Stress Disorders More Prevalent among Doctors due to the Pandemic

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Psychologists from HSE University have joined their peers from Ekaterinburg to look into the impact of the pandemic on the mental health of Russian doctors. They found that medical staff are suffering from stress, anxiety, and depression more often than before. The results of the study were published in International Journal of Environmental Research and Public Health.

The number of mental disorders has grown considerably during the COVID-19 pandemic. People are suffering more from depression, anxiety, stress, and post-traumatic stress disorder (PTSD). Medics turned out to be the most vulnerable cohort from this perspective. They are at a higher risk of being infected with COVID, since they have contact with a lot of patients, work longer hours, and see more human suffering because of their profession. Over the last two years, scholars in different countries (USA, Italy, Great Britain, China, India, etc) have carried out research to see whether the pandemic has impacted medics’ mental health. They found, for example, that in Great Britain, 58% experience PTSD, anxiety, or depression, while in the U.S. and Australia, between 30% and 50% of medics suffer from these disorders.

To understand the situation in Russia, a team of researchers from HSE University, Ural Division of RAS Institute of Immunology and Physiology, and Ural Federal University launched a pilot project among dentists. They choose this field, as dentists face a high risk of being infected with COVID at work since they are in direct contact with patients’ saliva, and dental procedures generate aerosols—airborne liquid particles that carry viruses and bacteria.

The study involved 128 doctors and dentistry employees from Ekaterinburg. The participants were asked to fill out a few questionnaires, in which they answered how often they had experienced certain anxiety conditions over the past few weeks, such as insomnia, bad memories, depression, and anxiety. To evaluate stress levels, they used the Depression Anxiety and Stress Scale-21 (DASS-21), one of the most popular tools to diagnose mental distress today. They used two scales to evaluate PTSD symptoms: Impact of Event Scale-Revised (IES-R) and PTSD Symptom Scale-Self-Report (PSS-SR). They complement each other and provide a more complete understanding of the individual’s mental state.

Alena Zolotareva, one of the study authors, Senior Research Fellow at the HSE International Laboratory of Positive Psychology of Personality and Motivation

‘Of course, we cannot give a diagnosis based on a self-report scale only. But the participants’ responses provide a rather realistic image of medics’ mental health and assess the levels of mental distress.’

The results of the survey among Russian doctors turned out to be comparable with the results of similar studies in other countries. Almost 22% of dentistry employees experience moderate or severe symptoms of mental distress. On the DASS-21 scale, 20% of respondents show symptoms of depression, while 24% experience anxiety and stress. PTSD symptoms of various severity are experienced by 29.7% respondents on the PSS-SR scale and 7.1% on IES-R. The employees who contact patients directly demonstrate stronger PTSD symptoms than those who do not see patients in person (such as prosthetists). This can be explained by the fact that employees suffer from permanent fear of becoming infected during direct contact.

The results of the Russian study, however, had their own peculiarities. For example, respondents aged 51 to 64 are to have experienced the highest levels of depression, anxiety, stress, and PTSD. In other countries (such as India and Italy), the levels of mental distress were inversely related to age. This may be explained by the fact that in Russia, this age group is the most vulnerable in terms of financial well-being. At the same time, people over 64 did not participate in the survey due to limitations during the pandemic.

‘The pilot study helped us see that medics are a vulnerable cohort who often suffer from mental distress. And while the sample was small—we talked only to dentists from Ekaterinburg—the data is comparable with the results of similar international studies,’ said Alena Zolotareva. ‘For us this means that we should continue working on the project and implement a larger scale study with more medics from different regions. In the future, this will help develop effective mental support tools for medics.’

The paper’s authors say that as of today, traditional psychological practices, such as relaxation techniques, keeping a diary of anxiety thoughts and feelings, and asking friends and family for help can help to cope with stress. In addition, stress levels decrease as the pandemic goes on, people get more information about the virus, and effective vaccines appear. A recent study by researchers from the USA and China showed that despite higher levels of stress, indicators of happiness among medics are also higher, and remain high after the stress decreases. This means that the profession itself may probably be a powerful resource for overcoming mental unwellness.