Level of depression and its associated factors among the frontline physicians of Bangladesh during the COVID-19 outbreak 10.55131/jphd/2023/210108

Main Article Content

Faojia Sultana
Prasenjit Mondal
MD Enayetullah Anqur
Md Sazid Imtiaz
Ashik Mohammad Amanullah
Shafiun Nahin Shimul

Abstract

The COVID-19 pandemic has exposed the frontline physicians to a greater risk of getting infected, tremendous workload, and drastic changes in their work environment, leading to an increased prevalence of depression among doctors from many countries, including Bangladesh. The aim of this study was to examine the association of various personal, professional and psychosocial factors with different degrees of depressive symptoms among the frontline doctors of Bangladesh working during the COVID-19 pandemic. An online, cross-sectional survey was conducted for that purpose and data were collected from 312 doctors working in Bangladeshi hospitals using a self-administered survey questionnaire inclusive of a validated tool (Patient Health Questionnaire-9). Among the participants, around half were of age 30-34 years (51.3%), 81.8% worked in public hospitals and 70.5% did not have any comorbidity. Regarding workplace conditions, 77% of the doctors reported a perceived shortage of healthcare providers at their workplace, while 95% reported a perceived shortage of equipment, most commonly N95 masks (49%), gowns (35%), eye-protective shields (35%). A total of 199 (63.8%) participants received formal training since the beginning of the pandemic. According to the response from PHQ-9 questionnaire, 17 (5%) participants reported having no depression, while 18 (6%), 18 (6%), 25 (8%), and 234 (75%) reported having mild, moderate, moderately severe, and severe depression. Findings from multiple logistic regression showed the odds of moderate-to-severe depression to be higher among physicians with comorbidities (OR:7.47, CI: 1.27-43.89, P: 0.026) and those who felt extremely worried from looking at negative news on social/mass media (aOR: 15.180, CI:1.98-116.683, P: 0.009). To preserve and promote the psychological well-being of Bangladeshi doctors, it is, therefore, crucial to take these identified sources and risk factors of depression under sincere consideration by the responsible authorities and appropriate measures should be designed to remove these sources of depression to better support the physicians of the country.

Article Details

How to Cite
1.
Sultana F, Mondal P, Anqur ME, Imtiaz MS, Amanullah AM, Shimul SN. Level of depression and its associated factors among the frontline physicians of Bangladesh during the COVID-19 outbreak: 10.55131/jphd/2023/210108. J Public Hlth Dev [Internet]. 2022 Dec. 23 [cited 2024 May 3];21(1):106-22. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/260588
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Original Articles
Author Biographies

Faojia Sultana, Institute of Health Economics, University of Dhaka, Bangladesh.

Institute of Health Economics, University of Dhaka, Bangladesh.

Prasenjit Mondal, Child Health Research Foundation, Dhaka, Bangladesh

Child Health Research Foundation, Dhaka, Bangladesh.

MD Enayetullah Anqur, Islamic University of Technology, Gazipur, Dhaka, Bangladesh.

Islamic University of Technology, Gazipur, Dhaka, Bangladesh.

Md Sazid Imtiaz, Department of Urology, National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh

Department of Urology, National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh

Ashik Mohammad Amanullah, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Shafiun Nahin Shimul, Institute of Health Economics, University of Dhaka, Bangladesh.

Institute of Health Economics, University of Dhaka, Bangladesh.

References

Worldometer. COVID-19: Coronavirus Pandemic. 2021.

Wang C, Tee M, Roy AE, Fardin MA, Srichokchatchawan W, Habib HA, et al. The impact of COVID-19 pandemic on physical and mental health of Asians: A study of seven middle-income countries in Asia. PLOS ONE. 2021;16(2): e0246824.

Hayat K, Rosenthal M, Xu S, Arshed M, Li P, Zhai P. View of Pakistani residents toward coronavirus disease (COVID-19) during a rapid outbreak: a rapid online survey. Int J Environ Res Public Health. 2020;17(10).

Islam MT, Talukder AK, Siddiqui MN, Islam T. Tackling the COVID-19 pandemic: The Bangladesh perspective. J Public Health Res. 2020;9(4):1794.

Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020;323(21):1233-4.

Ahmed SM, Alam BB, Anwar I, Begum T, Huque R, AM Khan J, et al. Bangladesh Health System Review: World Health Organization. 2015.

Islam MT, Talukder AK, Badruzzaman M, Khan MAHNA. Health service facilities are positively linked with outcome of COVID-19 patients in majority of the countries: The global situation. J Adv Biotechnol Exp Ther. 2020.

