Meta-analysis On The Prevalence Of Anxiety And Depression Among Front-line Medical Staff During The COVID-19 Epidemic

ObjectiveTo evaluate the anxiety and depression status of front-line medical staff and the effect of intervention measures by systematic review/Meta-analysis,and to provide basic data reference for improving the mental health level of clinical medical staff.MethodsThis study was conducted by Cochrane systematic review.Retrieve the data knowledge service platform of ten thousand,China hownet,VIP net,the Chinese biomedical literature service system,Pubmed,OVID,Embase,Web of Science.The research on the mental health status of front-line medical workers in mainland China was only in Chinese or English literature,and the type of research was controlled study observation on the impact of the mental health status of front-line medical workers.The time range for publication was form January 2020 to December 2022.According to the inclusion and exclusion criteria of literature and the requirements for systematic review/meta-analysis,literature was screened,determined and evaluated by two evaluators.Cochrance risk bias assessment tool was selected as the quality assessment tool,with the literatures classified as three categories:high risk bias,low risk bias and unknown risk.In order to describe the characteristics of the literature,the extracted data included the author,year of the literature,the sample number of the observed population,the gender distribution,the age range and mean,the situation of the observation group and the control group,etc.Using Rev Manager5.4.1 software for data analysis,according to the nature and type of literature,calculate the ratio of effects,and derive the forest map,funnel map,etc.The statistical parameters included Z value,P value,I~2 value,mean difference(MD)and 95%CI(confidence interval).The heterogeneity test level was set as P=0.1,and P<0.1 was considered significant.I~2was used for quantitative analysis of heterogeneity,and the significance was set as I~2=50%.When I~2>50%,the heterogeneity of the literature was judged to be large.ResultsA total of 54 literature were included.1.SAS score:The Meta-analysis encompassed 19 literature,comprising 10963 front-line medical personnel,17864non-front-line medical personnel and other personnel,respectively,as indicated by the SAS.According to the random effect model analysis,SAS scores of the two groups were statistically significant(z=4.57,p<0.0001),MD=6.33,95%CI(3.62,9.04).2.SDS Score:The Meta-analysis encompassed 14 literature,comprising7544 front-line medical personnel,16246 non-front-line medical personnel or other personnel,all of whom had a SDS score.The random effect model analysis showed that the SDS scores of the two groups were statistically significant(z=3.78,p=0.0002),MD=6.48,95%CI(3.12,9.84).3.Anxiety SCL-90 score:The Meta-analysis encompassed 14literature,comprising 1915 front-line medical personnel,13920 non-front-line medical personnel or other personnel,respectively.The random-effect model analysis showed that the anxiety SL-90 in the two groups was statistically significant(z=2.80,p<0.005),MD=0.32,95%CI(0.10,0.55).4.Depression SCL-90 score:The Meta-analysis encompassed 14 literature,comprising 1915 front-line medical staff,non-front-line medical staff or other staff,13920 people,respectively.The random-effect model analysis showed that SCR-90 of depression in the two groups was statistically significant(z=2.69,p=0.007),,MD=0.39,95%CI(0.10,0.67).5.Detection rate of anxiety GAD-7:The Meta-analysis encompassed 16 GAD-7detection rates,including 6010 front-line medical staff,.38737 non-front-line medical staff and other staff,respectively.The random effect model analysis revealed that the detection rates of GAD-7 in the observation group and control group were statistically significant(z=2.49,p=0.001),RD=0.08,95%CI(0.02,0.15).6.PHQ-9 depression detection rate:The Meta-analysis encompassed 13 literature on PHQ-9 detection rates comprising4904 and 5164 front-line medical personnel,non-front-line medical personnel and other personnel,respectively.The random effect model analysis showed that no statistically significant difference was found between the two groups in the detection rates of anxiety PHQ-9(z=1.15,p=0.25),,RD=0.03,95%CI(-0.02,0.08).ConclusionSAS score,SDS score,SCL-90 anxiety score,SCL-90 depression score and GAD-7 detection rate of front-line medical staff in mainland China were generally higher than those of non-front-line medical staff or other staff,while PHQ-9 detection rate was not higher than that of non-front-line medical staff or other staff.