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The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis
Open accessAbstract
OBJECTIVES: The mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19. METHODS: We searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17th February 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95 % prediction intervals. RESULTS: The meta-analysis included 401 studies, representing 458,754 participants across 58 countries. Pooled prevalence of depression was 28.5 % (95 % CI: 26.3-30.7), anxiety was 28.7 % (95 % CI: 26.5-31.0), PTSD was 25.5 % (95 % CI: 22.5-28.5), alcohol and substance use disorder was 25.3 % (95 % CI: 13.3-39.6) and insomnia was 24.4 % (95 % CI: 19.4-29.9). Prevalence rates were stratified by physicians, nurses, allied health, support staff and healthcare students, which varied considerably. There were significantly higher odds of probable mental health disorders in women, those working in high-risk units and those providing direct care. LIMITATIONS: Majority of studies used self-report measures which reflected probable mental health disorders rather than actual diagnosis. CONCLUSIONS: These updated findings have enhanced our understanding of at-risk groups working in hospitals. Targeted support and research towards these differences in mental health risks are recommended to mitigate any long-term consequences.
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“In particular, nurses experienced poorer mental health than other health care professionals [2].”
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“During the COVID-19 pandemic, health care professionals experienced high levels of depression, anxiety, and posttraumatic stress symptoms [2].”
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“There have also been inconsistent findings on at risk groups among hospital HCWs during the COVID-19 pandemic, with varied findings on whether mental health issues varies between profession (Olaya et al., 2021; Pappa et al., 2020; Santabárbara et al., 2021; Varghese et al., 2021; Wu et al., 2021), gender (Ching et al.”
ResultRisk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnel
Jacob, J. T., Baker, J. M., Fridkin, S. K., Lopman, B. A., Steinberg, J. P., Christenson, R. H., King, B. R., Leekha, S., O’Hara, L. M., Rock, P., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.1283 · Cited by 148 · cited 1×
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BackgroundPhiri, P., Ramakrishnan, R., Rathod, S., Elliot, K., Thayanandan, T., Sandle, N., Haque, N., Chau, S. W. H., Wong, O. W. H., Chan, S. S. M., et al. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100806 · Cited by 137 · cited 5×
“342 the findings, while overall rates of PTSD in hospital HCWs were similar to those in the general public, nurses, allied health, non-medical staff and support staff were more likely to experience PTSD symptoms than the general public (Phiri et al., 2021).”
BackgroundResultInfluentialHospital staff well‐being during the first wave of COVID‐19: Staff perspectives
Digby, R., Winton‐Brown, T., Finlayson, F., Dobson, H., & Bucknall, T. K. (2020) · International Journal of Mental Health Nursing · doi:10.1111/inm.12804 · Cited by 132 · cited 1×
“tion risks, inadequate protective equipment, inconsistent communications, and increased workload (Digby et al., 2021; Ding et al., 2021; Hennein and Lowe, 2020; Joo and Liu, 2021; Liu et al., 2020).”
BackgroundLi, X., Zhou, Y., & Xu, X. (2020) · Journal of Nursing Management · doi:10.1111/jonm.13146 · Cited by 127
Barello, S., Falcó‐Pegueroles, A., Rosa, D., Tolotti, A., Graffigna, G., & Bonetti, L. (2020) · International Journal of Public Health · doi:10.1007/s00038-020-01463-7 · Cited by 125 · cited 1×
“…around nosocomial infection risks, such as fear of being infected (De Brier et al., 2020; Serrano-Ripoll et al., 2020), fear of infecting others (i.e., family and community members) (Barello et al., 2020; Kisely et al., 2020), and PPE adequacy (Kisely et al., 2020; Troglio Da Silva and Neto, 2021).”
BackgroundSacrificed: Ontario Healthcare Workers in the Time of COVID-19
Brophy, J. T., Keith, M. M., Hurley, M., & McArthur, J. E. (2020) · NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy · doi:10.1177/1048291120974358 · Cited by 122 · cited 1×
“, 2020) and have been found to be associated with PTSD symptoms (Brooks et al., 2020; Brophy et al., 2020; Carmassi et al., 2020).”
