Introduction:

The COVID-19 pandemic has raised growing concerns towards the mental health of healthcare workers.

Objectives:

To investigate the prevalence and associated factors of anxiety, depression, and post-traumatic stress disorder symptoms in Portuguese healthcare workers during the COVID-19 pandemic.

Material and Methods:

An online questionnaire was delivered to a convenience sample of healthcare workers. The questionnaire collected data on demographics, clinical history, psychosocial support, COVID-19 infection, type of work performed during the pandemic and evaluated anxiety, depression and post-traumatic stress disorder symptoms through the Hospital Anxiety and Depression Scale (HADS - HADS-Anxiety and HADS-Depression subscales) and the Impact of Events Scale 6 (IES-6).

Results:

A significant percentage of healthcare workers (n=554) reports anxiety (40,61%), depression (25,99%) and post-traumatic stress disorder symptoms (20,40%). Factors associated with more severe symptoms include changes in household (HADS-Anxiety,p<0,001; HADS-Depression,p=0,015; IES-6,p=0,002) and lower satisfaction with social support (HADS-Anxiety and HADS-Depression,p<0,001). Nurses and nurse assistants display more anxiety (p=0,011;p<0,001) and depression symptoms (p=0,003;p=0,007) compared with doctors. Working with COVID-19 patients is associated with higher symptom scores (HADS-Anxietyp=0,030; HADS-Depressionp=0,019;IES-6p=0,008).

Discussion:

Changes in daily routine brought by the pandemic are significant risk factors for the development of the identified symptoms. Satisfaction with social support is more relevant than frequency of contact. Healthcare workers with longer and closer contact with COVID-19 patients bear an increased risk of anxiety, depression, and post-traumatic stress disorder symptoms, compared with those with clinical activity without COVID-19 patients and non-clinical activity.

Conclusions:

The COVID-19 pandemic is associated with significant anxiety, depression, and post-traumatic stress disorder symptoms in healthcare workers, and is influenced by changes in daily routine, psychosocial support, professional group, and type of clinical work. The collected data outlines the dimension of psychological suffering in healthcare workers and may contribute to the development of intervention strategies for this population.

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