Elsevier

Journal of Affective Disorders

Volume 277, 1 December 2020, Pages 347-357
Journal of Affective Disorders

Research paper
Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis

https://doi.org/10.1016/j.jad.2020.08.034Get rights and content

Highlights

  • Healthcare workers are at high risk of mental health problems during viral epidemic outbreaks.

  • This review of 117 studies offers pooled estimations of prevalence of acute stress disorder (40%), followed by anxiety (30%), burnout (28%), depression (24%), and post-traumatic stress disorder (13%).

  • It identifies a number of factors (sociodemographic, occupational and social) associated with mental health problems.

  • Interventional high-quality research is urgently needed to inform evidence-based policies for viral pandemics.

Abstract

Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers' (HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact.

Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception to August 2020). We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems, and used GRADE to ascertain the certainty of evidence.

Results: We included 117 studies. The pooled prevalence was higher for acute stress disorder (40% (95%CI 39 to 41%)), followed by anxiety (30%, (30 to 31%)), burnout (28% (26 to 31%)), depression (24% (24 to 25%)), and post-traumatic stress disorder (13% (13 to 14%)). We identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, stigmatization), and occupational (working in a high-risk environment, specific occupational roles, and lower levels of specialised training and job experience) factors. Four studies reported interventions for frontline HCW: two educational interventions increased confidence in pandemic self-efficacy and in interpersonal problems solving (very low certainty), whereas one multifaceted intervention improved anxiety, depression, and sleep quality (very low certainty).

Limitations: We only searched three databases, and the initial screening was undertaken by a single reviewer.

Conclusion: Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.

Keywords

Systematic review
Meta-analysis
COVID-19
Viral pandemic
Mental health
Healthcare workers

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