BackgroundMagnavita, N., Soave, P. M., & Antonelli, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147316 · Cited by 113 · cited 5×
“…et al., 2022; Doulias et al., 2021; Gündoğmuş et al., 2021; Katsuta et al., 2021; Lasalvia et al., 2021; Lasalvia et al., 2020; Li et al., n.d.; Magnavita et al., 2021a, 2021b; Magnavita et al., 2020; Moore et al., 2021; Mosolova et al., 2021; Noaimi et al., 2021; Schmid et al., 2021;…”
BackgroundInfluentialChing, S. M., Ng, K. Y., Lee, K. W., Yee, A. H. A., Lim, P. Y., Ranita, H., Devaraj, N. K., Ooi, P. B., & Cheong, A. T. (2021) · PLoS ONE · doi:10.1371/journal.pone.0257983 · Cited by 108 · cited 1×
“, 2021), gender (Ching et al., 2021; Li et al., 2021b; Raoofi et al., 2021; Serrano-Ripoll et al., 2020; Varghese et al., 2021; Yuan et al., 2021b; Zhao et al., 2021) and frontline status (frontline HCWs defined as those providing direct care or working in high risk settings) (Bell and Wade, 2020; Carmassi et al.”
BackgroundOlaya, B., Pérez-Moreno, M. A., Bueno‐Notivol, J., Gracia‐García, P., Lasheras, I., & Santabárbara, J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10153406 · Cited by 107 · cited 1×
“There have also been inconsistent findings on at risk groups among hospital HCWs during the COVID-19 pandemic, with varied findings on whether mental health issues varies between profession (Olaya et al., 2021; Pappa et al., 2020; Santabárbara et al., 2021; Varghese et al., 2021; Wu et al., 2021), gender (Ching et al.”
ResultHennein, R., & Lowe, S. R. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240646 · Cited by 98
Stigmatization from Work-Related COVID-19 Exposure: A Systematic Review with Meta-Analysis
Schubert, M., Ludwig, J., Freiberg, A., Hahne, T. M., Starke, K. R., Girbig, M., Faller, G., Apfelbacher, C., Knesebeck, O. V. D., & Seidler, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18126183 · Cited by 90 · cited 1×
“Another contributing factor could be the social stigma and social rejection (Ding et al., 2021; Gómez-Durán et al., 2020; Schubert et al., 2021; Yuan et al., 2021b) faced by these professional groups due to their work, which have been found to increase experiences of”
BackgroundMagnavita, N., Soave, P. M., & Antonelli, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189888 · Cited by 90
Prevalence of depressive symptoms among nurses in China: A systematic review and meta-analysis
Xie, N., Qin, Y., Wang, T., Zeng, Y., Deng, X., & Guan, L. (2020) · PLoS ONE · doi:10.1371/journal.pone.0235448 · Cited by 88 · cited 1×
“With regards to physicians, hospital nurses and healthcare students, pre-pandemic studies largely supports that mental health issues have been evident in this cohort since pre-pandemic (Chen and Meier, 2021; Dyrbye et al., 2006; Gheshlagh et al., 2017; Rotenstein et al., 2016; Tung et al., 2018; Xie et al., 2020), due…”
BackgroundANXIETY SYMPTOMS AS PRECURSORS OF MAJOR DEPRESSION AND SUICIDAL IDEATION
Batterham, P. J., Christensen, H. M., & Calear, A. L. (2013) · Depression and Anxiety · doi:10.1002/da.22066 · Cited by 84 · cited 1×
“depression (Batterham et al., 2013), support strategies will still benefit from focusing on reducing anxiety symptoms in addition to depression”
BackgroundChau, S. W. H., Wong, O. W. H., Ramakrishnan, R., Chan, S. S. M., Wong, E. K.-Y., Li, P. Y. T., Raymont, V., Elliot, K., Rathod, S., Delanerolle, G., et al. (2021) · BMC Public Health · doi:10.1186/s12889-021-10701-3 · Cited by 81
Zhao, Y.-J., Jin, Y., Rao, W., Li, W., Zhao, N., Cheung, T. C. C., Ng, C. H., Wang, Y. Y., Zhang, Q., & Xiang, Y. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.03.016 · Cited by 71 · cited 2×
