key: cord-0745012-mbqp8p07 authors: Zandifar, Atefeh; Badrfam, Rahim; Mohammadian Khonsari, Nami; Assareh, Marzieh; Karim, Hossein; Azimzadeh, Mehdi; Noori Sepehr, Mohammad; Tajbakhsh, Ramin; Rahimi, Fatemeh; Ghanipour, Nima; Agoushi, Arash; Hassani Gelsefid, Saeed; Etemadi, Fateme; Qorbani, Mostafa title: COVID ‐19 and medical staff's mental health in educational hospitals in Alborz province, Iran date: 2020-06-27 journal: Psychiatry Clin Neurosci DOI: 10.1111/pcn.13098 sha: bf9a13dff8ad96e211f346a493a4c7087468f20d doc_id: 745012 cord_uid: mbqp8p07 nan The COVID-19 pandemic is still ongoing. So far (June 1,2020), more than 6 million people around the world have been infected with the disease, and more than 370,000 have died. 1 Different conditions in the field of COVID-19 compared to the previous conditions in different societies and the existence of the situation with novelty have created special perplexing conditions for many lay public and health care workers (HCWs).HCWs on the other hand, have many concerns about safety and personal protective equipment, assigned tasks in the inpatient department of patients with COVID-19, the potential need to quarantine after work, concerns about getting infected and transmitting the infection to the family and stigma. 2, 3 In the early days of the spread of the disease at the community level, there were other concerns for HCWs. Restrictions on financial and human resources and hospital beds, drug shortages and problems related to restrictions on the possibility of using special hospital facilities such as the use of intensive care units, in managing the situation, caused many problems. 4, 5 Another problem that arose from the limited resources and spread of the disease at the community level was the use of physicians and other personnel of unrelated specialized disciplines in the field of COVID-19 disease to help advance diagnostic and therapeutic processes. This seemed inevitable to health policymakers. The incident raised other concerns about the ability to manage the difficult conditions of hospitalized patients with covid-19 diagnosis for a group of staff. 6 In this situation, in addition to the need to pay attention to the state of mental health among the masses, 7, 8 who may experience fear, anxiety, depression, sleep disorders, suicidal thoughts and other related disorders, 9, 10 it is important to pay attention to the mental health status of the HCWs of patients with COVID-19. Due to the need to determine the mental health status of health care workers for further diagnostic, therapeutic and supportive measures and related planning, in this study, we examined the mental health status of HCWs during COVID-19 pandemic, at the level of all university hospitals in Alborz Province, Iran. The ethics committee of Alborz University of Medical Sciences, Iran, has confirmed this study. (IR.ABZUMS.REC.1399.011, date: 06-04-2020) This study is a cross-sectional study conducted at the level of 9 educational hospitals in Alborz province (multi-centers study) that have accepted patients with COVID-19. The study was conducted by sending an online questionnaire to the staff and collecting and evaluating its results. We used DASS-21 Questionnaire to assess the depression, anxiety, and stress of HCWs. Among health care providers, 41.7%, 51.2%, and 33.9 %, respectively, had degrees of depression, anxiety, and stress. Depression was more common in women, bachelor's degree, residency in medicine, over the age of 40 and doctors and staff in direct contact with patients. Anxiety was more prevalent in women, higher education, being a medical resident, in the age range of 30 to 40 years, nurses, bachelor's degree personnel and staff in direct contact with patients. Also, stress in women, bachelor's degree, residency in medicine, age range 30 to 40 years, doctors and staff in direct contact with patients, has a higher prevalence. (Table 1) There was a positive linear correlation between depression and anxiety, depression and stress, and stress and anxiety among HCWs. This study found a high prevalence of depression, anxiety and stress among COVID-19-related HCWs in Iran. Nearly half of them had some degree of depression. About half of them suffered from anxiety and one-third experienced stress. Physicians and nurses, especially those in the front line, experienced a greater prevalence of these disorders. In terms of employment relationships, medical residents experienced a higher prevalence of anxiety, stress, and depression than other employment groups (Official and Unofficial). In terms of gender, we also saw a similar situation in terms of the prevalence of anxiety, stress and depression in female than male. The high correlation between these mental disorders also emphasizes the need to pay attention to other disorders when identifying one of them. Due to the important role of Health Care Workers, especially during the recent pandemic in the field of COVID-19, health policymakers should pay special attention to the mental health of them. Providing adequate personnel in accordance with the capabilities of health systems, trying to prioritize the personal protective equipment and establishing appropriate mental health care systems as online systems or face-to-face counseling can play an important role in improving the mental health of staff. The authors declare that they have no conflict of interest. Badrfam R, Zandifar A. Coronavirus disease 2019 in Iran: the need for more attention to primary health care. Public Health 2020;182:187. Shariati MB, Ardebili MME, Shalbafan MM. Working in the emergency and inpatient COVID-19 special wards: a different experience for Iranian psychiatric trainees amid the outbreak: Running title: Experience of Iranian psychiatric trainees in COVID-19 special wards. Asian J of Psychiatr 2020. Zandifar World Health Organization,situation-reports Why all COVID-19 Hospitals should have Mental Health Professionals: The importance of mental health in a worldwide crisis Stigma Over COVID-19; New Conception Beyond Individual Sense Fighting COVID-19 in Iran; economic challenges ahead We would like to thank the health care workers who are responsible for the care and treatment of patients with COVID-19. We thank all those who contributed to the various stages of this project.* The patients have given informed consent, and was their anonymity preserved.