Nurses and doctors reported high levels of distress at height of COVID-19

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During the height of the novel coronavirus (COVID-19) pandemic, healthcare workers on the front lines had high levels of acute stress, anxiety, and depression, according to a new study by researchers at Columbia University Irving Medical Center and New York-Presbyterian published in the journal General Hospital Psychiatry.

Levels of stress, anxiety and depression were particularly high among those with the greatest amount of patient contact and interaction. Among the findings were more than half had high levels of acute stress, nearly half screened positive for depressive symptoms, one-third had anxiety, and most had insomnia symptoms and experienced loneliness.

The researchers analyzed data from 657 clinicians at New York-Presbyterian and Columbia University Irving Medical Center who were screened for stress, anxiety, and depression symptoms between April 9 and April 24 during the peak of the pandemic in New York City. More than half (375) of respondents were nurses and advanced practice providers.

Overall, 57 percent of participants, and 64 percent of nurses and advanced practice providers, said they had experienced symptoms of acute stress, such as nightmares, an inability to stop thinking about COVID-19, a feeling of being constantly on guard, and numbness or detachment from people or their surroundings. Acute stress symptoms that persist for more than a month can lead to post-traumatic stress syndrome (PTSD).

Although the environment took a psychological toll on all healthcare workers, nurses were particularly affected. The different responsibilities of nurses may partly explain the higher rates of positive acute stress screens and other impacts, as nurses spend more time delivering direct patient care.

Nearly half (48 percent) of all participants screened positive for depressive symptoms and one-third (33 percent) for anxiety, according to the study.

Insomnia and loneliness were also pervasive in this group, 71 percent and 65 percent, respectively. Three out of four participants were highly distressed about the possibility of transmitting COVID-19 to loved ones. Most were highly distressed about the need to maintain social distance from family and friends and a lack of control and uncertainty during the pandemic.

The researchers are currently doing a follow-up survey to see if these clinicians' psychological symptoms, coping strategies, and sense of optimism change over time.

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