Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review

Ignacio Ricci Cabello; Jose F Meneses Echavez; Maria Jesus Serrano-Ripoll; David Fraile-Navarro; Maria Antonia Fiol de Roque; Guadalupe Pastor Moreno; Adoracion Castro; Isabel Ruiz Perez; Rocio Zamanillo Campos; Daniela Goncalves-Bradley

Wu 2008 (35) SARS China Hospital HCWs N=549 PTSD (IES-R) Current alcohol abuse/dependence symptom counts 3 years after the outbreak were positively associated with having been quarantined, or worked in high-risk locations such as SARS wards, during the outbreak. However, having had family members or friends contract, SARS was not related to alcohol abuse/dependence symptom count. Symptoms of PTS and of depression, and having used drinking as a coping method, were also significantly associated with increased alcohol abuse/dependence symptoms. The relationship between outbreak exposure and alcohol abuse/dependence symptom count remained significant even when sociodemographic and other factors were controlled for. When the intrusion, avoidance and hyperarousal PTS symptom clusters were entered into the model, hyperarousal was found to be significantly associated with alcohol abuse/dependence symptoms All agreed SARS had changed their clinical practices. Significant anxiety was found in family doctors. Three quarters of respondents recalled requesting more investigations while a quarter believed they had over-prescribed antibiotics. GPs who were exposed to SARS or who had worked in high infection districts were less likely to quarantine themselves (10.8% versus 33.3%; P<0.01; 6.5% versus 27.5%; P<0.01 respectively). Exposure to SARS, the infection rates in their working district, and anxiety levels had significant impact on the level of protection or prescribing behaviour.