Covid-19 pandemic impact on mental health: a web-based cross-sectional survey on a sample of Italian general practitioners

Main Article Content

Andrea Amerio
Davide Bianchi
Francesca Santi
Luigi Costantini
Anna Odone
Carlo Signorelli
Alessandra Costanza
Gianluca Serafini
Mario Amore
Andrea Aguglia

Keywords

Covid-19, General practitioners, Mental Health, Italy

Abstract

Background: Since the World Health Organization declared the new 2019 coronavirus disease (Covid-19) outbreak first a Public Health Emergency of International Concern and then a pandemic, Italy held more than 195.350 cases and 26.380 deaths. Working in the frontline with suspected Covid-19 infection patients, general practitioners (GPs) are daily under both physical and psychological pressure.  Methods: A web-based cross-sectional survey was carried out on italian GPs working in Genoa (Italy), to assess the impact of Covid-19 pandemic on mental health. The survey was anonymous and a free Google Forms® software was used. Results: One hundred thirty-one GPs completed the survey. Compared to GPs with absent or mild depressive symptoms (PHQ-9 < 10), GPs reporting moderate to severe depressive symptoms (N=30, 22.9%; PHQ-9 ≥ 10) reported more helplessness (96.7% vs. 79.2%, p=.025), spent more than three hours searching for COVID-19 information (43.3% vs. 19.8%, p=.024), perceived less adequate personal protective equipment (PPE) (6.7% vs. 23.8%, p=.049) and visited more COVID-19 infected patients (16.63 ± 27.30 vs. 9.52 ± 11.75, p=.041). Moreover, PHQ-9 ≥ 10 GPs reported a significant higher severity for both anxiety and insomnia (13.43 ± 4.96 vs. 4.88 ± 3.53 and 11.60 ± 5.53 vs. 4.84 ± 3.81, respectively; p<.001), and a worse quality of life in both mental (34.60 ± 7.45 vs. 46.01 ± 7.83, p<.001) and physical (43.50 ± 9.37 vs. 52.94 ± 4.78, p<.001) component summary. Conclusions: Our results give early insight into the urgent need to provide continuity of care for patients at the community-level, adequate PPE to GPs and a clear guidance from public health institutions. A precarious healthcare system both at a national and regional level might have triggered negative mental health outcomes in Italian GPs.

a

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...
Abstract 303 | PDF Downloads 250

References

1. https://www.who.int/
2. Odone A, Landriscina T, Amerio A, et al. The impact of the current economic crisis on mental health in Italy: evidence from two representative national surveys. Eur J Public Health 2018;28(3):490-495.
3. http://www.protezionecivile.gov.it/
4. https://portale.fnomceo.it/
5. Fiorino G, Colombo M, Natale C, et al. Clinician Education and Adoption of Preventive Measures for COVID-19: A Survey of a Convenience Sample of General Practitioners in Lombardy, Italy. Ann Intern Med 2020 [Online ahead of print]
6. Li DKT, Zhu S. Contributions and challenges of general practitioners in China fighting against the novel coronavirus crisis. Fam Med Community Health 2020;8(2):e000361.
7. Shanafelt T, et al. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA 2020 [Online ahead of print]
8. Rimmer A. Covid-19: GPs call for same personal protective equipment as hospital doctors. BMJ 2020;368:m1055.
9. Spitzer R, Kroken K, Williams JB. Validation and Utility of a Self-Report Version of PRIME-MD: The PHQ Primary Care Study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA 1999;282:1737.
10. Spitzer RL, Kroenke K, Williams JBW, et al. A Brief Measure for Assessing Generalized Anxiety Disorder. Arch Intern Med 2006;166:1092.
11. Morin CM, Belleville G, Bélanger L, et al. The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response. Sleep 2011;34:601–608.
12. Ware JJr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care 1996;34(3):220–233.
13. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. 2nd Ed. 2018, New York, NY: Guilford Press.
14. Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ 2020;368:m1211.
15. Thornton J. Covid-19: how coronavirus will change the face of general practice forever. BMJ 2020;368:m1279.
16. Omboni S. Telemedicine During The COVID-19 in Italy: A Missed Opportunity? Telemed J E Health 2020 [Epub ahead of print]
17. Signorelli C, Odone A, Cella P, et al. Childhood vaccine coverage in Italy after the new law on mandatory immunization. Ann Ig 2018;30(4 Supple 1):1–10.
18. Amerio A, Starace F, Costanza A, et al. Putting Codman’s lesson to work: Measuring and improving the quality of Italian mental health care. Acta Psychiatr Scand 2020;141(1):91-92.
19. Odone A, Delmonte D, Scognamiglio T, et al. COVID-19 deaths in Lombardy, Italy: data in context. Lancet Public Health 2020 [Epub ahead of print]
20. Chang BB, Chiu TY. Ready for a long fight against the COVID-19 outbreak: an innovative model of tiered primary health care in Taiwan. BJGP Open 2020 [Epub ahead of print]
21. Kidd M. Australia’s primary care COVID-19 response. Aust J Gen Pract 2020 [Epub ahead of print]

Most read articles by the same author(s)