Virginia Research Day 2021

An Assessment of Mental Health Outcomes During the COVID-19 Pandemic Edward Magalhaes, PhD., LPC; Alexis Stoner, PhD., MPH; Robert Schranze, OMS-IV; Josh Palmer, MPH, OMS-IV; Savannah Grandy, OMS-IV; Edward Via College of Osteopathic Medicine - Virginia Campus (Blacksburg, VA) and Carolinas Campus (Spartanburg, SC) Abstract Results Results

There have been various studies evaluating the psychological and behavioral response to disasters and pandemics among healthcare workers. Most recently, researchers in Wuhan found that a considerable proportion of healthcare workers reported increased depression, anxiety, insomnia, and stress during the peak of the COVID-19 pandemic in China (Lai et al, 2020). Pandemic healthcare workers are often at increased risk for stress and anxiety due to unclear/changing policies, illness stigma, and altered home/work boundaries (Morganstein et al, 2020). This study sought to assess the impact of the COVID-19 pandemic on mental health outcomes (anxiety, depression, and stress) of a sample of individuals 18 and older across 13 states. We utilized an anonymous online survey, which collected demographical information and utilized the GAD-7, PHQ-9, and IES-R to help assess levels of anxiety, depression, and stress among participants. A total of 1356 participants completed the survey, with significant levels (p<.05) of difference seen across age, gender, educational level, and marital status. Prior diagnosis and access to telehealth also showed to have a significant impact (p<.05) on psychological distress. Overall, this study has helped to identify individuals who may be at greater risk for mental health outcomes due to the COVID-19 pandemic. The following is a cross-sectional study using a survey methodology approach to describe the impact of the COVID-19 pandemic on mental health outcomes. This anonymous survey included a 7-item Generalized Anxiety Disorder scale (GAD-7) to assess anxiety, a 9-item Patient Health Questionnaire (PHQ-9) to assess depression, and a 22-item Impact of Event Scale Revised (IES-R) to assess stress. The survey was distributed to adults 18 years of age or older throughout the following states: Massachusetts, New York, New Jersey, Pennsylvania, Ohio, Virginia, North Carolina, South Carolina, Florida, Alabama, Louisiana, California, and Washington. Distribution was employed using VCOM’s clinical sites, hospital systems, medical associations, community health and outreach organizations, and social media platforms. Analyses included descriptive statistics, chi square, and fisher exact to test for significance (p<.05) between groups. Methods

This study indicates that specific risk factors may be significantly associated with reported mental health outcomes during the COVID-19 pandemic. For instance, nurses (who are identified as a target population that should receive early and often mental health screenings), reported to have the highest levels of anxiety among healthcare workers. Similarly, our study aligns with previous research that identified parents who are heavily involved with school to be an at-risk population for increased stress and anxiety during pandemics (Morganstein et al, 2020). This study may provide better insight into who may be at greater risk of developing adverse mental health outcomes during future pandemics. As the pandemic continues to evolve, it is important to allocate mental health resources to populations, such as those discussed above, that may be at a greater risk for adverse mental health outcomes. We feel that our study can be used along with others to further identify these specific populations and the importance of mental health services when access is limited. (p<.05) amongst age, gender, and education level of respondents. In Table 4 , IES-R levels significantly differed (p<.05) according to age, gender, education, and marital status. Additionally, there was a significant difference between healthcare and non-healthcare workers levels with regards to their PHQ-9 and IES-R levels (p=0.02 and p=0.028). IES-R levels significantly differed (p<.05) among types of healthcare workers with over half (54.1%) of those who reported severe levels identifying as nurses. There was a significant difference in reported PHQ-9 and GAD-7 levels among those who had a prior mental health diagnosis before the pandemic (p<.05). While having a child in school was not a significant contributor to differences in GAD-7 levels, anxiety levels significantly differed according to level of involvement in their children’s school (p=0.037). Geographical location had no significance on anxiety, depression, and stress levels. Conclusions A total of 1356 participants completed the survey. As seen in Table 2 , GAD-7 levels differed significantly (p<.05) according to age, gender, education level, and marital status. PHQ-9 levels in Table 3 demonstrate a significant difference

Table 2: GAD-7

Table 1: Demographics

Table 3: PHQ-9

Table 4: IES-R

References

1. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., . . . Hu, S. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3 (3). doi:10.1001/jamanetworkopen.2020.3976 2. Morganstein, J. C., & Ursano, R. J. (2020). Ecological Disasters and Mental Health: Causes, Consequences, and Interventions. Frontiers in Psychiatry, 11 . doi:10.3389/fpsyt.2020.00001 3. Kohrt, B., & Mendenhall, E. (2016). Global mental health: Anthropological perspectives . London: Routledge. 4. Ursano, R., Raphael, B., Weisaeth, L., & Fullerton, C. S. (2017). Textbook of disaster psychiatry . Cambridge: Cambridge University Press.

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