Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

Roger, Claire; Ling, Lowel; Petrier, Mélissa; Elotmani, Loubna; Atchade, Enora; Allaouchiche, Bernard; Aubrun, Frédéric; Constantin, Jean-Michel; Dahyot-Fizelier, Claire; Delhaye, Nathalie; Dupont, Hervé; Fischer, Marc-Olivier; Garnier, Marc; Gayat, Etienne; Ichai, Carole; Jaber, Samir; Morel, Jérome; Plaud, Benoit; Rimmelé, Thomas; Robin, Sylvaine; Saba, Renee; Joynt, Gavin M.; Lefrant, Jean-Yves; Fabbro-Peray, Pascale; Lipman, Jeffrey; Conejero, Ismael; Laupland, Kevin

doi:10.1186/s12991-023-00488-5

Annals of General Psychiatry

Table 2 Associated factors with the anxiety and the depression

From: Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

N = 525^*	Proven anxiety, No^ƚ. /Total No. (%)	Univariate analysis^ǂ		Multivariate analysis^* (N = 525)
N = 525^*	Proven anxiety, No^ƚ. /Total No. (%)	OR (95% CI)	p-value	AOR (95% CI)^§	p-value
Anxiety
Factors
Type of hospital
University hospital	94/470 (20.0)	1 [Reference]	.001	1 [Reference]	.01
Public hospital	20/52 (38.5)	2.6 (1.5–4.4)		2.3 (1.3–3.9)
Private hospital	2/3 (66.7)	6.0 (0.6–56.9)		2.8 (0.2–30.6)
Gender
Male	24/146 (16.4)	1 [Reference]	< .0001	1 [Reference]	.0008
Female	92/379 (24.3)	2.5 (1.7–3.8)	< .0001	2.1 (1.4–3.2)	.0008
Type of housing
House	65/251 (25.9)	1 [Reference]	.003	NA^**	NA
Apartment	51/274 (18.6)	0.7 (0.5–1.0)	.003	NA	NA
Housing with an exterior
Yes	91/385 (23.6)	1 [Reference]	.05	NA	NA
No	25/140 (17.9)	0.7 (0.7–1.0)	.05	NA	NA
Financially impacted during the pandemic
No	91/443 (20.5)	1 [Reference]	.01	1 [Reference]	.02
Yes	25/82 (30.5)	1.8 (1.1–2.8)	.01	1.7 (1.1–2.7)	.02
Occupation
Caregiver	108/511 (21.1)	1 [Reference]	.002	1 [Reference]	.01
Non-caregiver	8/14 (57.1)	5.0 (1.8–14.2)	.002	3.9 (1.3–11.3)	.01
Theoretical or practical training on individual preventive measures for managing COVID-19 patient
Yes	76/391 (19.4)	1 [Reference]	.01	1 [Reference]	.04
No	40/134 (29.9)	1.6 (1.1–2.4)	.01	1.5 (1.0–2.2)	.04
Sufficient training to manage COVID-19 patient
Yes	58/310 (18.7)	1 [Reference]	.05	NA	NA
No	58/215 (27.0)	1.4 (1.0–2.0)	.05	NA	NA
Sufficient information for managing COVID-19 patient
Yes	64/346 (18.5)	1 [Reference]	.008	NA	NA
No	52/179 (29.1)	1.6 (1.1–2.3)	.008	NA	NA
Refusal to admit patients to the ICU even with available beds according to predefined criteria
Yes	44/230 (19.1)	1 [Reference]	.02	NA	NA
No	72/295 (24.4)	1.5 (1.1–2.1)	.02	NA	NA
Management of COVID-19 patient
Yes	101/486 (20.8)	1 [Reference]	< .0001	NA	NA
No	15/39 (38.5)	2.5 (1.4–4.6)	< .0001	NA	NA
Agree to manage COVID-19 patient
Yes	83/416 (20.0)	1 [Reference]	.01	NA	NA
No	33/109 (30.3)	1.6 (1.1–2.4)	.01	NA	NA
Fear for managing COVID-19 patient
No	47/249 (18.9)	1 [Reference]	.002	1 [Reference]	.02
Yes	69 /276 (25.0)	1.7 (1.2–2.4)	.002	1.5 (1.0–2.1)	.02
Comorbidity at risk of severe COVID-19
No	92/437 (21.1)	1 [Reference]	.03	NA	NA
Yes	24/88 (27.3)	1.6 (1.0–2.5)	.03	NA	NA

