The relationship between post-traumatic stress and positive mental health symptoms among health workers during COVID-19 pandemic in Lombardy, Italy

Background: The COVID-19 pandemic is exposing health workers (HW) worldwide to extreme burden and risk of developing post-traumatic stress disorder (PTSD). This problem emerged in Lombardy, the Italian region where the pandemic exacted the heaviest toll. Study aims were to assess mental health of HW in Lombardy after the peak of COVID-19 related hospitalizations, through the joint evaluation of PTSD and positive mental health; and to explore the potential role of positive mental health in PTSD development. Methods: HW completed an online survey including demographic and work-related information; PTSD Checklist for DSM-5; Mental Health Continuum Short-Form. Analyses comprised calculation of percentages of participants meeting a provisional PTSD and mental health diagnosis (flourishing, moderate, languishing); a binary logistic regression with demographics, work-related features, and positive mental health as predictors, and provisional PTSD diagnosis as outcome. Results: Out of 653 participants, 39.8% received a provisional PTSD diagnosis; 33.4% reported flourishing, 57.7% moderate, and 8.9% languishing mental health. Regression analysis highlighted that women vs. men, nurses vs. technical/rehabilitation HW, frontline vs. second-line workers and languishing vs. moderately mentally healthy HW were more likely to receive a provisional PTSD diagnosis, whereas flourishing participants were more likely not to receive it. No role emerged for job seniority. Limitations: Self-reported PTSD scores, stress symptoms related to COVID-19 considered as a global stressor, cross-sectional study design. Conclusions: Findings suggest the potential usefulness of supporting vulnerable HW categories during massive disease outbreaks through emergency-focused professional training and psychological intervention addressing both positive mental health promotion and PTSD prevention.