Symptoms of anxiety, depression and fear in healthcare workers and non-healthcare workers undergoing outpatient COVID-19 testing in an urban Australian setting
M. E. Brennan
A B C G , M. L. Marinovich D E , B. Verdonk C , M. Vukasovic F and A. Coggins F
A The University of Sydney, Sydney Medical School, Camperdown, NSW, Australia.
B The University of Notre Dame Australia, School of Medicine, Sydney, NSW, Australia.
C COVID-19 Clinic, Westmead Hospital, Westmead, NSW 2145, Australia.
D Curtin School of Population Health, Curtin University, Perth, WA, Australia.
E Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
F Emergency Department, Westmead Hospital, Westmead, NSW 2145, Australia.
G Corresponding author. Email: meagan.brennan@nd.edu.au
Australian Journal of Primary Health 27(6) 442-449 https://doi.org/10.1071/PY21139
Submitted: 25 June 2021 Accepted: 26 August 2021 Published: 25 November 2021
Journal Compilation © La Trobe University 2021 Open Access CC BY
Abstract
This study assessed symptoms of anxiety, depression and fear of COVID-19 in members of the general community and healthcare workers (HCWs) attending for COVID testing. This cross-sectional study was conducted in a public hospital COVID-19 testing clinic (June–September 2020) using self-administered questionnaires (i.e. the Hospital Anxiety and Depression Scale (HADS) and the Fear of COVID-19 Scale). In all, 430 participants who met the criteria for COVID-19 testing with nasopharyngeal and throat swabs completed the questionnaires. The mean (±s.d.) age of participants was 37.6 ± 12.6 years. HCWs made up 35.1% of the sample. Overall, the mean (±s.d.) score for anxiety was 6.09 ± 4.41 and ‘case’ prevalence (any severity) was 151/430 (35.1%), higher than normative population scores. Higher anxiety was found in women (P = 0.001) and in clients who had previously been tested for coronavirus (P = 0.03). HCWs had lower anxiety scores than members of the general community (P = 0.001). For depression, the mean (±s.d.) score was 4.18 ± 3.60, with a ‘case’ prevalence (any severity) of 82/430 (19.1%), similar to normative population scores. Women reported a higher level of COVID-19 fear (P = 0.001), as did people with a lower education level (P = 0.001). A greater psychological impact of COVID-19 was observed in women, people undergoing repeat testing and participants reporting lower levels of educational attainment. HCWs had fewer symptoms of anxiety and depression than non-HCWs attending the same clinic for COVID-19 testing. This information can be used to plan mental health interventions in primary care and testing settings during this and future pandemics.
Keywords: mental health, public health practice.
References
Ahmed MA, Jouhar R, Ahmed N, Adnan S, Aftab M, Zafar MS, Khurshid Z (2020) Fear and practice modifications among dentists to combat novel Coronavirus disease (COVID-19) outbreak. International Journal of Environmental Research and Public Health 17, 2821| Fear and practice modifications among dentists to combat novel Coronavirus disease (COVID-19) outbreak.Crossref | GoogleScholarGoogle Scholar |
Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH (2020) The Fear of COVID-19 Scale: development and initial validation. International Journal of Mental Health and Addiction
| The Fear of COVID-19 Scale: development and initial validation.Crossref | GoogleScholarGoogle Scholar | 32837427PubMed |
Breeman S, Cotton S, Fielding S, Jones GT (2015) Normative data for the Hospital Anxiety and Depression Scale. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation 24, 391–398.
| Normative data for the Hospital Anxiety and Depression Scale.Crossref | GoogleScholarGoogle Scholar |
Gonzalez-Sanguino C, Ausin B, Castellanos MA, Saiz J, Lopez-Gomez A, Ugidos C, Munoz M (2020) Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain, Behavior, and Immunity 87, 172–176.
| Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain.Crossref | GoogleScholarGoogle Scholar | 32405150PubMed |
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu Z, Hu S (2020) Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open 3, e203976
Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, Cheng ASK (2020) The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiology and Infection 148, e98
| The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 32430088PubMed |
Newby JM, O’Moore K, Tang S, Christensen H, Faasse K (2020) Acute mental health responses during the COVID-19 pandemic in Australia. PLoS One 15, e0236562
| Acute mental health responses during the COVID-19 pandemic in Australia.Crossref | GoogleScholarGoogle Scholar | 32722711PubMed |
Pfefferbaum B, North CS (2020) Mental health and the Covid-19 pandemic. The New England Journal of Medicine 383, 510–512.
