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How serious are the mental health effects of pandemics on health care staff?

Post-traumatic stress disorder (PTSD), anxiety and depression are common among health care staff during and immediately after pandemics – according to a new rapid systematic review and meta-analysis by UK researchers.

The study, published in the European Journal of Psychotraumatology, investigated how treating patients in past pandemics such as SARS and MERS affected the mental health of front-line staff.

From database searches, 19 studies, predominantly covering the SARS outbreak in Asia and Canada, met the review criteria. Quantitative synthesis was used to obtain estimates of the prevalence of mental health disorders in four time windows, determined a priori (the acute phase, during and up to 1.5 months post-pandemic; 1.5-5.9 months; 6-11.9 months; 12 months plus).

For clinically significant PTSD in the acute phase, the prevalence estimate was 23.4 per cent (95% CI, 16.3-31.2%; n=4147; I2=96.2%), whereas in the 12 months plus window, the estimate was 11.9 per cent (8.4-15.8%; n=1136; I2=74.3%).

For general mental distress such as anxiety or depression, prevalence estimates were: acute phase, 34.1 per cent (18.7-51.4%; n=3971; I2=99.1%); 6-12 months, 17.9 per cent (13.1-23.2%; n=223; I2=0.0%); and 12 months plus, 29.3 per cent (6.0-61.0%; n=710; I2=97.8%).

No differences between doctors and nurses with respect to PTSD and general mental distress were apparent in the acute phase of the pandemics; however, data were limited.

The team hope their work will help highlight the effect that the COVID-19 pandemic could be having on the mental health of doctors and nurses around the world, and called for long-term follow-up research on this.

Co-author Prof Richard Meiser-Stedman, University of East Anglia's Norwich Medical School, said: “In addition to the challenge of treating a large volume of severely unwell patients, front-line staff also have to contend with threats to their own physical health through infection, particularly as they have had to face shortages of essential personal protective equipment.”


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