Comprehensive Psychiatry 102 (2020) 152202
Contents lists available at ScienceDirect
Comprehensive Psychiatry
journal homepage: www.elsevier.com/locate/comppsych
The mental state and risk factors of Chinese medical staff and medical
students in early stages of the COVID-19 epidemic
Shuang Wu a,1, Zhe Li b,1, Zhixiong Li c, Weiyi Xiang d, Yiwen Yuan b, Yaya Liu b,e, Zhenzhen Xiong a,⁎
a
School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610083, China
b
Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
c
The Third Department of Clinical Psychology, Karamay Municipal People's Hospital, Karamay, Xinjiang 830054, China
d
The West China College of Medicine, Sichuan University, Chengdu 610041, China
e
Zun Yi Psychiatric Hospital, Zunyi, Guizhou 563000, China
a r t i c l e i n f o a b s t r a c t
Objective: This study aimed to investigate the mental state of medical staff and medical students in the early
stages of the SARS-CoV-2 outbreak, as well as analyze the risk factors of serious mental illness (SMI), so as to pro-
vide a scientific basis for further psychological intervention and management.
Keywords: Method: A cross-sectional survey was conducted from February 2–7, 2020. The Kessler 6 Psychological Distress
SARS-CoV-2 Scale and a general information questionnaire were administered on-line to a convenience sample of 548 med-
COVID-19 ical staff and medical students in China. Multivariate binary logistic regression analysis was used to screen the
Serious Mental Illness risk factors of SMI in medical staff and medical students.
Medical staff Results: Of the 505 respondents in the final analysis, 188 (37.23%) were at high risk of SMI. Respondents were at
Medical students significantly higher risk of SMI if they had been suspected of being infected with the SARS-CoV-2 (OR = 7.00, 95%
CI: 1.19–41.14), had relatives suspected of being infected with the SARS-CoV-2 (OR = 23.60, 95% CI:
1.11–501.30), felt concerned towards media coverage of outbreak-related information (OR = 11.95, 95% CI:
3.07–46.57), recently dreamed related to SARS-CoV-2 (OR = 4.21, 95% CI: 2.22–8.01), experienced difficulty in
controlling emotions during SARS-CoV-2 epidemic (OR = 3.25, 95% CI: 1.66–6.37), or spent hours watching out-
breaks per day (OR = 1.29, 95% CI: 1.13–1.46).
Conclusion: Our findings highlight that medical staff and medical students were vulnerable to SMI during the
early stages of the SARS-CoV-2 outbreak and identify the factors associated with SMI which can be used to for-
mulate psychological interventions to improve the mental health. The independent risk factors for SMI among
them are suspicion that they or relatives were infected with the SARS-CoV-2, greater interest in media reports
about the epidemic, frequency of recent dreams related to SARS-CoV-2, difficulty in controlling emotions during
the epidemic, and hours spent watching outbreaks per day.
© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/4.0/).
1. Introduction rate of 5.1% [4]. Due to its high incidence, strong risk of contagion and
asymptomatic transmission, the epidemic situation is severe, and con-
Outbreaks of infectious diseases remain a major problem worldwide. trol is difficult, leading to the strictest prevention and control measures
They have substantial impacts not only on medical treatment, the econ- [5,6]. With widespread work stop-offs, school suspensions and the
omy, and society, but also on the psychological health of healthcare shortage of protective materials, this SARS-CoV-2 epidemic exceeds
workers, which has become a prominent public health problem [1–3]. the coping ability of individuals and society, causing anxiety and panic
The novel coronavirus, designated 2019-nCoV and later SARS-CoV-2, around the world. Recent studies found that 53.8% of the general popu-
is one of the most challenging threats to public health in China and in lation rated the psychological impact of the outbreak as moderate to se-
many other regions around the world. As of July 17th, 2020, vere stress (8.1%), anxiety (28.8%), and depression (16.5%) during the
13,616,593 cases were reported and 585,727 deaths with a case fatality initial phase and showed no significant changes after 4 weeks during
the COVID-19 epidemic in China [7,8]. Serious worries about their phys-
ical health, anger and impulsivity and intense suicidal ideation were sig-
⁎ Corresponding author at: School of Nursing, Chengdu Medical College, No. 601 Tian
Hui Road, Rong Du Avenue, Chengdu, Sichuan 610083, China.