“, 2020), and the COVID-19 pandemic (Batra et al., 2020; Zhao et al., 2021), it is again unclear to what extent”
BackgroundThe prevalence of job stress among nurses in Iran: A meta-analysis study
Sayehmiri, K., Gheshlagh, R. G., Parizad, N., Dalvand, S., Zarei, M., Farajzadeh, M., & Karami, M. (2017) · Nursing and Midwifery Studies · doi:10.4103/nms.nms_33_17 · Cited by 69
Galli, F., Pozzi, G., Ruggiero, F., Mameli, F., Cavicchioli, M., Barbieri, S., Canevini, M. P., Priori, A., Pravettoni, G., Sani, G., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.568664 · Cited by 64
Anxiety during the COVID-19 pandemic in hospital staff: systematic review plus meta-analysis
Raoofi, S., Kan, F. P., Rafiei, S., Khani, S., Hosseinifard, H., Tajik, F., Masoumi, M., Raoofi, N., Ahmadi, S., Aghalou, S., et al. (2021) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2021-003125 · Cited by 63
Psychological impact of quarantine on healthcare workers
Durán, E. L. G., Martín-Fumadó, C., & Forero, C. G. (2020) · Occupational and Environmental Medicine · doi:10.1136/oemed-2020-106587 · Cited by 61 · cited 1×
“While an effective measure to reduce nosocomial outbreaks of COVID-19 in hospitals (Grzelakowska and Kryś, 2021; Huang et al., 2021), studies have demonstrated that quarantine procedures can have severe psychological impact due to feelings of threat, restrain and social isolation (Basso et al.,…”
BackgroundTaylor‐Phillips, S., Geppert, J., Stinton, C., Freeman, K., Johnson, S. A., Fraser, H., Sutcliffe, P. A., & Clarke, A. (2017) · Research Synthesis Methods · doi:10.1002/jrsm.1255 · Cited by 60
“Female Preponderance” of Depression in Non-clinical Populations: A Meta-Analytic Study
Wang, K., Lu, H., Cheung, E. F. C., Neumann, D. L., Shum, D., & Chan, R. C. K. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01398 · Cited by 57
Viral Sequencing to Investigate Sources of SARS-CoV-2 Infection in US Healthcare Personnel
Braun, K. M., Moreno, G. K., Buys, A., Somsen, E. D., Bobholz, M. J., Accola, M. A., Anderson, L., Rehrauer, W. M., Baker, D. A., Safdar, N., et al. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab281 · Cited by 54
Mosolova, E., Sosin, D. N., & Mosolov, S. N. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114226 · Cited by 48 · cited 1×
“Two repeated measures study (Gündoğmuş et al., 2021; Mosolova et al., 2021) compared prevalence rates during the peaks of the first and second COVID-19 outbreak in their local area.”
BackgroundLasalvia, A., Bodini, L., Amaddeo, F., Porru, S., Carta, A., Poli, R., & Bonetto, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413374 · Cited by 47
Yan, H., Ding, Y., & Guo, W. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000922 · Cited by 46 · cited 5×
“…6 March 2023 Journal of Affective Disorders 330 (2023) 329–345 et al., 2020b; Yan et al., 2021), anxiety (Raoofi et al., 2021; Salari et al., 2020b; Yan et al., 2021), post-traumatic stress disorder (PTSD) (Yan et al., 2021) and insomnia (Salari et al., 2020a; Salari et al., 2020b; Yan et al.,…”
BackgroundInfluentialBaumann, B. M., Cooper, R. J., Medak, A. J., Lim, S. C., Chinnock, B. F., Frazier, R., Roberts, B. W., Epel, E. S., & Rodriguez, R. M. (2021) · Academic Emergency Medicine · doi:10.1111/acem.14219 · Cited by 45 · cited 2×
“In another study (Baumann et al., 2021) with emergency department (ED) physicians (n-T1 = 262, n-T2 = 252), PTSD also decreased after two months but at a lower rate of 7 %.”
