The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study

BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a new infectious disease with high transmissibility and morbidity. It has caused substantial mental distress to medical professionals. We aimed to compare the psychological impact of the COVID-19 outbreak between frontline and non-frontline medical workers in China. METHODS: This case-control study recruited 1173 frontline and 1173 age- and sex-matched non-frontline medical workers during the COVID-19 outbreak (February 11 to 26, 2020). A set of online questionnaires were used to measure mental problems (i.e., anxiety, insomnia, and depressive symptoms), and help-seeking behavior and treatment for these mental problems. RESULTS: Frontline medical workers had higher rates of any mental problem (52.6% vs. 34.0%, adjusted OR=1.88, 95% CI=1.57–2.25), anxiety symptoms (15.7% vs. 7.4%, adjusted OR=1.95, 95% CI=1.46–2.61), depressed mood (marginally insignificant; 14.3% vs. 10.1%, adjusted OR=1.32, 95% CI=0.99–1.76) and insomnia (47.8% vs. 29.1%, adjusted OR=1.96, 95% CI=1.63–2.36) than non-frontline medical workers. No significant difference was observed in terms of suicidal ideation (12.0% vs. 9.0%, adjusted OR=1.25, 95% CI=0.92–1.71), help-seeking (4.5% vs. 4.5%, adjusted OR=1.00, 95% CI=0.53–1.87) or treatment (3.4% vs. 2.3%, adjusted OR=1.38, 95% CI=0.54–3.52) for mental problems. LIMITATIONS: The case-control nature of the data precludes causal inferences, and there is a possibility of bias related to self-reports. CONCLUSIONS: Frontline medical workers had more mental problems but comparable help-seeking behaviors and treatment for these problems than non-frontline medical workers. These findings highlight the timely mental support and intervention for medical workers, especially for those on the frontline.