| Mental health and the Covid-19 pandemic.Crossref | GoogleScholarGoogle Scholar | 32283003PubMed |
Rahman MA, Hoque N, Alif SM, Salehin M, Islam SMS, Banik B, Sharif A, Nazim NB, Sultana F, Cross W (2020) Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. Globalization and Health 16, 95
| Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia.Crossref | GoogleScholarGoogle Scholar | 33032629PubMed |
Rahman MA, Salehin M, Islam SMS, Alif SM, Sultana F, Sharif A, Hoque N, Nazim NB, Cross WM (2021) Reliability of the tools used to examine psychological distress, fear of COVID-19 and coping amongst migrants and non-migrants in Australia. International Journal of Mental Health Nursing 30, 747–758.
| Reliability of the tools used to examine psychological distress, fear of COVID-19 and coping amongst migrants and non-migrants in Australia.Crossref | GoogleScholarGoogle Scholar | 33555128PubMed |
Rajkumar RP (2020) COVID-19 and mental health: a review of the existing literature. Asian Journal of Psychiatry 52, 102066
| COVID-19 and mental health: a review of the existing literature.Crossref | GoogleScholarGoogle Scholar | 32302935PubMed |
Royal Australian College of General Practitioners (RACGP) (n.d.) ‘Position Statement: Mental health care in general practice.’ Available at https://www.racgp.org.au/advocacy/position-statements/view-all-position-statements/clinical-and-practice-management/mental-health-care-in-general-practice [Verified June 2021]
Soraci P, Ferrari A, Abbiati FA, Del Fante E, De Pace R, Urso A, Griffiths MD (2020) Validation and psychometric evaluation of the Italian version of the Fear of COVID-19 Scale. International Journal of Mental Health and Addiction
| Validation and psychometric evaluation of the Italian version of the Fear of COVID-19 Scale.Crossref | GoogleScholarGoogle Scholar | 32372892PubMed |
Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, Fenning AS, Vandelanotte C (2020) Depression, Anxiety and Stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. International Journal of Environmental Research and Public Health 17, 4065
Tzur Bitan D, Grossman-Giron A, Bloch Y, Mayer Y, Shiffman N, Mendlovic S (2020) Fear of COVID-19 scale: Psychometric characteristics, reliability and validity in the Israeli population. Psychiatry Research 289, 113100
| Fear of COVID-19 scale: Psychometric characteristics, reliability and validity in the Israeli population.Crossref | GoogleScholarGoogle Scholar | 33250092PubMed |
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC (2020a) Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health 17, 1729
| Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus disease (COVID-19) epidemic among the general population in China.Crossref | GoogleScholarGoogle Scholar |
Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, Choo FN, Tran B, Ho R, Sharma VK, Ho C (2020b) A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity 87, 40–48.
| A longitudinal study on the mental health of general population during the COVID-19 epidemic in China.Crossref | GoogleScholarGoogle Scholar | 32298802PubMed |
Wang Y, Di Y, Ye J, Wei W (2021) Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychology, Health and Medicine 26, 13–22.
| Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China.Crossref | GoogleScholarGoogle Scholar | 32223317PubMed |
Winter T, Riordan BC, Pakpour AH, Griffiths MD, Mason A, Poulgrain JW, Scarf D (2020) Evaluation of the English version of the Fear of COVID-19 Scale and its relationship with behavior change and political beliefs. International Journal of Mental Health and Addiction
| Evaluation of the English version of the Fear of COVID-19 Scale and its relationship with behavior change and political beliefs.Crossref | GoogleScholarGoogle Scholar | 32837431PubMed |
Wu Y, Wang J, Luo C, Hu S, Lin X, Anderson AE, Bruera E, Yang X, Wei S, Qian Y (2020) A comparison of burnout frequency among oncology physicians and nurses working on the frontline and usual wards during the COVID-19 epidemic in Wuhan, China. Journal of Pain and Symptom Management 60, e60–e65.
| A comparison of burnout frequency among oncology physicians and nurses working on the frontline and usual wards during the COVID-19 epidemic in Wuhan, China.Crossref | GoogleScholarGoogle Scholar | 32283221PubMed |
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67, 361–370.
| The hospital anxiety and depression scale.Crossref | GoogleScholarGoogle Scholar | 6880820PubMed |