Badahdah A, Khamis F, Mahyijari NA, Balushi MA, Hatmi HA. The mental health of health care workers in Oman during the COVID-19 pandemic. Int J Soc Psychiatry. 2020.

Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559-65.

Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Ann Intern Med. 2020;173(4):317-20.

Aly HM, Nemr NA, Kishk RM, Elsaid N. Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study. BMJ Open. 2021;11(4):e045281.

Elkholy H, Tawfik F, Ibrahim I, Salah El-Din W, Sabry M, Mohammed S, et al. Mental health of frontline healthcare workers exposed to COVID-19 in Egypt: A call for action. Int J Soc Psychiatry. 2021;67(5):522-31.

Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976.

Perera B, Wickramarachchi B, Samanmalie C, Hettiarachchi M. Psychological experiences of healthcare professionals in Sri Lanka during COVID-19. BMC Psychol. 2021;9(1):49.

Tan YQ, Wang Z, Yap QV, Chan YH, Ho RC, Hamid A, et al. Psychological Health of Surgeons in a Time of COVID-19: A Global Survey. Ann Surg. 2021.

Daniel W, Cross C. Biostatistics: a foundation for analysis in the health sciences: Wiley; 2018.

Du J, Dong L, Wang T, Yuan C, Fu R, Zhang L, et al. Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020;67:144-5.

Liu Z, Han B, Jiang R, Huang Y, Ma C, Wen J, et al. Mental health status of doctors and nurses during COVID-19 epidemic in China. The Lancet Preprint. 2020.

Kroenke K, Spitzer R, Williams J. The PHQ‑9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606‑13.

Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry Research. 2020.

Karakose T, Malkoc N. Psychological impact of the COVID-19 pandemic on medical doctors in Turkey. Social Behavior and Personality. 2021.

Chew NWS, Ngiam JN, Tan BY, Tham SM, Tan CY, Jing M, et al. Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic. BJPsych Open. 2020;6(6):e116.

Dong Y, Yeo MC, Tham XC, Danuaji R, Nguyen TH, Sharma AK, et al. Investigating Psychological Differences Between Nurses and Other Health Care Workers From the Asia-Pacific Region During the Early Phase of COVID-19: Machine Learning Approach. JMIR Nurs. 2022;5(1):e32647.

Ho RC, Tran BX, McIntyre RS. The impact of COVID-19 pandemic on global mental health: From the general public to healthcare workers. Ann Acad Med Singap. 2021;50(3):198-9.

Le XTT, Nguyen QT, Onyango B, Nguyen QN, Pham QT, Ta NTK, et al. Perception Toward Exposure Risk of COVID-19 Among Health Workers in Vietnam: Status and Correlated Factors. Front Public Health. 2021;9:589317.

Pham QT, Le XTT, Phan TC, Nguyen QN, Ta NKT, Nguyen AN, et al. Impacts of COVID-19 on the Life and Work of Healthcare Workers During the Nationwide Partial Lockdown in Vietnam. Front Psychol. 2021;12:563193.

Ceri V, Cicek I. Psychological Well-Being, Depression and Stress During COVID-19 Pandemic in Turkey: A Comparative Study of Healthcare Professionals and Non-Healthcare Professionals. Psychol Health Med. 2021;26(1):85-97.

Hacimusalar Y, Kahve AC, Yasar AB, Aydin MS. Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey. J Psychiatr Res. 2020;129:181-8.

Banna MHA, Sayeed A, Kundu S, Christopher E, Hasan MT, Begum MR, et al. The impact of the COVID-19 pandemic on the mental health of the adult population in Bangladesh: a nationwide cross-sectional study. Int J Environ Health Res. 2022;32(4):850-61.

Kumar A, Nayar KR. COVID 19 and its mental health consequences. J Ment Health. 2021;30(1):1-2. doi: 10.1080/09638237.2020.1757052.

Zheng W. Mental health and a novel coronavirus (2019-nCoV) in China. J Affect Disord. 2020;269:201-2.

Gupta AK, Mehra A, Niraula A, Kafle K, Deo SP, Singh B, et al. Prevalence of anxiety and depression among the healthcare workers in Nepal during the COVID-19 pandemic. Asian J Psychiatr. 2020;54:102260.

Sunjaya DK, Herawati DMD, Siregar AYM. Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia. BMC Public Health. 2021;21(1):227.

