A Systematic Review and Provisional Metanalysis on Psychopathologic Burden on Health Care Workers of Coronavirus Outbreaks.
A Systematic Review and Provisional Metanalysis on Psychopathologic Burden on Health Care Workers of Coronavirus Outbreaks.
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DOI：
10.3389/fpsyt.2020.568664
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发表时间：
2020
影响因子：
4.7
通讯作者：
Ferrucci R
中科院分区：
文献类型：
--
作者：
Galli F;Pozzi G;Ruggiero F;Mameli F;Cavicchioli M;Barbieri S;Canevini MP;Priori A;Pravettoni G;Sani G;Ferrucci R
新型冠状病毒（SARS-CoV-2）与之前爆发的严重急性呼吸系统综合症（SARS）和中东呼吸系统综合症（MERS）有一些相似之处。本次系统评价和荟萃分析的目的是提供前两次致命冠状病毒爆发对医护人员 (HCW) 造成的心理病理负担的证据，为管理当前的 COVID-19 爆发负担吸取经验教训。根据 Cochrane 协作指南和 PRISMA 声明，该研究量化了一线工作对医护人员心理健康的影响。研究人员对主要数据库（Pubmed、Scopus、Embase、Medline 和 Web of Science）进行了搜索，以查找评估一线工作报告的心理健康指数的观察性和病例对照研究。这项研究计算了报告临床显着水平的精神症状的样本百分比。科恩的 d 用于将直接参与应对大流行紧急情况的医护人员与未直接暴露于此类条件的对照组的心理健康结果进行比较。每当至少三项独立研究产生数据时，就会估计汇总效应大小（dw）。还估计了研究结果的异质性和发表的偏差。已针对总共 7,393 名医护人员选择了 15 项研究。 9.6% 至 51% 的医护人员报告有创伤后应激障碍 (PTSD) 症状，20% 至 75% 的医护人员报告有精神症状，其中焦虑和抑郁普遍存在。疫情爆发后一年到三年内，2% 至 19% 的人报告有 PTSD 症状，5% 至 90% 的人报告精神症状。有趣的是，直接参与大流行紧急情况的 HWC 比没有直接接触的 HWC 表现出明显更高的抑郁和焦虑症状 (dw = .66 (.46–.85)；p <.001)。同样，直接参与显着影响 PTSD 症状的严重程度（dw = .30 (.21–.39)；p <.001）。总体而言，卫生保健专业人员和大多数一线工作人员表现出与疫情爆发后和至少三年后罹患精神疾病的可能风险存在关联。需要立即对接触 COVID-19 的专业人员实施心理健康干预措施。需要进一步的研究来仔细调查长期后果，并寻找中介和缓冲因素。临床心理学家和精神病学家在提供适当干预措施方面的作用至关重要。
The new coronavirus (SARS-CoV-2) shows several similarities with previous outbreaks of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Aim of this systematic review and meta-analysis is to provide evidence of the psychopathologic burden on health care workers (HCWs) of the first two deadly coronavirus outbreaks to get lessons for managing the current burden of COVID-19 outbreak. According to Cochrane Collaboration guidelines and the PRISMA Statement, the study quantified the effects of frontline work on mental health of HCWs. Major databases — Pubmed, Scopus, Embase, Medline, and Web of Science — were searched for observational and case-control studies evaluating mental health indexes reported by front-line work. This study computed the percentage of sample that reported clinically significant levels of psychiatric symptoms. Cohen’s d was used for comparing mental health outcomes of health care workers directly involved in addressing pandemic emergency with a control group that was not directly exposed to such conditions. Pooled effect sizes (dw) were estimated whenever at least three independent studies yielded data. Heterogeneity of findings and bias of publication were estimated as well. Fifteen studies have been selected for a total of 7,393 HCWs. From 9.6% to 51% of HCWs reported symptoms of Post-Traumatic Stress Disorder (PTSD) and from 20% to 75% reported psychiatric symptoms, with a prevalence of anxiety and depression. From one to the three years after outbreak, from 2% to 19% reported PTSD symptoms and from 5% to 90% psychiatric symptoms. Interestingly, HWCs who were directly involved in pandemic emergency showed significantly higher depressive and anxious symptoms (dw = .66 (.46–.85); p <.001) than ones who were not directly exposed. Similarly, the direct involvement significantly affected the severity of PTSD symptoms (dw = .30 (.21–.39); p <.001). Health care professionals in general and most of all frontline workers showed an association with a likely risk of developing psychiatric disorders following outbreaks and for at least three years later. Mental health interventions for professionals exposed to COVID-19 need to be immediately implemented. Further studies are warranted to investigate long-term consequences carefully, and to look for mediating and buffering factors as well. The role of clinical psychologists and psychiatrists in delivering adequate interventions is critically important.
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影响因子：
7
作者：
Huedo-Medina, Tania B.;Sanchez-Meca, Julio;Botella, Juan
通讯作者：
Botella, Juan
影响因子：
3
作者：
Furlan, Andrea D.;Pennick, Victoria;van Tulder, Maurits
通讯作者：
van Tulder, Maurits
影响因子：
3.7
作者：
Hou, Tianya;Zhang, Taiquan;Ni, Chunyan
通讯作者：
Ni, Chunyan
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG
影响因子：
3.8
作者：
Lancee, William J.;Maunder, Robert G.;Goldbloom, David S.
通讯作者：
Goldbloom, David S.