Anxiety, Depression, and Resilience of Healthcare Workers in Japan During the Coronavirus Disease 2019 Outbreak

Intern Med. 2020;59(21):2693-2699. doi: 10.2169/internalmedicine.5694-20. Epub 2020 Nov 1.


Objective Coronavirus disease 2019 (COVID-19) is spreading around the world. The aim of this study was to assess the degree of anxiety, depression, resilience, and other psychiatric symptoms among healthcare workers in Japan during the COVID-19 pandemic. Methods This survey involved medical healthcare workers at the Japanese Red Cross Medical Center (Tokyo, Japan) between April 22 and May 15, 2020. The degree of symptoms of anxiety, depression, and resilience was assessed using the Japanese versions of the 7-item Generalized Anxiety Disorder Scale (GAD-7), Center for Epidemiologic Studies Depression Scale (CES-D), and 10-item Connor-Davidson Resilience Scale. Furthermore, we added original questionnaires comprising three factors: (i) anxiety and fear of infection and death; (ii) isolation and unreasonable treatment; and (iii) motivation and escape behavior at work. Results In total, 848 healthcare workers participated in this survey: 104 doctors, 461 nurses, 184 other co-medical staff, and 99 office workers. Among all participants, 85 (10.0%) developed moderate-to-severe anxiety disorder, and 237 (27.9%) developed depression. Problems with anxiety and fear of infection and death, isolation and unreasonable treatment, and motivation and escape from work were higher in the depression group than in the non-depression group (total CES-D score ≥ 16 points). Being a nurse and high total GAD-7 scores were risk factors of depression. Older workers and those with higher resilience were less likely to develop depression than others. Conclusion During the COVID-19 epidemic, many healthcare workers suffered from psychiatric symptoms. Psychological support and interventions for protecting the mental health of them are needed.

Keywords: anxiety; coronavirus disease 2019; depression; healthcare worker; resilience.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / psychology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / etiology*
  • Female
  • Health Personnel / psychology*
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Mental Health*
  • Pandemics*
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / psychology
  • SARS-CoV-2