The evaluation of sleep disturbances for Chinese frontline medical workers under the outbreak of COVID-19.

To evaluate sleep disturbances of Chinese frontline medical workers (FMW) under the outbreak of coronavirus disease 2019 (COVID-19), and make a comparison with non-FMW. The medical workers from multiple hospitals in Hubei Province, China, volunteered to participate in this cross-sectional study. An online questionnaire, including Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS) and Visual Analogue Scale (VAS), was used to evaluate sleep disturbances and mental status. Sleep disturbances were defined as PSQI>6 points or/and AIS>6 points. We compared the scores of PSQI, AIS, anxiety and depression VAS, as well as prevalence of sleep disturbances between FMW and non-FMW. A total of 1306 subjects (801 FMW and 505 non-FMW) were enrolled. Compared to non-FMW, FMW had significantly higher scores of PSQI (9.3 ± 3.8 vs 7.5 ± 3.7; P < 0.001; Cohen's d = 0.47), AIS (6.9 ± 4.3 vs 5.3 ± 3.8; P < 0.001; Cohen's d = 0.38), anxiety (4.9 ± 2.7 vs 4.3 ± 2.6; P < 0.001; Cohen's d = 0.22) and depression (4.1 ± 2.5 vs 3.6 ± 2.4; P = 0.001; Cohen's d = 0.21), as well as higher prevalence of sleep disturbances according to PSQI > 6 points (78.4% vs 61.0%; relative risk [RR] = 1.29; P < 0.001) and AIS > 6 points (51.7% vs 35.6%; RR = 1.45; P < 0.001). FMW have higher prevalence of sleep disturbances and worse sleep quality than non-FMW. Further interventions should be administrated for FMW, aiming to maintain their healthy condition and guarantee their professional performance in the battle against COVID-19.

Qi J ，Xu J ，Li BZ ，Huang JS ，Yang Y ，Zhang ZT ，Yao DA ，Liu QH ，Jia M ，Gong DK ，Ni XH ，Zhang QM ，Shang FR ，Xiong N ，Zhu CL ，Wang T ，Zhang X ... -  《-》

The prevalence and risk factors of psychological disturbances of frontline medical staff in china under the COVID-19 epidemic: Workload should be concerned.

To our best knowledge, this was the first time to investigate the prevalence and risk factors of psychological disturbances, including depression, anxiety, somatization symptoms, insomnia and suicide, among frontline medical staff, who were working with the COVID-10 infected patients directly. Patient Health Questionnaire Depression (PHQ-9), Generalized Anxiety Disorder Questionnaire scale (GAD-7), Symptom Check List-90 (SCL-90) somatization, Insomnia Severity Index (ISI), and the suicidal module of the Mini International Neuropsychiatric Interview were used for online survey. A total of 606 frontline hospital staff and1099 general population were recruited. The prevalence of depression, anxiety, somatization symptoms, insomnia, and suicide risk in frontline medical staffs were 57.6%, 45.4%, 12.0%, 32.0% and 13.0%, respectively. Except for suicide risk, the prevalence of other psychological disorders in frontline medical staff were higher than those in general population (all p<0.01). Among the frontline medical staff, the daily working hours were associated with all psychological disturbance (all p<0.01), women with anxiety (p = 0.02), body mass index (BMI) with anxiety and insomnia (p = 0.02, p = 0.03). Age was negatively associated with depression, anxiety, and insomnia (all p<0.01). Finally, years of working and family income were negatively associated with suicide risk (p = 0.03, p<0.001). Our study demonstrates that during the outbreak of COVID-19, the frontline medical staff are more likely to suffer from psychological disturbances than general population. It is noticeable that daily working hours are a risk factor for all measured psychological disturbances, and some other variables may be involved in certain psychological disturbances of frontline medical staff.

Zhou Y ，Wang W ，Sun Y ，Qian W ，Liu Z ，Wang R ，Qi L ，Yang J ，Song X ，Zhou X ，Zeng L ，Liu T ，Li Z ，Zhang X ... -  《-》

Mental Health in Frontline Medical Workers during the 2019 Novel Coronavirus Disease Epidemic in China: A Comparison with the General Population.

Liang Y ，Wu K ，Zhou Y ，Huang X ，Zhou Y ，Liu Z ... -  《-》

Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis.

COVID-19 pandemic has the potential to significantly affect the mental health of healthcare workers (HCWs), who stand in the frontline of this crisis. It is, therefore, an immediate priority to monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. The aim of this review is to synthesize and analyze existing evidence on the prevalence of depression, anxiety and insomnia among HCWs during the Covid-19 outbreak. A systematic search of literature databases was conducted up to April 17th, 2020. Two reviewers independently assessed full-text articles according to predefined criteria. Risk of bias for each individual study was assessed and data pooled using random-effects meta-analyses to estimate the prevalence of specific mental health problems. The review protocol is registered in PROSPERO and is available online. Thirteen studies were included in the analysis with a combined total of 33,062 participants. Anxiety was assessed in 12 studies, with a pooled prevalence of 23·2% and depression in 10 studies, with a prevalence rate of 22·8%. A subgroup analysis revealed gender and occupational differences with female HCPs and nurses exhibiting higher rates of affective symptoms compared to male and medical staff respectively. Finally, insomnia prevalence was estimated at 38·9% across 5 studies. Early evidence suggests that a considerable proportion of HCWs experience mood and sleep disturbances during this outbreak, stressing the need to establish ways to mitigate mental health risks and adjust interventions under pandemic conditions.

Pappa S ，Ntella V ，Giannakas T ，Giannakoulis VG ，Papoutsi E ，Katsaounou P ... -  《-》

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.

Lai J ，Ma S ，Wang Y ，Cai Z ，Hu J ，Wei N ，Wu J ，Du H ，Chen T ，Li R ，Tan H ，Kang L ，Yao L ，Huang M ，Wang H ，Wang G ，Liu Z ，Hu S ... -  《JAMA Network Open》