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   Table of Contents      
ORIGINAL ARTICLE
Year : 2022  |  Volume : 8  |  Issue : 2  |  Page : 127-130

A Study on Prevalence of Depression Among Health Care Workers of a Tertiary Care Center in Northern India During COVID-19 Pandemic


1 Department of Psychiatry, Dr Rajendra Prasad Govt. Medical College, Kangra at Tanda, Himachal Pradesh, India
2 Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Date of Submission14-Oct-2021
Date of Decision03-May-2022
Date of Acceptance13-May-2022
Date of Web Publication23-Aug-2022

Correspondence Address:
Pankaj Kanwar
Assistant Professor, Department of Psychiatry, DRPGMC Kangra at Tanda, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mamcjms.mamcjms_111_21

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  Abstract 


Background: COVID-19 pandemic has given rise to a diverse set of problems related to mental health, employment, economic wellbeing, access to education, inflation, transportation, and vaccination in addition to physical health consequences. Health care workers (HCWs), being in forefront of providing care to COVID-19 patients, are a special vulnerable population suffering from COVID-19-related mental health problems. Method: A cross-sectional study to assess the prevalence of depression among HCWs working in different specialties of a tertiary care health center of Northern India was done. A self-designed performa containing sociodemographic details along with the “Zung self-rating depression scale” was used to obtain the prevalence of depression among HCWs. Result: Among 192 participants, 14.58% had signs of depression, out of which 11.96% had mild, 1.56% had moderate, and 1.04% had signs of severe depression. Conclusion: The depression among HCWs has increased after the onset of the COVID-19 pandemic.

Keywords: COVID-19, depression, health care workers, stress


How to cite this article:
Gupta V, Singh S, Kumar V, Kanwar P. A Study on Prevalence of Depression Among Health Care Workers of a Tertiary Care Center in Northern India During COVID-19 Pandemic. MAMC J Med Sci 2022;8:127-30

How to cite this URL:
Gupta V, Singh S, Kumar V, Kanwar P. A Study on Prevalence of Depression Among Health Care Workers of a Tertiary Care Center in Northern India During COVID-19 Pandemic. MAMC J Med Sci [serial online] 2022 [cited 2022 Sep 26];8:127-30. Available from: https://www.mamcjms.in/text.asp?2022/8/2/127/354341




  Introduction Top


As a highly communicable and lethal disease, COVID-19 not only impairs physical health but also has an impact on the mental health of health care workers and the general public.[1] The COVID-19 pandemic has resulted in unprecedented psychological stress, anxiety, fear, panic attacks, post-traumatic stress symptoms, stigma, avoidance of contact, depressive tendencies, sleep disturbances, helplessness, interpersonal difficulties, and isolation from family and social support, as well as concerns about their friends and family being exposed to infection.[2]

The frontline health care workers (HCWs) working in departments of respiratory, emergency, ICU, and infectious disease were twice more likely to suffer anxiety and depression than the nonclinical staff with minimal contact with coronavirus pneumonia patients.[3]

Depression is one of the most urgent yet underappreciated public health challenges globally. It was the leading contributor to years of life lost due to disability in 2015.[4]

HCWs being in forefront for managing COVID-19 patients and also providing general health care services may be facing new challenges at the workplace daily that may impact their mental health. In this background, the current study aimed to evaluate the depressive symptoms among HCWs.


  Material and Methods Top


This was a cross-sectional study that was carried out between September 2020 and November 2020 to evaluate the prevalence of depression during the COVID-19 pandemic among HCWs. Approval from the institutional ethics committee for this study was obtained and the confidentiality of participants was ensured during the data collection. Informed consent was attached in front of all performa distributed to the participants. All HCWs such as faculty members, residents, medical officers, nurses, and interns working in different specialties of the institute were included; however, HCWs who did not give valid consent were excluded from the study. The self-designed performa and “Zung self-rating depression scale” (SDS) were distributed while following COVID-19 appropriate behavior and responses were collected after 1 week.


  Sociodemographic details performa Top


A performa containing sociodemographic details such as age, gender, qualification, religion, family pattern, psychoactive substance use, and frequency of use in the last 3 months was designed.


