Abstract：
Frontline healthcare workers (FHCWs) responding to the COVID-19 pandemic develop posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms. Such symptoms are associated with burnout, occupational and relational difficulties. In the current study, we examined the prospective association between acute transdiagnostic COVID-19-related PTSD, MDD, and GAD symptoms at pandemic outset, and burnout and functional difficulties several months later in FHCWs in New York City.
Wave 1 symptoms of COVID-19-related PTSD, MDD, and GAD, were assessed in 787 FHCWs from April 14 to May 11th, 2020. Burnout and occupational difficulties were assessed at wave 1 and wave 2, approximately 7 months later.
After adjusting for wave 1 burnout, wave 1 MDD symptoms, particularly sleep difficulties, loss of interest, and feeling tired/having little energy, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 work difficulties, MDD and PTSD symptoms, particularly feeling tired/having little energy, loss of interest, and negative expectations of self/world, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 relationship difficulties, MDD, GAD, and PTSD symptoms, particularly depressed mood, irritability, and appetite disturbance, explained 26% incremental variance in this outcome.
Results highlight psychiatric symptoms assessed during the acute phase of the COVID-19 pandemic that may help predict burnout and work and relationship difficulties in FHCWs. Early interventions aimed at ameliorating transdiagnostic symptoms of MDD, PTSD, and GAD may help mitigate risk for burnout and functional difficulties in this population.
Wave 1 symptoms of COVID-19-related PTSD, MDD, and GAD, were assessed in 787 FHCWs from April 14 to May 11th, 2020. Burnout and occupational difficulties were assessed at wave 1 and wave 2, approximately 7 months later.
After adjusting for wave 1 burnout, wave 1 MDD symptoms, particularly sleep difficulties, loss of interest, and feeling tired/having little energy, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 work difficulties, MDD and PTSD symptoms, particularly feeling tired/having little energy, loss of interest, and negative expectations of self/world, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 relationship difficulties, MDD, GAD, and PTSD symptoms, particularly depressed mood, irritability, and appetite disturbance, explained 26% incremental variance in this outcome.
Results highlight psychiatric symptoms assessed during the acute phase of the COVID-19 pandemic that may help predict burnout and work and relationship difficulties in FHCWs. Early interventions aimed at ameliorating transdiagnostic symptoms of MDD, PTSD, and GAD may help mitigate risk for burnout and functional difficulties in this population.
摘要：
对COVID-19大流行作出反应的前线医护人员(FHCWs)发展为创伤后应激障碍(PTSD)，抑郁症（MDD）和广泛性焦虑症（GAD）症状。这些症状与倦怠有关，职业和关系困难。在目前的研究中,我们研究了急性确诊COVID-19相关PTSD之间的前瞻性关联，MDD,和GAD在大流行开始时的症状，几个月后，纽约市的FHCW出现了倦怠和功能困难。
COVID-19相关PTSD的第1波症状，MDD,GAD,从4月14日至5月11日，在787个FHCW中进行了评估，2020年。大约7个月后，在第1波和第2波评估了职业倦怠和职业困难。
调整为第1波燃尽后，第1波MDD症状，特别是睡眠困难，利息损失,感到疲倦/精力不足，共同解释了这一结果中42%的增量差异。针对第1波工作困难进行调整后，MDD和PTSD症状,特别是感到疲倦/精力不足，利息损失,对自我/世界的负面期望，共同解释了这一结果中42%的增量差异。在调整了第一波关系困难之后，MDD,GAD,和创伤后应激障碍症状，尤其是抑郁的情绪,烦躁，和食欲紊乱，解释了这一结果中26%的增量差异。
结果突出了在COVID-19大流行急性期评估的精神症状，这可能有助于预测FHCW的倦怠、工作和关系困难。早期干预旨在改善MDD的诊断症状，创伤后应激障碍,和GAD可能有助于减轻该人群的倦怠和功能困难的风险。
COVID-19相关PTSD的第1波症状，MDD,GAD,从4月14日至5月11日，在787个FHCW中进行了评估，2020年。大约7个月后，在第1波和第2波评估了职业倦怠和职业困难。
调整为第1波燃尽后，第1波MDD症状，特别是睡眠困难，利息损失,感到疲倦/精力不足，共同解释了这一结果中42%的增量差异。针对第1波工作困难进行调整后，MDD和PTSD症状,特别是感到疲倦/精力不足，利息损失,对自我/世界的负面期望，共同解释了这一结果中42%的增量差异。在调整了第一波关系困难之后，MDD,GAD,和创伤后应激障碍症状，尤其是抑郁的情绪,烦躁，和食欲紊乱，解释了这一结果中26%的增量差异。
结果突出了在COVID-19大流行急性期评估的精神症状，这可能有助于预测FHCW的倦怠、工作和关系困难。早期干预旨在改善MDD的诊断症状，创伤后应激障碍,和GAD可能有助于减轻该人群的倦怠和功能困难的风险。