Backgroundda Silva, F. C. T., & Neto, M. L. R. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.03.044 · Cited by 45
Th’ng, F., Rao, K. A., Ge, L., Mao, D. R., Neo, H. N., Molina, J. A. D. C., & Seow, E. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111228 · Cited by 42
A Systematic Review of the Posttraumatic Stress Disorder Checklist (PCL)
Bressler, R., Erford, B. T., & Dean, S. (2018) · Journal of Counseling & Development · doi:10.1002/jcad.12190 · Cited by 40 · cited 2×
“While not reflective of actual mental 657 health diagnoses, our findings still show for the first time the proportion of hospital HCWs 658 experiencing mental health issues at a clinical level that have a high probability to lead to a 659 mental health disorder, if not present already, and requires immediate clinical…”
BackgroundImpact of multiple waves of COVID-19 on healthcare networks in the United States
Hassan, E. M., & Mahmoud, H. N. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247463 · Cited by 33 · cited 2×
“As 63 different COVID-19 variants (World Health Organisation, 2022) continue to trigger multiple 64 waves of outbreaks worldwide (Hale et al., 2021; Hassan and Mahmoud, 2021), many are 65”
BackgroundGündoğmuş, İ., Ünsal, C., Bolu, A., Takmaz, T., Ökten, S. B., Aydın, M. B., Uçar, H., Gündüz, A., & Kul, A. T. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113976 · Cited by 29
The mental health of NHS staff during the COVID-19 pandemic: two-wave Scottish cohort study
Kock, J. H. D., Latham, H. A., Cowden, R. G., Cullen, B., Narzisi, K., Jerdan, S., Muñoz, S., Leslie, S. J., McNamara, N., Boggon, A., et al. (2022) · BJPsych Open · doi:10.1192/bjo.2021.1079 · Cited by 27
Katsuta, N., Ito, K., Fukuda, H., Seyama, K., Hori, S., Shida, Y., Nagura, R., Nojiri, S., & Sato, H. (2021) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12217 · Cited by 24 · cited 3×
“One study (Katsuta et al., 2021) (n- 1 = 2529, n-T2 = 2501) found no significant difference in the prevalence of depression pre-pandemic and during the COVID-19 pandemic among hospital HCWs. Similar results were found for the prevalence of anxiety in Moore et al. (2021) study among medical students…”
ResultSARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study
Huang, Q., Mondal, A., Jiang, X., Horn, M. A., Fan, F., Fu, P., Wang, X., Zhao, H., Ndeffo-Mbah, M. L., & Gurarie, D. (2021) · Royal Society Open Science · doi:10.1098/rsos.201895 · Cited by 23
Li, X., Yu, H., Yang, W., Mo, Q., Yang, Z., Wen, S., Zhao, F., Zhao, W., Tang, Y., Ma, L., et al. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.638985 · Cited by 23
Castioni, D., Galasso, O., Rava, A., Massè, A., Gasparini, G., & Mercurio, M. (2021) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000001728 · Cited by 19 · cited 1×
“Two studies (Castioni et al., 2021; Chene et al., 2021) compared prevalence rates before and after lockdown measures were implemented in their local area.”
BackgroundSheen, J. A., Clancy, E. M., Considine, J., Dwyer, A. J., Tchernegovski, P., Aridas, A., Lee, B. E. C., Reupert, A., & Boyd, L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19084897 · Cited by 19 · cited 1×
“by distressing experiences in the community that have been associated with mental health issues during the COVID-19 pandemic, such as the risk of infections in the community, lockdowns, quarantines, impacts on families and social distancing (Brooks et al., 2020; Sheen et al., 2022; Yuan et al., 2021a).”
BackgroundSelf-citationMoore, C., Blencowe, N., Hollén, L., & Hamel, C. V. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.2015065 · Cited by 17 · cited 1×
“Two studies (Katsuta et al., 2021; Moore et al., 2021) compared pre-pandemic rates with COVID-19 rates in hospital HCWs.”
Kumar, A., Kumar, A., Kirtana, J., Singh, A., Shankar, S. H., Khan, M., Srivastava, A., Kaur, R., & Wig, N. (2020) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1579_20 · Cited by 16 · cited 1×
“rates of quarantine have been significantly higher in hospitals HCWs compared to the general public (Kumar et al., 2020) and have been found to be associated with PTSD symptoms (Brooks et al.”
BackgroundShechter, A., Chiuzan, C. C., Shang, Y., Ko, G., Diaz, F., Venner, H. K., Shaw, K., Cannone, D. E., McMurry, C. L., Sullivan, A. M., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010262 · Cited by 15
Grzelakowska, K., & Kryś, J. (2021) · Medical Research Journal · doi:10.5603/mrj.a2021.0012 · Cited by 14
Damluji, A. A., Wei, S., Bruce, S. A., Haymond, A. N., Petricoin, E. F., Liotta, L. A., Maxwell, G. L., Moore, B. C., Bell, R., Garofalo, S., et al. (2021) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2021.100030 · Cited by 13 · cited 1×
“Early evidence from the United States have demonstrated that HCWs’ risk of infection in the workplace have reduced as hospitals improve their infection control procedures, PPE use and vaccination rates (Braun et al., 2021; Damluji et al., 2021; Dunbar et al., 2021; Jacob et al., 2021; Moghadas et al., 2021).”
