key: cord-0755587-7o615e3s authors: Elsaie, Mohamed L.; Hasan, Mohamed S.; Zaky, Mohamed S.; Hussein, Sherief M.; Kadah, Ahmed S.; Omar, Ahmed M. title: Implication of COVID‐19 on the mental health of Egyptian dermatologists: A cross‐sectional study date: 2021-08-22 journal: J Cosmet Dermatol DOI: 10.1111/jocd.14390 sha: ae0102b7c1593f10370593cad0500a0f90f0d293 doc_id: 755587 cord_uid: 7o615e3s BACKGROUND: Major epidemic outbreaks create an increased demand for healthcare workers (HCWs) and pose increased health risk and psychological distress to them as well. AIM: The aim of this cross sectional study was to find out the prevalence of depression, anxiety and stress among Egyptian dermatologists and their possible predictor factors. PATIENTS/METHODS: A cross sectional study was designed and data were collected using structured self‐administered online depression, anxiety, and stress scale (DASS‐21). RESULTS: The depression scale of DASS was 18.98 ± 9.56 among which 38% of dermatologists had either severe or extremely severe depression and 34.2% complained of moderate depression. Meanwhile, the anxiety scale was 12.92 ± 7.75 and 35.4 % of surveyed dermatologists had either severe or extremely severe anxiety. Thirty three percent of dermatologists were normal on stress score. Female dermatologists possessed more significant depression and stress than males (19.70 ± 9.71 vs. 16.62 ± 8.68, p = 0.003; 21.42 ± 9.53 vs. 17.40 ± 8.49, p <0.001 respectively). On the contrary, male dermatologists expressed more anxiety than female dermatologists however this was not statistically significant (13.26 ± 7.99 vs. 12.82 ± 7.69, p = 0.625). CONCLUSION: To our knowledge, this is the first study to explore the differential impacts of the COVID‐19 pandemic on Egyptian dermatologists. Mental health care and support are of extreme importance to physicians mid this pandemic. Major epidemic outbreaks create an increased demand for healthcare workers (HCWs) and pose increased health risk to them as well. 1 It is worth mentioning that during initial phase of COVID-19 outbreak, and 29% of all hospitalized patients were HCWs. 2 The constant increasing of infected cases, newer waves of the virus, increase in death tolls among physicians and uncertainty and scarcity of vaccination in many parts of the world to date while devising this study, extensive media pressure and plethora of rumors had all contributed to increased mental burden and anxiety of physicians and medical teams. 3 Such mentally exhaustive situations may negatively impact mental and emotional health of physicians and healthcare workers as such. 4 The number of Egyptian physicians infected by corona virus has increased alarmingly, and their death toll had reached 327 at the time of writing this study while only 1327 had received vaccination. 5 Despite the expanding literature on COVID-19's implications on mental health, little information about mental health in dermatologists is available in literature and none is available regarding Egyptian dermatologists. The aim of this cross-sectional study was to find out the prevalence of depression, anxiety, and stress among Egyptian dermatologists and their possible predictor factors. A cross-sectional web-based survey was conducted from December 15, 2020 to January 15, 2021. A Google form designed questionnaire was created and distributed to public sector Dermatologists through emails and social platforms (WhatsApp and Facebook). The questionnaire consisted of two main parts. Part one included sociodemographic and work-related information of the participants while part two measured mental health using the depression, anxiety, and stress scale (DASS-21). 6 The Depression, Anxiety, and Stress Scale-21 Items (DASS-21) is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. 6 Questions 3, 5, 10, 13, 16, 17, and 21 formed the depression subscale. According to the scores, depression was divided into either normal (0-9), mild (10) (11) (12) (13) , moderate (14) (15) (16) (17) (18) (19) (20) , severe (21-27), or extremely severe (28-42). Questions 2, 4, 7, 9, 15, 19 , and 20 formed the anxiety subscale. According to the scores, anxiety was divided into either normal (0-7), mild (8) (9) , moderate (10) (11) (12) (13) (14) , severe (15-19), or extremely severe . Questions 1, 6, 8, 11, 12, 14, and 18 formed the stress subscale. According to the scores, stress was divided into either normal (0-14), mild (15) (16) (17) (18) , moderate (19) (20) (21) (22) (23) (24) (25) , severe (26-33), or extremely severe (34-42). In the present study used the following cutoffs, depression ≥10; anxiety ≥7 and stress ≥14. 