Mental Health Impact of the COVID-19 Pandemic on Physicians, Fellows, Residents, and Medical Students in a Metropolitan Hotspot
Jarred V Bratley, BS; Amir Dehdashtian, MD, MPH; Tessa M LeWitt, BS; Guillermina Nava, MD; Faisal Al-Mufarrej, MD
Division of Plastic Surgery, Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan
Introduction: The COVID-19 pandemic significantly changed the way-of-life for medical students, residents/fellows, and physicians. The group experienced patient care challenges, public health policies, and socioeconomic side effects of COVID-19. Specifically, the pandemic also caused unprecedented changes to medical education and postgraduate training. The personal and professional stressors are mental health risks. Therefore, the mental health impact of COVID-19 is a high-stakes topic for teaching hospitals. Our study evaluated the psychological effects of COVID-19 in the medical education system. This study is important for several purposes: 1. to track the mental health impact, 2. to translate the methods to other hotspots, and 3. to inform decision-making about mental health services
Methods: A standardized survey collected data from Wayne State University School of Medicine (WSUSOM) affiliated medical students, residents/fellows, and attendings. A total of n = 442 respondents completed the cross-sectional, online survey between May and June 2020. The multiple-choice survey included demographic questions and also the Depression Anxiety Stress Scales-21 (DASS-21) psychometric tool. Respondents completed back-to-back DASS-21 question sets: first, a current DASS-21 to measure pandemic-time psychological symptoms and second, a retrospective DASS-21 to measure baseline. Independent scores for depression, anxiety, and stress were calculated. We followed recommended cut-off scores to stratify normal, mild, moderate, severe, and extremely severe symptoms
Results: All survey respondents were WSUSOM affiliated students (n = 137), residents/fellows (n = 138), and physicians (n = 167). The adverse psychological impact of COVID-19 was evident for survey-takers. Mean DASS-21 depression, anxiety, and stress scores significantly increased versus retrospective scores (Figure 1). Symptoms of depression, anxiety, and stress were more prevalent during the COVID-19 pandemic. Figure 2 visualizes the distribution of mild, moderate, severe, and extremely severe symptoms. The DASS-21 tool quantitated mild to extremely severe symptoms in a worrisome percentage (24.9% screened positive for anxiety, 30.1% for depression, and 25.6% for stress). The pandemic was associated with significantly higher percentages than pre-pandemic (Figure 3). CONCLUSIONS: This study compared mental health during and before the COVID-19 pandemic. The pandemic caused significant distress for physicians and trainees. The authors recommend developing accessible, high-quality wellness and mental health care programs.
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