Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study

M Tasdik Hasan; Sahadat Hossain; Farhana Safa; Afifa Anjum; Abid Hasan Khan; Kamrun Nahar Koly; Syeda Fatema Alam; Md Abdur Rafi; Vivek Podder; Tonima Islam Trisa; Rhedeya Nury Nodi; Dewan Tasnia Azad; Fatema Ashraf; S M Quamrul Akther; Helal Uddin Ahmed; Simon Rosenbaum; Graham Thornicroft

doi:10.1017/gmh.2022.30

Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study

Glob Ment Health (Camb). 2022 May 24:9:285-297. doi: 10.1017/gmh.2022.30. eCollection 2022.

Authors

M Tasdik Hasan^{1

2

3

4}, Sahadat Hossain⁵, Farhana Safa⁶, Afifa Anjum⁵, Abid Hasan Khan⁵, Kamrun Nahar Koly⁷, Syeda Fatema Alam⁸, Md Abdur Rafi⁹, Vivek Podder¹⁰, Tonima Islam Trisa⁷, Rhedeya Nury Nodi¹, Dewan Tasnia Azad¹¹, Fatema Ashraf^{1

8}, S M Quamrul Akther⁸, Helal Uddin Ahmed¹², Simon Rosenbaum¹³, Graham Thornicroft¹⁴

Affiliations

¹ Public Health Foundation, Bangladesh (PHF, BD), Dhaka, Bangladesh.
² Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
³ Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia.
⁴ Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh.
⁵ Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh.
⁶ Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁷ International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
⁸ Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
⁹ Rajshahi Medical College, Rajshahi, Bangladesh.
¹⁰ Tairunnessa Memorial Medical College and Hospital, Gazipur, Bangladesh.
¹¹ Jashore Medical College, Jashore, Bangladesh.
¹² National Institute of Mental Health and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
¹³ School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.
¹⁴ Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Abstract

Objectives: In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak.

Methods and design: A cross-sectional study using an online survey following a convenience sampling technique was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS).

Results: The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded personal protective equipment (PPE), not received adequate training, lacking perceived self-efficacy to manage COVID-19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 h of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models.

Conclusions: This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers.

Keywords: Anxiety symptoms; Bangladesh; COVID-19; depressive symptoms; physicians.

Grants and funding

R01 MH100470/MH/NIMH NIH HHS/United States