Psychological symptoms and related risk factors among healthcare workers and medical students during the early phase of the COVID-19 pandemic in Japan

Aim: The aim of this study was to investigate the mental health status of healthcare workers and medical students during the early phase of the COVID-19 pandemic. Methods: An online questionnaire was administered to 637 students and 3189 healthcare workers from May to July, 2020. The patient healthcare questionnaire-9 (PHQ-9) and state anxiety (A-State) of the state-trait anxiety inventory-form (STAI) were used to assess depression and anxiety symptoms, respectively. Individuals were categorized into severe (15 or higher) depression and severe (50-51 or higher) anxiety groups. Results: Healthcare workers and those taking care of COVID-19 patients had a higher risk of severe depression (PHQ-9 scores >15) than other comparison groups. Students and men also had a higher risk of severe anxiety (STAI>50-51). Multivariable logistic regression analysis showed that healthcare workers had a fivefold higher risk of developing severe depression symptoms (adjusted odds ratio [OR]=4.99, confidence interval [CI] 2.24-5.97, P-value<0.001) and those taking care of COVID-19 patients had 2.8-fold higher risk of developing severe depression symptoms (OR 2.75, CI 1.36-5.53, P-value=0.005). Conclusion: Both medical students and healthcare workers have been experiencing depression and anxiety symptoms during the first wave of the pandemic. Our findings showed a high rate of severe anxiety symptoms in medical students and a high rate of severe depression symptoms in healthcare workers. Those who treated COVID-19 patients were at greater risk of developing major depressive disorder than those who treated non-COVID-19 patients.