Symptoms of Mental Health Disorders in Critical Care Clinicians Facing the COVID-19 Second Wave: A Cross-Sectional Study

Azoulay, Elie; Cariou, Alain; Bruneel, Fabrice; Demoule, Alexandre; Kouatchet, Achille; Reuter, Danielle; Klouche, Kada; Argaud, Laurent; Barbier, François; Jourdain, Mercé; Reignier, Jean; Papazian, Laurent; Resche-Rigon, Matthieu; Guisset, Olivier; Labbé, Vincent; Van Der Meersch, Guillaume; Guitton, Christophe

Background Working in the ICU during the first COVID-19 wave was associated with high levels of mental health disorders. Research question What are the mental health symptoms in healthcare providers (HCPs) facing the second wave? Study design and methods Cross-sectional study (October 30-December 1, 2020) in sixteen ICUs during the second wave in France. HCPs completed the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R, for posttraumatic stress disorder), and the Maslach Burnout Inventory (MBI). Results There were 845/1203 (70%) respondents (66% nursing staff, 32% medical staff, 2% other professionals); 487 (57.6%) had managed more than ten new COVID-19 patients in the previous week. Insomnia affected 320 (37.9%) and 7.7% were taking a psychotropic drug daily. Symptoms of anxiety, depression, post-traumatic stress disorder, and burnout were reported in 60.0% [95%CI, 56.6-63.3%], 36.1% [32.9-39.5%], 28.4% [25.4-31.6%], and 45.1% [41.7-48.5%] of respondents, respectively. Independent predictors of such symptoms included respondent characteristics (sex, profession, experience, personality traits), work organization (ability to rest and to care for family), and self-perceptions (fear of getting infected or infecting family and friends, feeling pressure related to the surge, intention to leave the ICU, lassitude, working conditions, feeling they had a high risk profession, and missing the clapping). The number of COVID-19 patients managed in the first wave or over the last week was not associated with symptoms of mental health disorders. Interpretation The prevalence of symptoms of mental health disorders is high in ICU HCPs managing the second COVID-19 surge. The highest tiers of hospital management urgently need to provide psychological support, peer-support groups, and a communication structure that ensure the well-being of HCPs.