Neuropsychiatric Disease and Treatment (Mar 2024)
Effect of Surgical Masks and N95 Respirators on Anxiety
Abstract
Yan Zhang,1,* Qiongyao Yang,2– 4,* Qianru Ma,5,* Yuanxiong Wu,5,* Yue Wang,2– 4 Chuanchuan Chen,2– 4 Yitan Yao,2– 4 Ziqiao Feng,2,3 Xiaoping Yuan,2,3 Shengya Shi,2,3 Kai Zhang2,3 1Department of Pneumology, Second People’s Hospital of Anhui Province, Hefei, People’s Republic of China; 2Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People’s Republic of China; 3Anhui Psychiatric Center, Anhui Medical University, Hefei, People’s Republic of China; 4School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People’s Republic of China; 5Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kai Zhang, Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, People’s Republic of China, Tel/Fax +86-551-82324114, Email [email protected]: Masks are designed to reduce the spread of airborne pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although wearing a mask has some adverse effects. The primary objective of this study was to explore the effects of surgical masks and N95 respirators on patients diagnosed with anxiety.Methods: Subjects diagnosed with first-episode anxiety disorders were recruited from outpatient departments between February and July, 2023. A self-administered questionnaire was administered at baseline and at follow-up. The questionnaire addressed demographic information, Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) and Insomnia Severity Index (ISI). Subjects were divided into three groups (n=30 each): control (no mask); surgical mask; and N95 respirator. The Kruskal–Wallis test and repeated measures analysis of variance were used to examine associations between face mask use and emotion.Results: Ninety subjects completed the study, of whom 51 (56.67%) were male and 39 (43.33%) were female. Time and group effects were observed in HAM-A score among the 3 groups. After 4 weeks, mean (± SD) HAM-A score decreased from 32.63± 13.37 to 28.07± 9.33 in the control group, increased from 33.67± 12.47 to 36.80± 10.32 in the surgical mask group, and from 32.33± 14.73 to 41.13± 8.29 in the N95 respirator group, with no sex differences among the 3 groups. HAM-A score was significantly higher in the mask groups than that in the control group at follow-up. Only N95 respirator group exhibited significant time effects on HAM-D and ISI scores, with a decreasing trend in HAM-D score and an opposite trend in ISI score.Conclusion: Prolonged mask use may exacerbate anxiety, especially among those wearing N95 respirator masks. In a post-pandemic environment, governments should improve public health beliefs regarding coronavirus disease 2019 and promote the safety of face mask use, thus reducing the physiological and psychological effects of improper mask use.Keywords: anxiety, COVID-19, health beliefs, mask, N95
