Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff*
Authors: Lima-Setta Fernanda , de Moraes Claudia Leite , Silami Pedro Henrique Nunes Costa , Reichenheim Michael Eduardo , de Mello e Silva Juliana Freitas , Stochero Luciane , de Oliveira Mariana Barros Genuíno , Robaina Jaqueline Rodrigues , Rodrigues-Santos Gustavo , de Almeida Carlos Gustavo , Amoretti Carolina Friedrich , Bellinat Ana Paula Novaes , Brandão Igor Bromonschenkel , de Carvalho Patrícia Barbosa , Falcão Ricardo Viana , Gregory Simone Camera , de Lorena Jacques Melissa , Sapolnik Roberto , Jae Claudia Mei Lan , Koliski Adriana , Krauzer João Ronaldo Mafalda , de Lima Lúcio Flávio Peixoto , Lorenzo Vivian Botelho , Cobas Macedo João Henrique Garcia , Zaponi Melek Sandra Lange , Fonseca da Mota Isabele Coelho , Neves Cinara Carneiro , Castro Mirela Alves , Rascão Fernanda Lobo , Massaud-Ribeiro Letícia , Riveiro Paula Marins , Rodrigues Klara Amanda , Scarlato Ana Carolina Cabral Pinheiro , Peres da Silva Thiago , Souza Ana Carolina Miranda C. F. F. , de Araújo Torreão Lara , de Seixas Zeitel Raquel , Alves da Cunha Antonio José Ledo , Prata-Barbosa Arnaldo , de Magalhães-Barbosa Maria Clara ,   on behalf of the Brazilian Research Network in Pediatric Intensive Care (BRnet-PIC)
Published: December 2022

OBJECTIVES:
To assess the prevalence of burnout, anxiety and depression symptoms, and posttraumatic stress disorder (PTSD) in PICU workers in Brazil during the first peak of the COVID-19 pandemic. To compare the results of subgroups stratified by age, gender, professional category, health system, and previous mental health disorders.

DESIGN:
Multicenter, cross-sectional study using an electronic survey.

SETTING:
Twenty-nine public and private Brazilian PICUs.

SUBJECTS:
Multidisciplinary PICU workers.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Self-reported questionnaires were used to measure burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), and PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) in 1,084 respondents. Subjects were mainly young (37.1 ± 8.4 yr old) and females (85%), with a median workload of 50 hours per week. The prevalence of anxiety and depression was 33% and 19%, respectively, whereas PTSD was 13%. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8–24] and 40 [IQR, 33–44], respectively) whereas low in the depersonalization one (2 [IQR, 0–5]), suggesting a profile of overextended professionals, with a burnout prevalence of 24%. Professionals reporting prior mental health disorders had higher prevalence of burnout (30% vs 22%; p = 0.02), anxiety (51% vs 29%; p < 0.001), and depression symptoms (32.5% vs 15%; p < 0.001), with superior PCL-5 scores for PTSD (p < 0.001). Public hospital workers presented more burnout (29% vs 18.6%, p < 0.001) and more PTSD levels (14.8% vs 10%, p = 0.03). Younger professionals were also more burned out (p < 0.05 in all three dimensions).

CONCLUSIONS:
The prevalence of mental health disorders in Brazilian PICU workers during the first 2020 peak of COVID-19 was as high as those described in adult ICU workers. Some subgroups, particularly those reporting previous mental disorders and younger professionals, should receive special attention to prevent future crises.