The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis

Sophie M Allan, Rebecca Bealey, Jennifer Birch, Toby Cushing, Sheryl Parke, Georgina Sergi, Michael Bloomfield, Richard Meiser-Stedman, Sophie M Allan, Rebecca Bealey, Jennifer Birch, Toby Cushing, Sheryl Parke, Georgina Sergi, Michael Bloomfield, Richard Meiser-Stedman

Abstract

Background: Healthcare workers (HCWs) are considered at elevated risk of experiencing mental health disorders in working with patients with COVID-19. Objective: To estimate the prevalence of common mental health disorders in HCWs based in hospitals where pandemic-affected patients were treated. Method: Databases were searched for studies published before 30 March 2020. Quantitative synthesis was used to obtain estimates of the prevalence of mental health disorders in four time windows, determined a priori (the acute phase, i.e. during and up to 1.5 months post-pandemic; 1.5-5.9 months; 6-11.9 months; 12 months and later). Results: Nineteen studies met the review criteria. They predominantly addressed the acute phase of the SARS outbreak in Asia. The most studied outcomes were clinically significant post-traumatic stress symptoms (PTSS) and general psychiatric caseness. For clinically significant PTSS in the acute phase, the prevalence estimate was 23.4% (95% CI 16.3, 31.2; N = 4147; I2 = 96.2%); in the 12 months plus window, the estimate was 11.9% (8.4, 15.8; N = 1136; I2 = 74.3%). For general psychiatric caseness, prevalence estimates were acute phase, 34.1% (18.7, 51.4; N = 3971; I2 = 99.1%); 6-12 months, 17.9% (13.1, 23.2; N = 223; I2 = 0.0%); 12 months plus, 29.3% (6.0, 61.0; N = 710; I2 = 97.8%). No differences between doctors and nurses with respective to PTSS and general psychiatric caseness were apparent in the acute phase. Conclusions: Mental health disorders are particularly common in HCWs working with pandemic-afflicted patients immediately following a pandemic, but the course of disorders following this period is poorly understood. There was considerable heterogeneity between studies, likely linked to methodological differences. More extended follow up of HCWs is needed.

Keywords: COVID-19; PTSD; anxiety; depression; healthcare workers; pandemic.

Conflict of interest statement

Sophie M. Allan, Rebecca Bealey, Jennifer Birch,Toby Cushing, Sheryl Parke, Georgina Sergi and Richard Meiser-Stedman report no conflicts of interest. Michael Bloomfield is aconsultant psychiatrist at the Traumatic Stress Clinic in Londonwhich is part of the UK National Health Service. Dr Bloomfield has previously undertaken consultancy work for SpectrumTherapeutics.

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Forest plot showing prevalence of PTSS by time window.
Figure 3.
Figure 3.
Forest plot showing prevalence of general psychiatric screening by time window.

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