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Prevalence and influencing factors of depression and anxiety among Chinese hospital healthcare workers during the COVID-19 pandemic

Year: 2024

Type: article

Abstract: To the Editor, We analyzed the study by Jing et al.1 on the impact of the surge period of coronavirus disease 2019 (COVID-19) on Chinese healthcare worker’s (HCW) mental health, specifically depressive and anxiety symptoms. The authors used a cross-sectional study to gather data via online questionnaires and interviews across seven geographical locations across China. To improve research findings, we recommend the following considerations. Firstly, even though the authors discussed numerous factors contributing to anxiety and depressive symptoms among HCWs, they overlooked other significant stressors that could also be influential. The implementation of strict lockdown measures may have exacerbated HCWs' pre-existing psychological distress. This notion finds support in a study by Lu et al.2 in late 2020, which observed a reduction in the prevalence of anxiety and depression among both the general public and HCWs in Wuhan, China, following the easing of lockdown measures. Additionally, the authors should have addressed the widespread food insecurity crisis, such as the situation in Shanghai in 2022 during a city-wide lockdown. Liu et al.3 reported that nearly 70% of the 3 230 study participants in Shanghai reported exposure to food insecurity, which undoubtedly heightened psychological stress levels.3,4 Secondly, the authors presented comprehensive data regarding various demographic and professional cohorts affected during the surge period of COVID-19. Despite conducting stratified analyses based on gender, income and years of experience, which yielded no significant disparities, a notable stratified analysis based on occupational categories—specifically physicians and nurses—was absent. A study conducted by Kunz et al.5 in Augsburg, Germany, provided compelling evidence indicating that nurses exhibited worse mental health outcomes compared to physicians. Given this observation, replicating a subgroup analysis focusing on nurses and physicians in China could shed light on potential cultural and societal influences impacting mental health outcomes amidst the COVID-19 pandemic. Thirdly, despite the authors' acknowledgment of the potential for social media utilization to mitigate mental strain experienced by HCWs, the investigation failed to integrate data concerning HCWs' social media usage. Given the heightened global isolation and consequent surge in phone usage resulting from the COVID-19 pandemic, an in-depth assessment of the impact of social media was warranted. The study by Zhong et al.6 revealed that social media conferred benefits to residents of Wuhan, offering informational, emotional and peer support across diverse platforms. However, excessive social media engagement is correlated with mental health adversities.6 Therefore, additional investigations should undertake subgroup analyses of HCWs stratified by screen time to elucidate whether social media serves to ameliorate or exacerbate pre-existing psychological stressors. In conclusion, the study by Jing et al.1 provides valuable insight into the impact of COVID-19 surge period on HCWs’ mental health, whether it may be depression or anxiety. Further research could incorporate the impact of food insecurity and stringent lockdown protocols on mental health among HCWs; conduct subgroup analysis on nurses and physicians; and lastly, examine the impact of social media usage on the emotional well-being of HCW. Jalal Ibrahim (Conceptualization [equal], Investigation [equal], Writing—original draft [equal]), Patrick Wu (Conceptualization [equal], Investigation [equal], Project administration [equal], Writing—original draft [equal], Writing—review & editing [equal]), Adina Boulos (Conceptualization [Supporting], Writing—original draft [Supporting]), Su Boon Yong (Project administration [equal], Writing—review & editing [equal]), and Chin-Yuan Yii (Project administration [equal]) Funding support for this article was provided by the CHINA MEDICAL University Hospital (DMR-113-137).

Source: QJM

DOI: 10.1093/qjmed/hcae080

Authors: J Ibrahim, P Wu, A Boulos, S -B Yong, C -Y Yii

Institutions: Lake Erie College of Osteopathic Medicine, China Medical University, China Medical University Hospital, Landseed Hospital

Language: English

Topic: COVID-19 and Mental Health

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: China Medical University Hospital, China Medical University, Division of Materials Research