Schmid, B., Schulz, S. M., Schüler, M., Göpfert, D., Hein, G., Heuschmann, P. U., Wurmb, T. E., Pauli, P., Meybohm, P., & Rittner, H. L. (2021) · Europe PMC (PubMed Central) · doi:10.3205/000298 · Cited by 13 · cited 3×
“Eight datasets from 11 studies (Baumann et al., 2021; De Kock et al., 2022; Lasalvia et al., 2021; Lasalvia et al., 2020; Magnavita et al., 2021a, 2021b; Magnavita et al., 2020; Noaimi et al., 2021; Schmid et al., 2021; Shechter et al., 2021; Th’ng et al., 2021), investigated the progression of mental health outcomes…”
BackgroundResultCOVID-19 Impact in Neurosurgery Residency: Grit During Pandemic
Algattas, H., Roy, S., Agarwal, N., & Maroon, J. C. (2021) · World Neurosurgery · doi:10.1016/j.wneu.2021.04.057 · Cited by 10 · cited 3×
“One study (Algattas et al., 2021) with a small sample of neuropsychology residents (n = 17) found that the prevalence of depression during a COVID-19 outbreak was significantly lower than rates found before the outbreak.”
BackgroundResultDunbar, E. E., Godbout, E. J., Pryor, R. J., Rozycki, H. J., & Bearman, G. M. (2021) · Infection Control and Hospital Epidemiology · doi:10.1017/ice.2021.62 · Cited by 9
Basso, M., Visintini, E., Achil, I., Fabris, S., Mattiussi, E., Danielis, M., & Palese, A. (2021) · Public Health Nursing · doi:10.1111/phn.12910 · Cited by 8
Ding, S., Deng, S., Zhang, Y., Wang, Q., & Yang, X. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3761833 · Cited by 7 · cited 5×
“This is not surprising given the increases in workloads, infection risks, uncertainty, and feelings of threat during the pandemic (Ding et al., 2021; Joo and Liu, 2021; Liu et al., 2020), which may have increased the likelihood of developing depression and anxiety in hospital HCWs during this time.”
InfluentialChene, G., Nohuz, E., Cerruto, E., Moret, S., Atallah, A., Saoud, M., & the French Covid-Pro-Impact Consortium (2021) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2021.2014812 · Cited by 5 · cited 1×
“Two studies (Castioni et al., 2021; Chene et al., 2021) compared prevalence rates before and after lockdown measures were implemented in their local area.”
BackgroundExperiences of Nurses Fighting Coronavirus Disease 2019 (COVID-19): A Qualitative Meta-Integration
Liu, M., Zhang, N., Wang, W., Chen, Q., Chen, W., & Lin, Q. (2020) · American Journal of Nursing Science · doi:10.11648/j.ajns.20200906.11 · Cited by 4
Junior doctors’ wellbeing at peak and post-peak pandemic: a repeated cross-sectional study
Doulias, T., Thrikandiyur, A., Titus, N., Soundararasha, K., Coxon, A., Amarantidis, E., & Arulampalam, T. (2023) · Annals of The Royal College of Surgeons of England · doi:10.1308/rcsann.2021.0272 · Cited by 4
Noaimi, H. M. A., Noaimi, M. M. A., Fayez, F. M. A., Mushkhes, H. Q. A., & A-ni, W. (2021) · Bahrain Medical Bulletin · Cited by 2
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Metadata
- Authors
- Lee, B. E. C., Ling, M., Boyd, L., Olsson, C., & Sheen, J.
- Affiliations
- Deakin University (AU)
- Eastern Health (AU)
- Corresponding author
- Lee, Brian En Chyi
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2023-06
- Volume
- 330
- Pages
- 329-345
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC10017178
- OpenAlex
- W4324335442
- Cited by
- 120
- References
- 124
- Citations by year
- 2026: 17 · 2025: 34 · 2024: 55 · 2023: 14
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- State Government of Victoria
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, mental illness, depression, anxiety, post-traumatic stress disorder, alcohol and substance use disorders, insomnia, prevalence, nurses, physicians, health professions students, workplace mental health, sex differences, direct care workers
- MeSH terms
- COVID-19, Delivery of Health Care, Depression, Female, Health Personnel, Hospitals, Humans, Mental Health, Prevalence, Pandemics
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