
2020
Feb
;
368
:
m751
.
[PubMed]
0959-8138
5.
World Health Organization [Internet]. Geneva: WHO statement on cases of COVID-19 surpassing 100 000. [cited 2020 March 7]. Available from: https://www.who.int/news-room/detail/07-03-2020-who-statement-on-cases-of-covid-19-surpassing-100-000
6.
Guan
WJ
,
Ni
ZY
,
Hu
Y
,
Liang
WH
,
Ou
CQ
,
He
JX
, et al.;
China Medical Treatment Expert Group for Covid-19
.
Clinical Characteristics of Coronavirus Disease 2019 in China
.
N Engl J Med
.
2020
Feb
;
NEJMoa2002032
.
[PubMed]
0028-4793
7.
Zhou
P
,
Yang
XL
,
Wang
XG
,
Hu
B
,
Zhang
L
,
Zhang
W
, et al.
A pneumonia outbreak associated with a new coronavirus of probable bat origin
.
Nature
.
2020
Mar
;
579
(
7798
):
270
3
.
[PubMed]
0028-0836
8.
Wang
M
,
Cao
R
,
Zhang
L
,
Yang
X
,
Liu
J
,
Xu
M
, et al.
Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
.
Cell Res
.
2020
Mar
;
30
(
3
):
269
71
.
[PubMed]
1001-0602
9.
Fava
GA
,
McEwen
BS
,
Guidi
J
,
Gostoli
S
,
Offidani
E
,
Sonino
N
.
Clinical characterization of allostatic overload
.
Psychoneuroendocrinology
.
2019
Oct
;
108
:
94
101
.
[PubMed]
0306-4530
10.
Bao
Y
,
Sun
Y
,
Meng
S
,
Shi
J
,
Lu
L
.
2019-nCoV epidemic: address mental health care to empower society
.
Lancet
.
2020
Feb
;
395
(
10224
):
e37
8
.
[PubMed]
0140-6736
11.
Kang
L
,
Li
Y
,
Hu
S
,
Chen
M
,
Yang
C
,
Yang
BX
, et al.
The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus
.
Lancet Psychiatry
.
2020
Mar
;
7
(
3
):
e14
.
[PubMed]
2215-0366
12.
Liu
S
,
Yang
L
,
Zhang
C
,
Xiang
YT
,
Liu
Z
,
Hu
S
, et al.
Online mental health services in China during the COVID-19 outbreak
.
Lancet Psychiatry
.
2020
Apr
;
7
(
4
):
e17
8
.
[PubMed]
2215-0366
13.
Guangming Online [Internet]. Beijing: Central Steering Group: Over 3,000 medical staff in Hubei were infected in the early stage of the epidemic, currently no infection reports among medical aid staff [cited 2020 March 6]. Available from: https://politics.gmw.cn/2020-03/06/content_33626862.htm
14.
Morin
CM
,
Belleville
G
,
Bélanger
L
,
Ivers
H
.
The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response
.
Sleep (Basel)
.
2011
May
;
34
(
5
):
601
8
.
[PubMed]
0302-5128
15.
Wong
SY
,
Zhang
DX
,
Li
CC
,
Yip
BH
,
Chan
DC
,
Ling
YM
, et al.
Comparing the effects of mindfulness-based cognitive therapy and sleep psycho-education with exercise on chronic insomnia: a randomised controlled trial
.
Psychother Psychosom
.
2017
;
86
(
4
):
241
53
.
[PubMed]
0033-3190
16.
Löwe
B
,
Wahl
I
,
Rose
M
,
Spitzer
C
,
Glaesmer
H
,
Wingenfeld
K
, et al.
A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population
.
J Affect Disord
.
2010
Apr
;
122
(
1-2
):
86
95
.
[PubMed]
0165-0327
17.
Wang
ZY
.
Symptom Check List (SCL-90)
.
Shanghai Jingshen Yixue
.
1984
;
2
(
2
):
68
70
.1002-0829
18.
Chen
S
,
Li
L
.
Re-testing reliability, validity, and norm applicatility of SCL-90
.
Chin J Nerv Ment Dis.
2003
;
29
(
5
):
323
7
.
19.
Chen
X
,
Li
P
,
Wang
F
,
Ji
G
,
Miao
L
,
You
S
.
