TY - UNPB
T1 - Most Accurate Prevalence of PTSD and Common Mental Disorders in Healthcare Workers in England: A Two-Phase Epidemiological Survey
AU - Scott, Hannah R.
AU - Hegarty, Siobhan
AU - Hotopf, Matthew
AU - Madan, Ira
AU - McManus, Sally
AU - Moran, Paul
AU - Souliou, Emilia
AU - Raine, Rosalind
AU - Razavi, Reza
AU - Weston, Danny
AU - Greenberg, Neil
AU - Stevelink, Sharon A. M.
AU - Wessely, Simon
AU - Gafoor, Rafael
AU - Lamb, Danielle
AU - Bakolis, Ioannis
AU - Bhundia, Rupa
AU - Carr, Ewan
AU - Docherty, Mary Jane
AU - Gnanapragasam, Sam
PY - 2022/6/2
Y1 - 2022/6/2
N2 - Background: Previous studies on the impact of the COVID-19 pandemic on healthcare workers’ (HCWs) mental health have relied on self-reported screening measures to estimate point prevalence. Screening measures, which are designed to be sensitive, have low positive predictive value and often overestimate prevalence. We now present a more accurate prevalence of common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) among HCWs in England using diagnostic interviews.<br><br>Methods: A two-stage, cross-sectional study comprising diagnostic interviews (n=337) within a larger multi-site longitudinal cohort of HCWs (n=23,462) conducted during the COVID-19 pandemic. This study included two representative participant groups: i) 243 participants were screened with the General Health Questionnaire (GHQ-12) and assessed with the Clinical Interview Schedule – Revised (CIS-R) for CMDs; ii) 94 participants were screened with the PCL-6 and assessed with the Clinician Administered PTSD Scale (CAPS-5) for DSM-5 for PTSD.<br><br>Findings: The GHQ screening caseness for any CMD was 52.8% (95% CI 51.7 to 53.8). Using CIS-R diagnostic interviews, the estimated population prevalence of generalised anxiety disorder was 14.3% (95% CI 10.4 to 19.2) and for depression 13.7% (95% CI 10.1 to 18.3). The PCL-6 screening caseness for PTSD was 25.4% (95% CI 24.3 to 26.5). Using CAPS-5 diagnostic interviews, the estimated population prevalence of PTSD was 7.9% (95% CI 4.0 to 15.1).<br><br>Conclusion: The prevalence estimates of CMD and PTSD in HCWs are considerably lower when assessed through diagnostic interviews than when estimated using screening tools. Nevertheless, 1-in-5 HCWs met the threshold for a diagnosable mental disorder which might benefit from clinical intervention.<br><br>Funding Information: This study was supported by the Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees (M952); NHS England and Improvement; Economic and Social Research Council (ES/V009931/1); National Institute of Health and Care Research (NIHR) Biomedical Research Centre at the Maudsley and King's College London (KCL); NIHR Protection Research Unit in Emergency Preparedness and Response at KCL.<br><br>Declaration of Interests: MH and SW are senior NIHR Investigators. NG sits on the NHSEI expert reference group and also runs March on Stress which is a psychological health consultancy that provides mental health training to some NHS Trusts. All other authors declare no competing interests.<br><br>Ethics Approval Statement: Ethical approval for the study was granted by the Health Research Authority (reference: 20/HRA/2107, IRAS: 282686) and local Trust Research and Development approval. The study was approved as having Urgent Public Health Status by the NIHR in August 2020.<br>
AB - Background: Previous studies on the impact of the COVID-19 pandemic on healthcare workers’ (HCWs) mental health have relied on self-reported screening measures to estimate point prevalence. Screening measures, which are designed to be sensitive, have low positive predictive value and often overestimate prevalence. We now present a more accurate prevalence of common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) among HCWs in England using diagnostic interviews.<br><br>Methods: A two-stage, cross-sectional study comprising diagnostic interviews (n=337) within a larger multi-site longitudinal cohort of HCWs (n=23,462) conducted during the COVID-19 pandemic. This study included two representative participant groups: i) 243 participants were screened with the General Health Questionnaire (GHQ-12) and assessed with the Clinical Interview Schedule – Revised (CIS-R) for CMDs; ii) 94 participants were screened with the PCL-6 and assessed with the Clinician Administered PTSD Scale (CAPS-5) for DSM-5 for PTSD.<br><br>Findings: The GHQ screening caseness for any CMD was 52.8% (95% CI 51.7 to 53.8). Using CIS-R diagnostic interviews, the estimated population prevalence of generalised anxiety disorder was 14.3% (95% CI 10.4 to 19.2) and for depression 13.7% (95% CI 10.1 to 18.3). The PCL-6 screening caseness for PTSD was 25.4% (95% CI 24.3 to 26.5). Using CAPS-5 diagnostic interviews, the estimated population prevalence of PTSD was 7.9% (95% CI 4.0 to 15.1).<br><br>Conclusion: The prevalence estimates of CMD and PTSD in HCWs are considerably lower when assessed through diagnostic interviews than when estimated using screening tools. Nevertheless, 1-in-5 HCWs met the threshold for a diagnosable mental disorder which might benefit from clinical intervention.<br><br>Funding Information: This study was supported by the Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees (M952); NHS England and Improvement; Economic and Social Research Council (ES/V009931/1); National Institute of Health and Care Research (NIHR) Biomedical Research Centre at the Maudsley and King's College London (KCL); NIHR Protection Research Unit in Emergency Preparedness and Response at KCL.<br><br>Declaration of Interests: MH and SW are senior NIHR Investigators. NG sits on the NHSEI expert reference group and also runs March on Stress which is a psychological health consultancy that provides mental health training to some NHS Trusts. All other authors declare no competing interests.<br><br>Ethics Approval Statement: Ethical approval for the study was granted by the Health Research Authority (reference: 20/HRA/2107, IRAS: 282686) and local Trust Research and Development approval. The study was approved as having Urgent Public Health Status by the NIHR in August 2020.<br>
KW - common mental disorders
KW - epidemiology
KW - healthcare workers
KW - mental health
KW - prevalence
KW - post-traumatic stress disorder
U2 - 10.2139/ssrn.4113120
DO - 10.2139/ssrn.4113120
M3 - Preprint
T3 - THELANCETPSYCH-D-22-00481
BT - Most Accurate Prevalence of PTSD and Common Mental Disorders in Healthcare Workers in England: A Two-Phase Epidemiological Survey
ER -