The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study.
Open accessAbstract
Background and objective Coronavirus disease 2019 (COVID-19) is a new infectious disease with high transmissibility and morbidity. It has caused substantial mental distress to medical professionals. We aimed to compare the psychological impact of the COVID-19 outbreak between frontline and non-frontline medical workers in China.Methods This case-control study recruited 1173 frontline and 1173 age- and sex-matched non-frontline medical workers during the COVID-19 outbreak (February 11 to 26, 2020). A set of online questionnaires were used to measure mental problems (i.e., anxiety, insomnia, and depressive symptoms), and help-seeking behavior and treatment for these mental problems.Results Frontline medical workers had higher rates of any mental problem (52.6% vs. 34.0%, adjusted OR=1.88, 95% CI=1.57-2.25), anxiety symptoms (15.7% vs. 7.4%, adjusted OR=1.95, 95% CI=1.46-2.61), depressed mood (marginally insignificant; 14.3% vs. 10.1%, adjusted OR=1.32, 95% CI=0.99-1.76) and insomnia (47.8% vs. 29.1%, adjusted OR=1.96, 95% CI=1.63-2.36) than non-frontline medical workers. No significant difference was observed in terms of suicidal ideation (12.0% vs. 9.0%, adjusted OR=1.25, 95% CI=0.92-1.71), help-seeking (4.5% vs. 4.5%, adjusted OR=1.00, 95% CI=0.53-1.87) or treatment (3.4% vs. 2.3%, adjusted OR=1.38, 95% CI=0.54-3.52) for mental problems.Limitations The case-control nature of the data precludes causal inferences, and there is a possibility of bias related to self-reports.Conclusions Frontline medical workers had more mental problems but comparable help-seeking behaviors and treatment for these problems than non-frontline medical workers. These findings highlight the timely mental support and intervention for medical workers, especially for those on the frontline.
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Cai et al. (2020) found no evidence of increased levels of suicidal thoughts amongst Chinese medical workers in contact with COVID patients.
“They found no evidence of increased levels of suicidal thoughts amongst those in contact with COVID patients.”
From The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review (2021) · cites this paper as Cai et al. (2020)
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BackgroundResult
- Authors
- Cai, Q., Feng, H., Huang, J., Wang, M., Wang, Q., Lu, X., Xie, Y., Wang, X., Liu, Z., Hou, B., Ouyang, K., Pan, J., Li, Q., Fu, B., Deng, Y., & Liu, Y.
- Affiliations
- Zhongnan Hospital of Wuhan University (CN)
- Chinese University of Hong Kong (HK)
- Wuhan University of Science and Technology (CN)
- The Central Hospital of Xiao gan (CN)
- Wuhan University (CN)
- Hubei University of Medicine (CN)
- Corresponding author
- Liu, Zhenxing
- Liu, Yumin
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 275
- Pages
- 210-215
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7329671
- OpenAlex
- W3038487118
- Cited by
- 248
- References
- 50
- Citations by year
- 2026: 3 · 2025: 16 · 2024: 15 · 2023: 41 · 2022: 62 · 2021: 93 · 2020: 18
- FWCI
- 21.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Foundation for Innovative Research Groups of the National Natural Science Foundation of China
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, mental health, anxiety, depression, insomnia, suicidal ideation, help-seeking, psychological distress, healthcare workers, China, 2020 outbreak, occupational stress, mental health treatment utilization, access to mental health care, mental health workforce shortage
- MeSH terms
- COVID-19, Adult, Anxiety, Anxiety Disorders, Mental Disorders, China, Depression, Disease Outbreaks, Female, Health Personnel, Humans, Sleep Initiation and Maintenance Disorders, Male, Mental Health, Pneumonia, Viral, Case-Control Studies, Coronavirus Infections, Pandemics
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