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[Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?]
Encephale. 2020 Jun; 46(3S):S73-S80.E

Abstract

OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic.

METHODS

Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms.

RESULTS

The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications.

CONCLUSIONS

In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management.

Authors+Show Affiliations

Pôle de psychiatrie et d'addictiologie, CHRU de Tours, Tours, France; Inserm, UMR 1253, iBrain, université de Tours, Tours, France. Electronic address: wissam.el-hage@univ-tours.fr.Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, Laxou, France.Inserm, UMR S1266, université de Paris, institut de psychiatrie et neurosciences de Paris, Paris, France; Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, centre-université de Paris, hôpital européen Georges-Pompidou, AP-HP, Paris, France.Inserm, UPS, service de psychiatrie et de psychologie médicale de l'adulte, centre expert dépression résistante FondaMental, ToNIC Toulouse NeuroImaging Center, université de Toulouse, hôpital Purpan, CHU de Toulouse, Toulouse, France.Pôle de psychiatrie et d'addictiologie, CHRU de Tours, Tours, France; QualiPsy EE 1901, qualité de vie et santé psychologique, département de psychologie, université de Tours, Tours, France.Pôle de psychiatrie générale et universitaire, centre de référence régional des pathologies anxieuses et de la dépression, université de Bordeaux, CH Charles-Perrens, Bordeaux, France; Neurocentre Magendie, Inserm U1215, Bordeaux, France.Inserm, UMRS 1144, université de Paris, Paris, France; DMU Neurosciences, centre expert troubles bipolaires FondaMental, hôpital Fernand-Widal, AP-HP Nord, Paris, France.Inserm, UMRS 1144, université de Paris, Paris, France; DMU Neurosciences, centre de neurologie cognitive, hôpital Lariboisière, AP-HP Nord, Paris, France.UPRES, EA 4638, département de psychiatrie et d'addictologie, université d'Angers, CHU d'Angers, Angers, France.Service de psychiatrie de l'adulte, centre expert dépression résistante FondaMental, université Bourgogne Franche-Comté, CHU de Besançon, Besançon, France.Inserm, UPS, Toulouse NeuroImaging Center, université de Toulouse, Toulouse, France.EA 4334, Movement Interactions Performance (MIP), université de Nantes, CHU de Nantes, Nantes, France.Inserm U1028, CNRS UMR 5292, pôle universitaire de psychiatrie, équipe PsyR2, centre de recherche en neurosciences de Lyon, université St-Étienne-Lyon 1, CHU Saint-Étienne, Saint-Étienne, France.Service de médecine légale, centre régional de psychotraumatologie Auvergne Rhône-Alpes, groupement hospitalier Édouard-Herriot, hospices civils de Lyon, Lyon, France.Inserm, U1246, SPHERE, université de Nantes et université de Tours, Nantes, France.Inserm, U1114, centre régional de psychotraumatologie Grand-Est, université de Strasbourg, Strasbourg, France.Pôle de psychiatrie et d'addictiologie, CHRU de Tours, Tours, France; Inserm, UMR 1253, iBrain, université de Tours, Tours, France.DMU IMPACT, département médico-universitaire de psychaitrie et d'addictologie, hôpital H. Mondor, AP-HP, Créteil, France; Fondation Fondamental, Créteil, France; UPEC, Inserm, université Paris Est Créteil, U955, équipe 15 Neuro-Psychiatrie translationnelle, Créteil, France.UMR 1266, Inserm, IPNP, CNRS, université Paris Descartes, GDR 3557-Institut de Psychiatrie, Paris, France; Service hospitalo-universitaire, GHU Paris Sainte-Anne, Paris, France.Pôle de psychiatrie générale et universitaire, centre de référence régional des pathologies anxieuses et de la dépression, université de Bordeaux, CH Charles-Perrens, Bordeaux, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

32370984

Citation

El-Hage, W, et al. "[Health Professionals Facing the Coronavirus Disease 2019 (COVID-19) Pandemic: what Are the Mental Health Risks?]." L'Encephale, vol. 46, no. 3S, 2020, pp. S73-S80.
El-Hage W, Hingray C, Lemogne C, et al. [Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?]. Encephale. 2020;46(3S):S73-S80.
El-Hage, W., Hingray, C., Lemogne, C., Yrondi, A., Brunault, P., Bienvenu, T., Etain, B., Paquet, C., Gohier, B., Bennabi, D., Birmes, P., Sauvaget, A., Fakra, E., Prieto, N., Bulteau, S., Vidailhet, P., Camus, V., Leboyer, M., Krebs, M. O., & Aouizerate, B. (2020). [Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?]. L'Encephale, 46(3S), S73-S80. https://doi.org/10.1016/j.encep.2020.04.008
El-Hage W, et al. [Health Professionals Facing the Coronavirus Disease 2019 (COVID-19) Pandemic: what Are the Mental Health Risks?]. Encephale. 2020;46(3S):S73-S80. PubMed PMID: 32370984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?] AU - El-Hage,W, AU - Hingray,C, AU - Lemogne,C, AU - Yrondi,A, AU - Brunault,P, AU - Bienvenu,T, AU - Etain,B, AU - Paquet,C, AU - Gohier,B, AU - Bennabi,D, AU - Birmes,P, AU - Sauvaget,A, AU - Fakra,E, AU - Prieto,N, AU - Bulteau,S, AU - Vidailhet,P, AU - Camus,V, AU - Leboyer,M, AU - Krebs,M-O, AU - Aouizerate,B, Y1 - 2020/04/22/ PY - 2020/04/15/received PY - 2020/04/17/accepted PY - 2020/5/7/pubmed PY - 2020/7/14/medline PY - 2020/5/7/entrez KW - Anxiety KW - Anxiété KW - COVID-19 KW - Depression KW - Dépression KW - Health personnel KW - Mental health KW - Post-traumatic stress disorder KW - Professionnels de santé KW - Santé mentale KW - Trouble de stress post-traumatique SP - S73 EP - S80 JF - L'Encephale JO - Encephale VL - 46 IS - 3S N2 - OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms. RESULTS: The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications. CONCLUSIONS: In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management. SN - 0013-7006 UR - https://www.unboundmedicine.com/medline/citation/32370984/[Health_professionals_facing_the_coronavirus_disease_2019__COVID_19__pandemic:_What_are_the_mental_health_risks] L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-7006(20)30076-2 DB - PRIME DP - Unbound Medicine ER -