Psychological Results of 438 Patients with persisting Gastroesophageal Reflux Disease Symptoms by Symptom Checklist 90-Revised Questionnaire
.
Euroasian J Hepatogastroenterol
.
2017
Jul-Dec
;
7
(
2
):
117
21
.
[PubMed]
2231-5047
20.
Zhang
B
,
Zhang
L
,
Chen
S
,
Luo
X
,
Dhirendra
P
,
Lin
Q
, et al.
The effect of e‑aid cognitive behavioral therapy in treating chronic insomnia disorder: an open‑label randomized controlled trial.
Chin J Psychiatry. 2019 December
2019
;52(6):373-378.
21.
Wang
L
,
Lu
K
,
Li
J
,
Sheng
L
,
Ding
R
,
Hu
D
. Value of patient health questionnaires (PHQ)-9 and PHQ-2 for screening depression disorders in cardiovascular outpatients. Chin J Cardiol. 2015 May
2015
;43(5):428-431.
22.
Wang
L
,
Lu
K
,
Wang
C
,
Sheng
L
,
Hu
D
,
Ding
R
.
Reliability and validity of GAD-2 and GAD-7 for anxiety screening in cardiovascular disease clinic
.
Sichuan Mental Health.
2014
;
27
(
3
):
198
201
.
23.
World Health Organization [Internet]. Geneva: Shortage of personal protective equipment endangering health workers worldwide [cited 2020 March 3]. Available from: https://www.who.int/news-room/detail/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide
24.
SINAnews [Internet]. Beijing: In January, Hubei had more than 3,000 medical infections, and the Wuhan Health and Medical Committee reported "None" for half a month [cited 2020 March 6]. Available from: https://news.sina.com.cn/o/2020-03-06/doc-iimxyqvz8395569.shtml
25.
Theorell
T
.
Evaluating life events and chronic stressors in relation to health: stressors and health in clinical work
.
Adv Psychosom Med
.
2012
;
32
:
58
71
.
[PubMed]
0065-3268
26.
The Telegraph [Internet]. London: Coronavirus: Doctors collapse from exhaustion as virus spreads through South Korea [cited 2020 March 3]. Available from: https://www.telegraph.co.uk/news/2020/03/03/coronavirus-doctors-collapse-exhaustion-virus-spreads-south/
27.
Chinanews [Internet]. Beijing: Two departments issue the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Plan (trial version 7) [cited 2020 March 4]. Available from: http://www.chinanews.com/gn/2020/03-04/9113100.shtml
28.
China.com
. [Internet]. Beijing: Liu Li, Wuhan Central Hospital, infected with COVID-19, died, totally five died in the hospital.
2020
[cited 2020 March 20]. Available from: https://news.china.com/socialgd/10000169/20200320/37949631.html
29.
Wang
HX
,
Wang
L
,
Zhang
WR
,
Xue
Q
,
Peng
M
,
Sun
ZC
, et al.
Effect of transcranial alternating current stimulation for the treatment of chronic insomnia: a randomized, double-blind, parallel-group, placebo-controlled clinical trial
.
Psychother Psychosom
.
2020
;
89
(
1
):
38
47
.
[PubMed]
0033-3190
30.
Sonino
N
,
Fava
GA
.
Rehabilitation in endocrine patients: a novel psychosomatic approach
.
Psychother Psychosom
.
2007
;
76
(
6
):
319
24
.
[PubMed]
0033-3190
31.
Aronsson
G
,
Theorell
T
,
Grape
T
,
Hammarström
A
,
Hogstedt
C
,
Marteinsdottir
I
, et al.
A systematic review including meta-analysis of work environment and burnout symptoms
.
BMC Public Health
.
2017
Mar
;
17
(
1
):
264
.
[PubMed]
1471-2458
32.
Cummings
J
.
Sharing a traumatic event: the experience of the listener and the storyteller within the dyad
.
Nurs Res
.
2011
Nov-Dec
;
60
(
6
):
386
92
.
[PubMed]
0029-6562
33.
Fava
GA
.
Well-Being Therapy: Treatment Manual and Clinical appliatios
.
Basel
:
Kager
;
2016
.
34.
Fava
GA
,
Cosci
F
,
Sonino
N
.
Current psychosomatic practice
.
Psychother Psychosom
.
2017
;
86
(
1
):
13
30
.
[PubMed]
0033-3190
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