Individual Perceived Stress Mediates Psychological Distress in Medical Workers During COVID-19 Epidemic Outbreak in Wuhan

BACKGROUND: Since the novel coronavirus disease (COVID-19) outbreak in Wuhan, thousands of medical workers have been dispatched to support Wuhan against the virus. The purpose of this study was to identify the independent risk factors for psychological distress in order to develop a more effective strategy and precise evidence-based psychological intervention for medical workers. METHODS: This multisite cross-sectional survey recruited doctors and nurses from local and nonlocal medical teams working at 16 hospitals in Wuhan to complete this online survey from February to March, 2020. Psychological status was evaluated through Perceived Stress Scales (PSS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Acute Stress Disorder Scale (ASDS). RESULTS: Of 966 participants, the prevalence of stress (95.9%), depression (46.0%) and anxiety (39.3%) were high. Local medical workers exhibited even higher scores of PSS, PHQ-9, GAD-7 and ASDS than those from outside Hubei (P<0.001). Females had more severe perceived stress, depression and anxiety than males (P<0.001). Multiple logistic regression showed that perceived stress is associated with increased odds of depression (OR=1.413; 95% CI: 1.338–1.493; P<0.001) and anxiety (OR=1.515; 95% CI: 1.407–1.631; P<0.001). CONCLUSION: Our findings demonstrated a high prevalence of stress, depression, anxiety and acute distress among medical workers on the front-line during the COVID-19 outbreak in Wuhan. The level of psychological impact may be mediated by individual perceptions of stressful events.