Experiences of coping with the first wave of COVID-19 epidemic in Philadelphia, PA: Mixed methods analysis of a cross-sectional survey of worries and symptoms of mood disorders

Changes in Anxiety and Depression Over the First Year of COVID-19 Pandemic in Philadelphia, PA: Work Characteristics and Mental Health Supports

OBJECTIVE

We investigated the change in anxiety and depression in a general population cohort over the first year of COVID-19 pandemic in relation to work characteristics and mental health support.

METHODS

We administered questionnaires to a convenience sample in Greater Philadelphia, in summer of 2020 and a year later. With more than 60% response rate, 461 people had repeated measurements.

RESULTS

Anxiety declined but depression increased in the cohort after a year of COVID-19 pandemic. Perceived increase in support from family and trade unions, stable employment, and professional mental health support were protective. Depression scores worsened mostly in healthcare, higher education, and manufacturing industries.

CONCLUSIONS

We observed that while anxiety dissipated over the first year of COVID-19 pandemic, depression worsened, perhaps more so in some industries and where mental health support faltered over time.

Pride and adversity among nurses and physicians during the pandemic in two US healthcare systems: a mixed methods analysis

Background

Our aims were to examine themes of the most difficult or distressing events reported by healthcare workers during the first wave of COVID-19 pandemic in two US health care systems in order to identify common themes and then to relate them to both behavioral theory and measures of anxiety and depression.

Methods

We conducted a cross-sectional survey of nurses and physicians during the early phases of the COVID-19 pandemic in the US. An emailed recruitment letter was sent, with about half choosing to supply open-ended responses relevant to thematic analysis. We measured symptoms of anxiety and depression separately, captured demographics, and asked two open-ended questions regarding events that were the most difficult or stressful, and reinforced pride. We reported descriptive statistics and coded thematic categories for their continuum “pride” and “distress” the factors related to fostering well-being according to the Self-Determination Theory.

Results

Themes that emerged from these narratives were congruent with prediction of Self-Determination theory that autonomy-supportive experiences will foster pride, while autonomy-thwarting experiences will cause distress. Those who reported distressful events were more anxious and depressed compared to those who did not. Among those who reported incidences that reinforced pride in the profession, depression was rarer compared to those who did not. These trends were evident after allowing for medical history and other covariates in logistic regressions.

Conclusion

Causal claims from our analysis should be made with caution due to the cross-sectional research design. Understanding perceptions of the pandemic by nurses and physicians may help identify and manage sources of distress, and suggest means of mitigating the risk of mental health distress through autonomy-supportive policies.