Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff

Afiliação

(1)    Department of Pediatrics, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil.

(2)    Pediatric Intensive Care Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

(3)    Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, RJ, Brazil.

(4)    Postgraduate Program in Family Health, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil.

(5)    Pediatric Intensive Care Unit, Hospital Estadual da Criança, Rio de Janeiro, RJ, Brazil.

(6)    Sergio Arouca National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

(7)    Pediatric Intensive Care Unit, Hospital Assunção, São Bernardo do Campo, SP, Brazil.

(8)    Pediatric Intensive Care Unit, Hospital Universitário Professor Edgard Santos, Salvador, BA, Brazil.

(9)    Pediatric Intensive Care Unit, Hospital Martagão Gesteira, Salvador, BA, Brazil.

Resumo

Objectives: To assess the prevalence of burnout, anxiety and depression symptoms, and posttraumatic stress disorder (PTSD) in PICU workers in Brazil during the first peak of the COVID-19 pandemic. To compare the results of subgroups stratified by age, gender, professional category, health system, and previous mental health disorders. Design: Multicenter, cross-sectional study using an electronic survey. Setting: Twenty-nine public and private Brazilian PICUs. Subjects: Multidisciplinary PICU workers. Interventions: None. Measurements and main results: Self-reported questionnaires were used to measure burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), and PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) in 1,084 respondents. Subjects were mainly young (37.1 ± 8.4 yr old) and females (85%), with a median workload of 50 hours per week. The prevalence of anxiety and depression was 33% and 19%, respectively, whereas PTSD was 13%. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8-24] and 40 [IQR, 33-44], respectively) whereas low in the depersonalization one (2 [IQR, 0-5]), suggesting a profile of overextended professionals, with a burnout prevalence of 24%. Professionals reporting prior mental health disorders had higher prevalence of burnout (30% vs 22%; p = 0.02), anxiety (51% vs 29%; p < 0.001), and depression symptoms (32.5% vs 15%; p < 0.001), with superior PCL-5 scores for PTSD (p < 0.001). Public hospital workers presented more burnout (29% vs 18.6%, p < 0.001) and more PTSD levels (14.8% vs 10%, p = 0.03). Younger professionals were also more burned out (p < 0.05 in all three dimensions). Conclusions: The prevalence of mental health disorders in Brazilian PICU workers during the first 2020 peak of COVID-19 was as high as those described in adult ICU workers. Some subgroups, particularly those reporting previous mental disorders and younger professionals, should receive special attention to prevent future crises.