7 Scores on the DASS-21 were multiplied by 2 to calculate the final score. After excluding all partially responded and incomplete question- Multivariable logistic regression analysis and its association with independent variables revealed prevalence of anxiety among 321 Of all emotional states, stress symptoms were the least frequently reported by all respondents (7.3%). Stress was significantly associ- Among all of the demographic variables, age was a common predictor of DAS with and without adjusting predictor variables. Gender of the respondents significantly associated and predicted higher depression and stress while predictors of anxiety with and without adjusting variables were residence and number of work hours Table 6 . To the best of our knowledge, it is the first study to assess the psy- which was comparable to high rates of anxiety (67.5%) reported among HCWs in Spain. 21 In Wuhan, China, the overall prevalence of psychological disturbance in HCWs (healthcare workers) affected 63% of healthcare workers throughout different waves of the pandemic. 22 These higher anxiety levels in the presented study and across the globe may be due to the fact that majority of HCWs worldwide had no experience in managing similar pandemics in the past. 14 The frequency of stress among dermatologists in this study was 67% which was comparable to values reported in Chinese HCWs (71.5%). 18 Other studies reported rates of stress among HCWs to be (6.6%) in Singapore, 9 In conclusion and as psychological outcomes are increasingly recognized to emerge as a consequence of COVID-19 and it is of paramount importance to self-recognize psychological distress among dermatologists to guarantee their mental health and prosperity. No conflict of interest. The study had received ethical committee permits. Data are available upon request from corresponding author. Mohamed L. Elsaie https://orcid.org/0000-0001-7541-5241 Mohamed S. Hasan https://orcid.org/0000-0001-8814-7741 Mental health care for medical staff in China during the COVID-19 outbreak COVID-19 in Wuhan: immediate psychological impact on 5062 health workers The mental health of healthcare workers in the COVID-19 pandemic: a systematic review Protecting Healthcare Workers during the coronavirus disease 2019 (COVID-19) outbreak: lessons from Taiwan's severe acute respiratory syndrome response COVID-19 related occupancy rate decline at university hospitals: Higher Education Minister The depression anxiety stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates Systematic review of the measurement properties of the depression anxiety stress scales-21 by applying updated COSMIN methodology Psychological Impact of the COVID-19 pandemic on health care workers in Singapore A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak Health care workers mental health during the first weeks of the SARS-CoV-2 Pandemic in Switzerland: a cross-sectional study Mental health outcomes among frontline and second-line health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Italy Mental Health and health-related quality-of-life outcomes among frontline health workers during the peak of COVID-19 outbreak in Vietnam: a crosssectional study Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019 Assessing the impact of COVID-19 on the mental health of healthcare workers in three Metropolitan Cities of Pakistan Coping with depression and anxiety in Egyptian physicians during COVID-19 pandemic Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics Staff mental health self-assessment during the COVID-19 outbreak Mental health status of doctors and nurses during COVID-19 epidemic in China Factors associated with mental health outcomes across healthcare settings in Oman during COVID-19: frontline versus non-frontline healthcare workers Mental health during and after the COVID-19 emergency in Italy Psychological symptoms of the outbreak of the COVID-19 confinement in Spain Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study Sleep disturbance and psychological profiles of medical staff and non-medical staff during the early outbreak of COVID-19 in Hubei Province Therapeutic implications of prevalence and predictor risk factors for burn out syndrome in Egyptian dermatologists: a cross sectional study Break the silence: physician suicide in the time of COVID-19 Sex differences in depression and anxiety disorders: potential biological determinants