Levels of depression and anxiety during COVID-19 pandemic: At what degree are health care workers affected in Tunisia

Ben Abdelghani, K.; Hamdi, O.; Miladi, S.; Sellami, M.; Ouenniche, K.; Souabni, L.; Kassab, S.; Chekili, S.; Fazaa, A.; Laatar, A.

Background: Since December 2019, a novel pneumonia caused by coronavirus-19 (COVID-19) has been spreading internationally. Facing this critical pandemic, health care workers who are involved in treating these patients are at risk of developing psychological distress. Objectives: To evaluate mental health outcomes among health care workers treating patients exposed to COVID-19. Methods: This cross-sectional study collected demographic data and mental health measurements from health workers in different hospitals using an online questionnaire. Participants were divided in two groups: G1 included participants working in a COVID-19 unit and G2 included those who worked in a normal ward. Participants were asked to complete the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7). The total scores of these measurement tools were interpreted as follows: PHQ-9 normal (0-4), mild (5-9), moderate (10-14) and severe (15-21) depression;GAD-7 normal (0-4), mild (5-9), moderate (10-14) and severe (15-21) anxiety. We compared the two groups in terms of psychological distress using a Chi-square test. Results: A total of 155 individuals with a mean age of 31.3 ± 25 years [26-45] and a sex-ratio of 0.3 completed the online questionnaire. Seventy-two participants (46%) worked in a COVID-unit. The mean number of nightshifts per month in the COVID-unit was 9.5 in G1 and 1.3 in G2 respectively. The mean number of work hours per day in the COVID unit was 5 hours in G1, and 0 in G2. G2 participants worked in COVID-units during nightshifts only. An increase in workload compared to the pre-epidemic was noted only in G1. Depression and anxiety scores were higher among participants of G1 compared to G2 (Table 1). The need for psychological support was more frequent in G1 compared to G2 (38% vs 9%;p=0.005). Participants of G1 were diagnosed with depression (9 cases), anxiety (9 cases) and burn-out (3 cases). In G2, 4 participants were diagnosed with anxiety. The prescribed treatments were: antidepressants (5 cases), anxiolytic (10 cases), and psychotherapy (12 cases). Conclusion: Individuals experience varying levels of distress during pandemics. In our study, health care workers in the frontline of COVID-units experienced high levels of anxiety and depression. Thus, necessary measures should be attached to psychological support strategies for health care workers.