Prevalence and Factors Associated with Depression and Anxiety Among Health Care Personnel in the United States During Coronavirus Disease 2019 (COVID-19) Pandemic

Introduction: Healthcare personnel (HCP) are at risk of psychological and emotional distress during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the prevalence and explore the factors associated with depression and anxiety among HCP taking care of patients with COVID-19 in the United States (US). Methods: The study is cross-sectional, anonymous, web-based survey of HCP distributed in the US via email and social media between April 14, 2020 and May 5, 2020. Participants were stratified based on their occupation (i.e., registered nurses, other first responders, physicians, respiratory therapists, and nurse practitioners or physician assistants) and specialty. Practice settings were stratified based on hospital type (academic or community-based) and location. Study outcomes were prevalence and factors associated with depression and anxiety using the 9-item Patient Health Questionnaire (PHQ-9; range: 0-27) and the 7-item Generalized Anxiety Disorder (GAD 7; range 0-21) questionnaires, respectively. Results: In all, 1426 HCP submitted surveys, predominantly females (81%), aged 31-40 years, and non-Hispanic white (78%). Overall, the prevalence of depression and anxiety was 57.4% and 56.7%, respectively. Factors associated with depression were HCP with COVID-19 risk factors (odds ratio [OR] = 1.46; 95% confidence interval [CI] = 1.1–1.94; P = .009), exposure (OR = 1.87; 95% CI = 1.44–2.44; P = <.001), and being uncomfortable with hospital infection control policies (OR = 1.87; 95% CI = 1.28–2.71; P = .001). Similarly, factors associated with anxiety included HCP with COVID-19 risk factors (OR = 1.36; CI = 1.03–1.81; P = .03), COVID-19 exposure (OR = 1.43; 95% CI = 1.09–1.86; P = .01), and not being comfortable with the healthcare facility infection control policies (OR = 1.66; 95% CI = 1.14–2.41; P = .008). Conclusion and Relevance: The majority of HCP surveyed had a high burden of depression and anxiety early in the COVID-19 pandemic in the US. Organizations and institutions will need to develop preventive and management strategies to optimize and sustain the mental health of HCP, particularly under pandemic conditions.