Chowdhury SR, Sunna TC, Das DC, Kabir H, Hossain A, Mahmud S, et al. Mental health symptoms among the nurses of Bangladesh during the COVID-19 pandemic. Middle East Curr Psychiatry. 2021;28(1):23. doi: 10.1186/s43045-021-00103-x

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7.

World Health Organization. Tracking universal health coverage: 2017 global monitoring report. Geneva: World Health Organization and the International Bank for Reconstruction and Development/ The World Bank. 2017.

Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med. 2020;2(8):1069-76.

Mistry SK, Ali A, Hossain MB, Yadav UN, Ghimire S, Rahman MA, et al. Exploring depressive symptoms and its associates among Bangladeshi older adults amid COVID-19 pandemic: findings from a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol. 2021;56(8):1487-97.

Zubayer AA, Rahman ME, Islam MB, Babu SZD, Rahman QM, Bhuiyan M, et al. Psychological states of Bangladeshi people four months after the COVID-19 pandemic: An online survey. Heliyon. 2020;6(9):e05057.

Islam SMD, Bodrud-Doza M, Khan RM, Haque MA, Mamun MA. Exploring COVID-19 stress and its factors in Bangladesh: A perception-based study. Heliyon. 2020;6(7): e04399.

Moghanibashi-Mansourieh A. Assessing the anxiety level of Iranian general population during COVID-19 outbreak. Asian J Psychiatr. 2020;51:102076.

Amin F, Sharif S, Saeed R, Durrani N, Jilani D. COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan. BMC Psychiatry. 2020;20(1): 459.

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-20.

Grover S, Mehra A, Sahoo S, Avasthi A, Rao TSS, Vaishnav M, et al. Evaluation of Psychological Impact of COVID-19 on Health-Care Workers. Indian J Psychiatry. 2021;63(3):222-7.

Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008;136(7):997-1007.

Mohd Noor N, Che Yusof R, Yacob MA. Anxiety in Frontline and Non-Frontline Healthcare Providers in Kelantan, Malaysia. Int J Environ Res Public Health. 2021;18(3).

Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland S, et al. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res. 2020;293:113441.

Husain SF, Yu R, Tang TB, Tam WW, Tran B, Quek TT, et al. Validating a functional near-infrared spectroscopy diagnostic paradigm for Major Depressive Disorder. Sci Rep. 2020;10(1):9740.

Ho CSH, Lim LJH, Lim AQ, Chan NHC, Tan RS, Lee SH, et al. Diagnostic and Predictive Applications of Functional Near-Infrared Spectroscopy for Major Depressive Disorder: A Systematic Review. Front Psychiatry. 2020;11:378.

Husain SF, Tang TB, Yu R, Tam WW, Tran B, Quek TT, et al. Cortical haemodynamic response measured by functional near infrared spectroscopy during a verbal fluency task in patients with major depression and borderline personality disorder. EBioMedicine. 2020;51:102586.

Low ZX, Yeo KA, Sharma VK, Leung GK, McIntyre RS, Guerrero A, et al. Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(9).

Nguyen DN, Le HT, Thai PK, Le XTT, Hoang MT, Vu LG, et al. Evaluating Training Need for Epidemic Control in Three Metropolitans: Implications for COVID-19 Preparedness in Vietnam. Front Public Health. 2020;8:589331.

Le HT, Mai HT, Pham HQ, Nguyen CT, Vu GT, Phung DT, et al. Feasibility of Intersectoral Collaboration in Epidemic Preparedness and Response at Grassroots Levels in the Threat of COVID-19 Pandemic in Vietnam. Front Public Health. 2020;8:589437.

Tran BX, Hoang MT, Pham HQ, Hoang CL, Le HT, Latkin CA, et al. The operational readiness capacities of the grassroots health system in responses to epidemics: Implications for COVID-19 control in Vietnam. J Glob Health. 2020;10(1):011006.

Tran BX, Phan HT, Nguyen TPT, Hoang MT, Vu GT, Thi Lei H, et al. Reaching further by Village Health Collaborators: The informal health taskforce of Vietnam for COVID-19 responses. J Glob Health. 2020;10(1):010354.

Zhang MW, Ho RC. Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technol Health Care. 2017;25(1):163-5.

Ho CS, Chee CY, Ho RC. Mental Health Strategies to Combat the Psychological Impact of Coronavirus Disease 2019 (COVID-19) Beyond Paranoia and Panic. Ann Acad Med Singap. 2020;49(3):155-60.

Soh HL, Ho RC, Ho CS, Tam WW. Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials. Sleep Med. 2020;75:315-25.