nificantly higher in psychiatric patients than people without psychiatric
E-mail address: (Z. Xiong). illnesses [9]. Psychological impacts may be substantial, especially for
1
These authors contributed equally to this work. healthcare professionals on the frontline of the epidemic. Reports
https://doi.org/10.1016/j.comppsych.2020.152202
0010-440X/© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Contents lists available at ScienceDirect
Comprehensive Psychiatry
journal homepage: www.elsevier.com/locate/comppsych
The mental state and risk factors of Chinese medical staff and medical
students in early stages of the COVID-19 epidemic
Shuang Wu a,1, Zhe Li b,1, Zhixiong Li c, Weiyi Xiang d, Yiwen Yuan b, Yaya Liu b,e, Zhenzhen Xiong a,⁎
a
School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610083, China
b
Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
c
The Third Department of Clinical Psychology, Karamay Municipal People's Hospital, Karamay, Xinjiang 830054, China
d
The West China College of Medicine, Sichuan University, Chengdu 610041, China
e
Zun Yi Psychiatric Hospital, Zunyi, Guizhou 563000, China
a r t i c l e i n f o a b s t r a c t
Objective: This study aimed to investigate the mental state of medical staff and medical students in the early
stages of the SARS-CoV-2 outbreak, as well as analyze the risk factors of serious mental illness (SMI), so as to pro-
vide a scientific basis for further psychological intervention and management.
Keywords: Method: A cross-sectional survey was conducted from February 2–7, 2020. The Kessler 6 Psychological Distress
SARS-CoV-2 Scale and a general information questionnaire were administered on-line to a convenience sample of 548 med-
COVID-19 ical staff and medical students in China. Multivariate binary logistic regression analysis was used to screen the
Serious Mental Illness risk factors of SMI in medical staff and medical students.
Medical staff Results: Of the 505 respondents in the final analysis, 188 (37.23%) were at high risk of SMI. Respondents were at
Medical students significantly higher risk of SMI if they had been suspected of being infected with the SARS-CoV-2 (OR = 7.00, 95%
CI: 1.19–41.14), had relatives suspected of being infected with the SARS-CoV-2 (OR = 23.60, 95% CI:
1.11–501.30), felt concerned towards media coverage of outbreak-related information (OR = 11.95, 95% CI:
3.07–46.57), recently dreamed related to SARS-CoV-2 (OR = 4.21, 95% CI: 2.22–8.01), experienced difficulty in
controlling emotions during SARS-CoV-2 epidemic (OR = 3.25, 95% CI: 1.66–6.37), or spent hours watching out-
breaks per day (OR = 1.29, 95% CI: 1.13–1.46).
Conclusion: Our findings highlight that medical staff and medical students were vulnerable to SMI during the
early stages of the SARS-CoV-2 outbreak and identify the factors associated with SMI which can be used to for-
mulate psychological interventions to improve the mental health. The independent risk factors for SMI among
them are suspicion that they or relatives were infected with the SARS-CoV-2, greater interest in media reports
about the epidemic, frequency of recent dreams related to SARS-CoV-2, difficulty in controlling emotions during
the epidemic, and hours spent watching outbreaks per day.
© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/4.0/).
1. Introduction rate of 5.1% [4]. Due to its high incidence, strong risk of contagion and
asymptomatic transmission, the epidemic situation is severe, and con-
Outbreaks of infectious diseases remain a major problem worldwide. trol is difficult, leading to the strictest prevention and control measures
They have substantial impacts not only on medical treatment, the econ- [5,6]. With widespread work stop-offs, school suspensions and the
omy, and society, but also on the psychological health of healthcare shortage of protective materials, this SARS-CoV-2 epidemic exceeds
workers, which has become a prominent public health problem [1–3]. the coping ability of individuals and society, causing anxiety and panic
The novel coronavirus, designated 2019-nCoV and later SARS-CoV-2, around the world. Recent studies found that 53.8% of the general popu-
is one of the most challenging threats to public health in China and in lation rated the psychological impact of the outbreak as moderate to se-
many other regions around the world. As of July 17th, 2020, vere stress (8.1%), anxiety (28.8%), and depression (16.5%) during the
13,616,593 cases were reported and 585,727 deaths with a case fatality initial phase and showed no significant changes after 4 weeks during
the COVID-19 epidemic in China [7,8]. Serious worries about their phys-
ical health, anger and impulsivity and intense suicidal ideation were sig-
⁎ Corresponding author at: School of Nursing, Chengdu Medical College, No. 601 Tian
Hui Road, Rong Du Avenue, Chengdu, Sichuan 610083, China.
nificantly higher in psychiatric patients than people without psychiatric
E-mail address: (Z. Xiong). illnesses [9]. Psychological impacts may be substantial, especially for
1
These authors contributed equally to this work. healthcare professionals on the frontline of the epidemic. Reports
https://doi.org/10.1016/j.comppsych.2020.152202
0010-440X/© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
