MENTAL HEALTH IN BELGIAN HOSPITAL WORKERS DURING THE FIRST WAVE OF COVID19

Objectives: Exploring anxiety, depression, and insomnia as a network of symptoms and their intensities among hospital workers after the first wave of COVID19.

Methods: 907 hospital workers have completed the survey including 442 Frontline Workers and 465 Hospital Workers. Online surveys were performed in two hospitals from June 6, 2020, and August 8, 2020, in Belgium. Anxiety, depression and insomnia was assessed by the GAD-7, PHQ‑9 and ISI, respectively. We estimated a Directed Acyclic Graph for the items of these questionnaires and networks were compared and described in terms of true positive (connection between two nodes present in both networks), falls positive (connection between two nodes present among Frontline network) and falls negative (connection between two nodes present among Hospital Workers network). Finally, intensity of symptoms was calculated using the total mean score and severity frequency of the three questionnaires.

Results: For both groups, the anxiety, depression, and insomnia items are independent: the three symptomatologies form clusters and do not seem to interact with each other, in both groups. Network comparison revealed 9 true positives, 11 false positives, and 9 false negative. Most of the different connections are found within the symptoms of insomnia. The insomnia symptom network in the Hospital group is characterized by "Difficulty maintaining sleep" as the initiating symptom that results to "Worry". In the Frontline group, "Interference" seems be the initiating symptom, which leads to the Early morning awakening. About intensity of symptoms, Frontline showed a significant higher intensity than Hospital Workers for anxiety, depression, and insomnia. Moreover, there were significantly more workers with moderate symptoms among Frontline than Hospital workers in comparison with “no symptoms” for our three scales.

Conclusion: The network of anxiety and depression are similar between Frontline and Hospital, but not the insomnia network characterized by different initiating symptoms and leading to a different final symptom. In addition, Frontline have significantly higher complaints of anxiety, depression, and insomnia than Hospital workers, which is consistent with the plethora of studies on this topic. These differences in networks should be considered to developing specific treatment of insomnia in these two populations.