N = 525^*	Proven depression, No. /Total No. (%)	Univariate analysis^ǂ		Multivariate analysis^* (N = 525)
N = 525^*	Proven depression, No. /Total No. (%)	OR (95% CI)	p-value	AOR (95% CI)	p-value
Depression
Factors
Type of hospital
University hospital	36/470 (7.7)	1 [Reference]	.01	1 [Reference]	.03
Public hospital	7/52 (13.5)	2.4 (1.3–4.3)		2.2 (1.2–4.1)
Private hospital	0/3 (0.0)	3.7 (0.4–32.0)		2.9 (0.3–28.3)
Gender
Male	8/146 (5.5)	1 [Reference]	.02	NA	NA
Female	32/379 (9.2)	1.7 (1.1–2.8)	.02	NA	NA
Type of housing
House	20/251 (8.0)	1 [Reference]	.06	NA	NA
Apartment	23/274 (8.4)	0.7 (0.5–1.0)	.06	NA	NA
Housing with an exterior
Yes	32/385 (8.3)	1 [Reference]	.01	NA	NA
No	11/140 (7.9)	0.5 (0.3–0.9)	.01	NA	NA
Looking after a child
No child to support/not concerned/no	27/395 (6.8)	1 [Reference]	.02	1 [Reference]	.01
Yes	16/130 (12.3)	1.7 (1.1–2.6)	.02	1.8 (1.1–2.8)	.01
Financially impacted during the pandemic
No	36/443 (8.1)	1 [Reference]	.13	NA	NA
Yes	7/82 (8.5)	1.5 (0.9–2.5)	.13	NA	NA
Occupation
Caregiver	38/511 (7.4)	1 [Reference]	.0003	1 [Reference]	.0001
Non-caregiver	5/14 (35.7)	6.4 (2.4–17.2)	.0003	8.0 (2.8–22.7)	.0001
Admission of COVID-19 patient
Yes	40/506 (7.9)	1 [Reference]	.07	NA	NA
No	3/19 (15.8)	2.3 (0.9–5.7)	.07	NA	NA
Theoretical or practical training on individual preventive measures for managing COVID-19 patient
Yes	30/391 (7.8)	1 [Reference]	.01	NA	NA
No	13/134 (9.7)	1.7 (1.1–2.6)	.01	NA	NA
Hands-on training in the management of a COVID-19 patient
Yes	21/291 (7.2)	1 [Reference]	.01	NA	NA
No	22/234 (9.4)	1.7 (1.1–2.5)	.01	NA	NA
Regularly information on the evolution of the pandemic
Yes	34/396 (8.6)	1 [Reference]	.01	1 [Reference]	.04
No	9/129 (7.0)	1.7 (1.1–2.7)	.01	1.6 (1.0–2.5)	.04
Sufficient training to manage COVID-19 patient
Yes	22/310 (7.1)	1 [Reference]	.0003	1 [Reference]	.004
No	21/215 (9.8)	2.1 (1.4–3.1)	.0003	1.8 (1.2–2.8)	.004
Sufficient information for managing COVID-19 patient
Yes	22/346 (6.4)	1 [Reference]	.001	NA	NA
No	21/179 (11.7)	2.0 (1.3–3.0)	.001	NA	NA
Sufficient personal protective equipment
Yes	24/345 (7.0)	1 [Reference]	.04	NA	NA
No	19/180 (10.6)	1.5 (1.0–2.3)	.04	NA	NA
Management of COVID-19 patient
Yes	35/486 (7.2)	1 [Reference]	.0007	NA	NA
No	8/39 (20.5)	3.0 (1.6–5.7)	.0007	NA	NA
Agree to manage COVID-19 patient
Yes	33/416 (7.9)	1 [Reference]	.13	NA	NA
No	10/109 (9.2)	1.4 (0.9–2.3)	.13	NA	NA
Fear for managing COVID-19 patient
No	18/249 (7.2)	1 [Reference]	.02	NA	NA
Yes	25/276 (9.1)	1.6 (1.1–2.4)	.02	NA	NA
Request for moving from the unit
No	39/503 (7.8)	1 [Reference]	.01	1 [Reference]	.02
Yes	4/22 (18.2)	2.7 (1.2–6.2)	.01	2.6 (1.1–6.3)	.02
Comorbidity at risk of severe COVID-19
No	29/437 (6.6)	1 [Reference]	.0004	1 [Reference]	.001
Yes	14/88 (15.9)	2.4 (1.5–3.8)	.0004	2.2 (1.4–3.7)	.001

^*According to the order of appearance of the survey forms, an imbalance in the completion rate was noted between the first questionnaire (Personal life questionnaire) and the last form (Personal and Professional questionnaire used to research the factors associated with the psychological disorders studied) (higher completion rate for the first questionnaire). To evaluate the prevalence associated with psychological disorders, all the answers filled in for each scale of evaluation of the latter were taken into account, although the questionnaire was not completed in full. For this reason, a difference in the numbers analyzed (between those for the prevalence of post-traumatic stress, anxiety, and depression and those for the analysis of associated factors) is observed (see Fig. 1). The search for factors associated with the occurrence of psychological disorders was carried out on 525 people (those who completed all the survey forms)
^ƚ Number of observations / Total number of observations
^ǂ The results presented correspond to the pre-selection of variables at p-value < 20%. The second selection of variables was made at the 5% threshold and then integrated into the multivariate model
^§ Adjusted odd ratio with a 95% confidence interval
^** Not Applicable

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