  Zung self-rating depression scale Top


SDS was used to obtain the prevalence of depression. The SDS is a short and self-administered scale to measure the depressed status of a patient. This scale contains 20 items that rate the following four categories of symptoms: 1) the pervasive affective disturbance (depressed mood), 2) the physiological symptoms (variations in sleep, appetite, or other biological symptoms), 3) psychomotor disturbances (either retardation or agitation), and 4) psychological disturbances (e.g., hopelessness, confusion, irritability, and suicidal ruminations). There are 10 positively expressed and 10 negatively expressed questions. Each question is scored on a scale of one to four for responses “a little of the time, some of the time, good part of the time, most of the time” in positively expressed and four to one in negatively expressed questions.[5] SDS has the advantages of sound conceptual basis and ease of administration and scoring. The SDS has fairly good reliability. Zung has reported split-half reliability of 0.73. The SDS is designed to quantify the severity of depressive symptomatology and has proven to be a valuable tool in the assessment of depressive disorders both in inpatients[5] and outpatients.[6]


  Statistical analysis Top


Data were collected and entered in a Microsoft excel spreadsheet, cleaned for errors, and analyzed using Epi Info software version 7.2.2. Descriptive statistics were used to summarize the demographic data. Frequencies, percentages, and their 95% confidence intervals were used to describe categorical variables. For continuous variables, means and standard deviations were calculated. Pearson chi-square and Fischer exact tests were used for univariate association analysis between exposure and outcome. A two-sided P < 0.05 was considered statistically significant.


  Results Top


Altogether 192 HCWs had submitted their responses, among which 41.67% were in the age group of 25 to 35 years and 24.48% were less than 25 years. More than half (55.21%) of participants were female and were married (54.17%). Most of the participants were Hindu (93.23) and from a rural background (63.02%) and more than two-thirds (76.56%) of participants belonged to nuclear families. In terms of education, 22.40 were qualified in providing nursing care (General Nursing and Midwifery), whereas 21.88% were undergraduate students (MBBS and interns), 32.81% were graduate and 17.71% had studied up to postgraduate level. Among all participants, 5.73% used alcohol, 1.56% tobacco, and 5.21% used alcohol and tobacco both within the past 3 months. Only 3.65% of participants used any psychoactive substance daily for the last 3 months. The department-wise participation was as from Ophthalmology 8.85%, Anaesthesia 7.51%, Surgery 5.73%, Medicine 4.16%, Obstetrics and Gynaecology 3.65%, Dermatology 3.13%, Bio-Chemistry 3.13%, Casualty 2.08%, Community Medicine 2.08%, Pathology 2.08%, Neurosurgery 1.56%, Cardiology 1.56%, Medical Officer administration 1.56%, Gastroenterology 1.04%, Pharmacology 0.52%, and Pulmonary Medicine 0.52%. Depression was observed among 14.58% of participants, of which 11.96% had mild, 1.56% moderate, and 1.04% had signs of severe depression [Table 1].
Table 1 Sociodemographic details of participants

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  Univariate analysis Top


Among the age group less than 45 years and more than 45 years, almost the same percentage of participants, 14.56% and 14.71%, respectively, had depression. Male participants (17.44%) had slightly more depression as compared to female participants (12.26%). Participants from a rural background who had depression were 14.05% in comparison to participants from the urban background (15.49%). Participants living in joint family structure had 15.56% prevalence of depression in comparison to those living in nuclear family (14.29%). Participants in the group who were using the psychoactive substance in the last 3 months had slightly more depression (20.00%) than a group of participants not using a psychoactive substance (13.77%) [Table 2].
Table 2 Association of sociodemographic variables with depression

