BMJ Open (Jul 2021)
Psychological distress and trauma in doctors providing frontline care during the COVID-19 pandemic in the United Kingdom and Ireland: a prospective longitudinal survey cohort study
- Daniel Horner,
- Jo Daniels,
- Charles Reynard,
- James Foley,
- Blair Graham,
- Mark David Lyttle,
- M Anderson,
- J Browning,
- M Clark,
- S Foster,
- S Hartshorn,
- M Jacobs,
- S Messahel,
- N Mullen,
- J Brown,
- Michael Barrett,
- S Subramaniam,
- S Williams,
- A Ahmed,
- E Williams,
- S Hall,
- Edward Carlton,
- C Bi,
- M Khan,
- R Hannah,
- S Taylor,
- L Dunlop,
- J Gumley,
- K Knight,
- C Williams,
- J Turner,
- B Taylor,
- R Mills,
- M Lim,
- J Evans,
- C O’Connell,
- Tom Roberts,
- A Rai,
- P Singh,
- M Williams,
- S Graham,
- Etimbuk Umana,
- R Taylor,
- S Rahman,
- J Wright,
- J Lynch,
- S Lewis,
- P Fitzpatrick,
- J Ng,
- V Talwar,
- N Ali,
- G Pells,
- P Ellis,
- J Bailey,
- John Cronin,
- J Morgan,
- K Samuel,
- A Ali,
- M Patel,
- R Evans,
- S Morgan,
- A Hill,
- S Rao,
- S Currie,
- C Thomas,
- K Thomas,
- William Hulme,
- Katie Samuel,
- Robert Hirst,
- H Cooper,
- L McKechnie,
- S Pradhan,
- A Brookes,
- W Niven,
- L Kane,
- C Rimmer,
- K Kaur,
- R Stewart,
- T Hussan,
- P Cuthbert,
- M Alex,
- F Barham,
- R Macfarlane,
- M Jee Poh Hock,
- C Ward,
- C Weegenaar,
- O Williams,
- S Manou,
- MH Elwan,
- C Nunn,
- C Reynard,
- L How,
- D McConnell,
- J Muller,
- H Malik,
- K Challen,
- C Magee,
- S Pintus,
- S Langston,
- C Szekeres,
- L Kehler,
- C Leech,
- Y Moulds,
- A Mackay,
- R Wright,
- A Saunders,
- S Naeem,
- N Cherian,
- C Boulind,
- L Brown,
- E Grocholski,
- A Tabner,
- M Colmar,
- D Raffo,
- L Somerset,
- C Holmes,
- L Armstrong,
- S Collins,
- J Lowe,
- J Ritchie,
- F Wood,
- M Mohammad,
- S Wilson,
- R O'Sullivan,
- R Ellis,
- M MacKenzie,
- B Johnson,
- R Das,
- L Robinson,
- P Turton,
- L Robertson,
- A Robertson,
- J Hunt,
- João Vinagre,
- H Millar,
- R Freeman,
- A Corfield,
- R McQuillan,
- A Hormis,
- L Mackenzie,
- S Sharma Hajela,
- J Phizacklea,
- J Maney,
- K Malik,
- D Metcalfe,
- N Mathai,
- S Timmis,
- A Sattout,
- R Newport,
- E Fadden,
- D Bawden,
- B O'Hare,
- C Roe,
- D Bewick,
- F Taylor,
- L Barnicott,
- A Charlton,
- L McCrae,
- C Munday,
- E Godden,
- A Turner,
- R Sainsbury,
- A Lawrence-Ball,
- R House,
- S Patil,
- I Skene,
- M Winstanley,
- N Tambe,
- D Mawhinney,
- M Elkanzi,
- T Perry,
- W Kan,
- M Cheema,
- A Clarey,
- R Greenhalgh,
- A Gulati,
- S Marimuthu,
- K Webster,
- A Howson,
- R Doonan,
- B Shrestha,
- L Stanley,
- A Trimble,
- E Colley,
- J Lockwood,
- T Mohamed,
- H Jarman,
- S Ramraj,
- V Worsnop,
- N Masood,
- R McLatchie,
- A Peasley,
- S Bongale,
- U Bait,
- S Nagendran,
- A Hay,
- F Mendes,
- H Raybould,
- T Baron,
- C Ponmani,
- M Depante,
- R Sneep,
- Z Al-Janabi,
- A Rainey,
- N Marriage,
- B Mallon,
- J McLaren,
- S Hart,
- M Elsheikh,
- L Cocker,
- S Keers,
- K L Vincent,
- D Craver,
- N Sarja,
- N Moultrie,
- M Viegas,
- S Purvis,
- E Wooffinden,
- C Davies,
- S Foreman,
- A Da-Costa,
- C Ngua,
- S Duckitt,
- N Hoskins,
- J Fryer,
- T Hine,
- F Ihsan,
- L Frost,
- H Abdullah,
- K Bader,
- K Gray,
- M Manoharan,
- R Muswell,
- P Amiri,
- M Bonsano,
- S Shrivastava,
- F Raza,
- E Christmas,
- M Riyat,
- L O'Rourke,
- H Knott,
- K Adeboye,
- M Ramazany,
- K Iftikhar,
- N Abela,
- R Darke,
- D Maasdorp,
- H Murphy,
- H Edmundson,
- c Orjioke,
- L Harwood,
- D Worley,
- K Lines,
- W Collier,
- J Everson,
- D Ranasinghe,
- N Maleki,
- A Stafford,
- S Gokani,
- M Charalambos,
- A Olajide,
- H Ahmad,
- K Holzman,
- A Patton,
- S Gilmartin,
- S Uí Bhroin,
- S Kukaswadia,
- C Prendergast,
- C Dalla Vecchia,
- M Grummell,
- I Grossi,
- B MacManus,
- A Boyle,
- A Waite,
- J Vinagre,
- D George,
- C Battle,
- J Anandarajah,
- I Hancock,
- D Manthalapo,
- Ramesh Babu,
- FM Burton,
- I Musliam,
- Veettil Asif,
- M JeePoh Hock
Affiliations
- Daniel Horner
- Trainee Emergency Research Network, The Royal College of Emergency Medicine, London, UK
- Jo Daniels
- senior lecturer in clinical psychology
- Charles Reynard
- Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK
- James Foley
- Emergency Medicine, Galway University Hospitals, Galway, Ireland
- Blair Graham
- Faculty of Health and Human Sciences, University of Plymouth Faculty of Health and Human Sciences, Plymouth, UK
- Mark David Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
- M Anderson
- J Browning
- M Clark
- S Foster
- S Hartshorn
- M Jacobs
- S Messahel
- N Mullen
- J Brown
- 2Groundswell, London, UK
- Michael Barrett
- School of Medicine, Women`s and Children`s Health, University College Dublin, Dublin, Ireland
- S Subramaniam
- S Williams
- Department of Pediatrics, Medical Center of Central Georgia, Macon, GA
- A Ahmed
- 1Internal Medicine, Rheumatology & Clinical Immunology Subspeciality, Kasr Alainy
- E Williams
- S Hall
- 2Cabrini Health and Monash University, Melbourne, Australia
- Edward Carlton
- Trainee Emergency Research Network, The Royal College of Emergency Medicine, London, UK
- C Bi
- M Khan
- R Hannah
- S Taylor
- L Dunlop
- J Gumley
- K Knight
- C Williams
- Department of Neurology, School of Veterinarian Medicine, University of California Davis, Davis, California, 95618, USA
- J Turner
- MUSC, Charleston, SC
- B Taylor
- R Mills
- M Lim
- 1School of Medicine
- J Evans
- Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, UK
- C O’Connell
- Tom Roberts
- Trainee Emergency Research Network, The Royal College of Emergency Medicine, London, UK
- A Rai
- 7West Virginia University, Morgantown, WV, USA
- P Singh
- M Williams
- S Graham
- 3University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA
- Etimbuk Umana
- Wellcome-Wolfson Institute for Experimental Medicine, Queen`s University Belfast, Belfast, UK
- R Taylor
- 1Research Institute of Primary Care and Health Sciences, Keele University, Keele
- S Rahman
- J Wright
- 2Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- J Lynch
- S Lewis
- P Fitzpatrick
- J Ng
- Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
- V Talwar
- N Ali
- G Pells
- P Ellis
- J Bailey
- 1School of Health Sciences, Bangor University, Bangor, UK
- John Cronin
- 1Emergency Department, St Vincent’s University Hospital, Ireland
- J Morgan
- K Samuel
- A Ali
- Neurology, University of Toledo, Toledo, OH
- M Patel
- R Evans
- S Morgan
- A Hill
- S Rao
- S Currie
- C Thomas
- K Thomas
- Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, Hippokration General Hospital, Athens, Greece
- William Hulme
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
- Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
- Robert Hirst
- Department of Anaesthesia, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
- H Cooper
- L McKechnie
- S Pradhan
- A Brookes
- W Niven
- L Kane
- C Rimmer
- K Kaur
- 2Medical Student, Keele University, Keele, United Kingdom
- R Stewart
- T Hussan
- P Cuthbert
- M Alex
- F Barham
- R Macfarlane
- M Jee Poh Hock
- C Ward
- C Weegenaar
- O Williams
- S Manou
- MH Elwan
- C Nunn
- C Reynard
- 1Pfizer UK, Tadworth, UK
- L How
- D McConnell
- J Muller
- 2University of Basel, Switzerland, Basel., Switzerland
- H Malik
- K Challen
- C Magee
- S Pintus
- S Langston
- C Szekeres
- L Kehler
- C Leech
- Y Moulds
- A Mackay
- R Wright
- A Saunders
- S Naeem
- 4 Emergency Department, Barts Health NHS Trust, London, UK
- N Cherian
- C Boulind
- L Brown
- 7 Emergency Department, Brighton and Sussex University Hospitals NHS Trust, Worthing, UK
- E Grocholski
- A Tabner
- M Colmar
- D Raffo
- L Somerset
- C Holmes
- L Armstrong
- S Collins
- J Lowe
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- J Ritchie
- F Wood
- M Mohammad
- S Wilson
- R O'Sullivan
- R Ellis
- M MacKenzie
- B Johnson
- 3University of Alabama at Birmingham, Birmingham
- R Das
- L Robinson
- 1MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- P Turton
- L Robertson
- A Robertson
- 4Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA
- J Hunt
- João Vinagre
- College of Anaesthesiologists of Ireland, Dublin, Ireland
- H Millar
- R Freeman
- A Corfield
- R McQuillan
- A Hormis
- L Mackenzie
- Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
- S Sharma Hajela
- J Phizacklea
- J Maney
- K Malik
- D Metcalfe
- N Mathai
- S Timmis
- A Sattout
- R Newport
- E Fadden
- D Bawden
- B O'Hare
- C Roe
- D Bewick
- F Taylor
- L Barnicott
- A Charlton
- L McCrae
- 5 Academic Centre for Defence Healthcare Engagement, Royal Centre for Defence Medicine, Birmingham, Birmingham, UK
- C Munday
- E Godden
- A Turner
- 1Lancashire Teaching Hospitals, Preston, UK
- R Sainsbury
- A Lawrence-Ball
- R House
- S Patil
- I Skene
- M Winstanley
- N Tambe
- D Mawhinney
- M Elkanzi
- T Perry
- W Kan
- M Cheema
- A Clarey
- R Greenhalgh
- Emergency Medicine Department, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- A Gulati
- S Marimuthu
- K Webster
- A Howson
- R Doonan
- B Shrestha
- L Stanley
- A Trimble
- E Colley
- J Lockwood
- T Mohamed
- H Jarman
- S Ramraj
- V Worsnop
- N Masood
- R McLatchie
- A Peasley
- S Bongale
- U Bait
- S Nagendran
- A Hay
- F Mendes
- H Raybould
- T Baron
- C Ponmani
- M Depante
- R Sneep
- Z Al-Janabi
- A Rainey
- N Marriage
- B Mallon
- J McLaren
- S Hart
- M Elsheikh
- L Cocker
- S Keers
- K L Vincent
- D Craver
- N Sarja
- N Moultrie
- M Viegas
- S Purvis
- E Wooffinden
- C Davies
- 2The Institute of Clinical Science and Technology, Cardiff, UK
- S Foreman
- A Da-Costa
- C Ngua
- S Duckitt
- N Hoskins
- J Fryer
- T Hine
- F Ihsan
- L Frost
- H Abdullah
- K Bader
- K Gray
- M Manoharan
- R Muswell
- P Amiri
- M Bonsano
- S Shrivastava
- F Raza
- E Christmas
- M Riyat
- L O'Rourke
- H Knott
- K Adeboye
- M Ramazany
- K Iftikhar
- N Abela
- R Darke
- D Maasdorp
- H Murphy
- H Edmundson
- c Orjioke
- L Harwood
- D Worley
- K Lines
- W Collier
- J Everson
- D Ranasinghe
- N Maleki
- A Stafford
- S Gokani
- M Charalambos
- A Olajide
- H Ahmad
- 1Bristol-Myers Squibb, Princeton
- K Holzman
- A Patton
- S Gilmartin
- S Uí Bhroin
- S Kukaswadia
- C Prendergast
- C Dalla Vecchia
- M Grummell
- I Grossi
- B MacManus
- A Boyle
- A Waite
- J Vinagre
- D George
- C Battle
- J Anandarajah
- I Hancock
- D Manthalapo
- Ramesh Babu
- Pediatric Urology, Sri Ramachandra University Medical College, Chennai, India
- FM Burton
- I Musliam
- Veettil Asif
- M JeePoh Hock
- DOI
- https://doi.org/10.1136/bmjopen-2021-049680
- Journal volume & issue
-
Vol. 11,
no. 7
Abstract
Objectives The psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of multiple pandemic waves, longitudinal data on the impact of COVID-19 are vital to ensure an adequate psychological care response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in frontline doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.Design A prospective online three-part longitudinal survey.Setting Acute hospitals in the UK and Ireland.Participants Frontline doctors working in emergency medicine, anaesthetics and intensive care medicine during the first wave of the COVID-19 pandemic in March 2020.Primary outcome measures Psychological distress and trauma measured using the General Health Questionnaire-12 and the Impact of Events-Revised.Results The initial acceleration survey distributed across networks generated a sample of 5440 doctors. Peak and deceleration response rates from the original sample were 71.6% (n=3896) and 56.6% (n=3079), respectively. Prevalence of psychological distress was 44.7% (n=1334) during the acceleration, 36.9% (n=1098) at peak and 31.5% (n=918) at the deceleration phase. The prevalence of trauma was 23.7% (n=647) at peak and 17.7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12.6% (n=343) at peak and 10.1% (n=276) at deceleration. Worry of family infection due to clinical work was the factor most strongly associated with both distress (R2=0.06) and trauma (R2=0.10).Conclusion Findings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a) provision of vital equipment to mitigate physical and psychological harm, (b) increased awareness and recognition of signs of psychological distress and (c) the development of clear pathways to effective psychological care.Trial registration number ISRCTN10666798.