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  Discussion Top


HCWs all over the globe are providing treatment and care to the patients who developed COVID-19 infection. HCWs are the vanguard in the prevention of the spread of COVID-19 infection throughout the world. This has led to extra effort from HCWs of all cadres during the COVID-19 pandemic. In this study, we found that 14.58% of the participants were having signs of depression that varied in severity. Previous studies on HCWs in different parts of the world reflect the prevalence of depression varies between 8.9% and 50.7%.[7],[8],[9],[10],[11] A study by Grover et al. in India found that 46.2% of participants had anxiety disorder, depression, or both.[12] Aly et al. observed that 94% of participants showed mild to severe depression in HCWs of a hospital in Egypt dealing with suspected and confirmed cases of COVID-19 or their contacts.[13] Most of these studies were online surveys carried out during different phases of the COVID-19 pandemic, using different assessment scales and administered in culturally different populations, which may be responsible for the wide range of results in the prevalence of depression. As per National Mental Health Survey, the current prevalence of depression in India was 0.8%.[14] However, in this survey, Mini International Neuropsychiatric Interview was used for diagnosing psychiatric disorders, and in the present study SDS was used. This significant difference in the prevalence of depression may not be completely related to the methodology used and higher prevalence has been noted in most of the earlier studies during the COVID-19 pandemic. Lu et al. in a study found that 11.8% of the medical staff presented with mild to moderate depression and 0.3% with severe depression.[3] In our study, we found that 11.96% have mild, 1.56% moderate, and 1.04% participants have severe depression, which is an almost similar finding in both studies.


  Limitations Top


This study was conducted on HCWs of a single hospital, so these results should be cautiously generalized to all other HCWs. The roles and responsibilities of HCWs in the hospital were changed frequently due to the rapid spread of the virus. So, enrolment in the study was not as expected. Future research is needed to elicit risk factors for depression among HCWs during the COVID-19 pandemic and the inclusion of the effect evaluation after therapeutic intervention.


  Conclusion Top


It can be concluded that the prevalence of depression among HCWs has increased after the onset of the COVID-19 pandemic. Selective primary prevention focussing on mental health issues of HCWs is the need of the hour to maintain the workplace productivity during these difficult times.


  Financial support and sponsorship Top


Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chew NWS, Lee GKH, Tan BYQ et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun 2020;88:559–65.  Back to cited text no. 1
    
2.
Zheng W. Mental health and a novel coronavirus (2019-nCoV) in China. J Affect Disord 2020;269:201–2.  Back to cited text no. 2
    
3.
Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: a cross-sectional study. Psychiatry Res 2020;288:112936.  Back to cited text no. 3
    
4.
World Health Organization (WHO). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.2017.  Back to cited text no. 4
    
5.
Zung WW. A self-rating depression scale. Arch Gen Psychiatry 1965;12:63–70.  Back to cited text no. 5
    
6.
Zung WW, Richards CB, Short MJ. Self-rating depression scale in an outpatient clinic. Further validation of the SDS. Arch Gen Psychiatry 1965;13:508–15.  Back to cited text no. 6
    
7.
Lai J, Ma S, Wang Y, Cai Z et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.  Back to cited text no. 7
    
8.
Guo J, Liao L, Wang B et al. Psychological effects of COVID-19 on hospital staff: a national cross-sectional survey in mainland China. Vasc Invest Ther 2021;4:6–11.  Back to cited text no. 8
    
9.
Qi J, Xu J, Li B et al. The evaluation of sleep disturbances for Chinese frontline medical workers under the outbreak of COVID-19. Sleep Med 2020;72:1–4.  Back to cited text no. 9
    
10.
Liu CY, Yang YZ, Zhang XM et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect 2020;148:e98.  Back to cited text no. 10
    
11.
Zhu Z, Xu S, Wang H et al. COVID-19 in Wuhan: Sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinical Medicine. 2020;24:100443. doi: https://doi.org/10.1016/j.eclinm.2020.100443  Back to cited text no. 11
    
12.
Grover S, Sahoo S, Mehra A et al. Evaluation of psychological impact of COVID-19 on health-care workers. Indian J Psychiatry. 2021;63: 222–7.  Back to cited text no. 12
    
13.
Aly HM, Nemr NA, Kishk RM, Elsaid NMAB. Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study. BMJ Open 2021;11:e045281. doi: https://doi.org/10.1136/bmjopen-2020-045281  Back to cited text no. 13
    
14.
Murthy RS. National mental health survey of India 2015–2016. Indian J Psychiatry 2017;59:21–6.  Back to cited text no. 14
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Abstract
Introduction
Material and Methods
Sociodemographic...
Zung self-rating...
Statistical analysis
Results
Univariate analysis
Discussion
Limitations
Conclusion
Financial suppor...
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