Table 1 Study Characteristics of Accepted Studies
Primary Studies | ||||||||
First author (year) | Country (disease outbreak) | Timepoint (design) | Sample | Mental health outcomes | Measures | |||
AO Chan and CY Huak [8]† | Singapore (SARS) | Concurrent (Cross-sectional) | 661 HCPs (106 SARS exposed HCPs and 555 non exposed HCPs) | PTSD Psychological Distress | IES GHQ-28 | |||
SS Chan et al. [9]◈ | Hong Kong (SARS) | Concurrent (Cross-sectional) | 1470 nurses | Psychological health | SARS NSQ | |||
CS Chen et al. [10]◈ | Taiwan (SARS) | Concurrent (Cross-sectional) | 128 nurses (42 control, 21 conscripted and 65 high-risk nurses) | PTSD Psychological symptoms | IES SCL-90-R | |||
NH Chen et al. [11]† | Taiwan (SARS) | Concurrent (Longitudinal) | 172 (90 SARS exposed HCPs and 82 non HCPs) | Social support | MOS SF-36 | |||
MY Chong et al. [12]† | Taiwan (SARS) | Concurrent (Cross-sectional) | 1257 HCPs | PTSD Psychological Morbidity | IES CHQ | |||
SE Chua et al. [13]◈ | Hong Kong (SARS) | Concurrent (Cross-sectional) | 613 (271 HCPs from SARS units and 342 healthy control subjects) | Perceived stress | PSS-10 | |||
L Fiksenbaum et al. [14] | Canada (SARS) | Concurrent1 (Cross-sectional) | 333 nurses | Burnout (emotional exhaustion) State anger | MBI-EE STAXI | |||
P Goulia et al. [15] † | Greece (A/H1N1) | Concurrent (Cross-sectional) | 469 HCPs | Psychological distress | GHQ-28 | |||
D Ji et al. [16] | Sierra Leone (Ebola) | Concurrent (Longitudinal) | 161 (59 local medical staff; 21 local logistic staff; 22 local medical students; 41 Chinese medical staff and 18 Ebola survivors) | Psychological symptoms (Global severity index, obsession-compulsion) | SCL-90-R | |||
JS Kim and JS Choi [17] | South Korea (MERS) | Concurrent (Cross-sectional) | 215 nurses from emergency department (119 MERS-exposed nurses and 96 MERS non-exposed nurses) | Burnout Job stress | OLBI Parker and DeCotiis scale | |||
D Koh et al. [18]†◈ | Singapore (SARS) | Concurrent (Cross-sectional) | 10,511 HCPs | PTSD | IES | |||
WJ Lancee et al. [19]† | Canada (SARS) | Long (Cross-sectional) | 139 HWCs | Axis I diagnosis excluding the psychosis and PTSD PTSD Burnout (Emotional exhaustion) | SCID CAPS and IES MBI-EE | |||
AM Lee et al. [20] | Hong Kong (SARS) | Concurrent Long (Longitudinal) | 79 SARS patients (49 non–HCPs and 30 HCPS) 96 SARS survivors (63 non–HCPs and 33 HCPS) | Perceived Stress Perceived Stress Anxiety and Depression PTSD Psychological Distress | PSS-10 PSS-10 Subscales of DASS-21 IES-R GHQ-12 | |||
SM Lee et al. [21] | South Korea (MERS) | Concurrent (Longitudinal) | 358 hospital staff (185 doing MERS-related tasks and 173 not doing MERS-related tasks) | PTSD | IES-R | |||
M Lehmann et al. [22] | Germany (Ebola) | Concurrent (Cross-sectional) | 86 (42 internal medicine staff; 32 Ebola patient treatment staff and 12 research laboratory staff) | Health-related quality of life Generalized anxiety disorder; Depression Fatigue | SF-12 GAD-7 Depression module of the PHQ-9 Fatigue subscale of the FACIT | |||
L Li et al. [23] | Liberia (Ebola) | Concurrent2 (Cross-sectional) | 52 HCPs | Psychological health (Obsessive compulsive symptoms) | SCL-90-R (obsessive-compulsive dimension) | |||
CY Lin et al. [24]† | Taiwan (SARS) | Concurrent3 (Cross-sectional) | 92 HCPs (66 emergency department staff and 26 psychiatric ward staff) | PTSD Psychiatric morbidity | DTS-C CHQ-12 | |||
X Liu et al. [25]† | China (SARS) | Long (Cross-sectional) | 549 hospital workers | Depressive symptoms PTS symptoms | CES-D IES-R | |||
YC Lu et al. [26]† | Taiwan (SARS) | Concurrent (Cross-sectional) | 127 HCPs (24 physicians, 49 nurses and 54 other HCPs) | Psychiatric morbidity | CHQ | |||
FW Lung et al. [27]† | Taiwan (SARS) | Concurrent Long (Longitudinal) | 127 HCPs (24 physicians, 49 nurses and 54 otherHCPs) (this is a follow-up of Lu et al., 2006) | Psychiatric morbidity | CHQ | |||
IWC Mak et al. [28] | Hong Kong (SARS) | Long (Cross-sectional) | 90 SARS survivors among which 27 HCPs and 63 non-HCPs | PTSD | IES-R | |||
Z Marjanovic et al. [29]◈ | Canada (SARS) | Concurrent (Cross-sectional) | 333 nurses | Burnout (Emotional exhaustion) state anger | MBI-EE STAXI | |||
K Matsuishi et al. [30]† | Japan (H1N1) | Concurrent4 (Cross-sectional) | 1625 hospital staff (218 medical doctors, 864 nurses, and 543 others) | PTSD | IES | |||
R Maunder [31] ◈† | Canada (SARS) | Concurrent (Cross-sectional) | 1557 HCPs (430 nurses) | PTSD | IES | |||
RG Maunder et al. [32]†◈ | Canada (SARS) | Long (Longitudinal) | Survey A: 769 HCPs (587 SARS exposed HCPs and 182 SARS non exposed HCPs) Survey B: 187 HCPs | PTSD Burnout (emotional Exhaustion) Maladaptative coping; | IES MBI-EE WCQ – (escape-avoidance, self-blame, confrontative coping subscales) | |||
GM McAlonan et al. [33]†◈ | Hong Kong (SARS) | Concurrent Long (Longitudinal) | 176 HCPs (106 high risk HCPs and 70 low risk HCPs) 184 HCPs (71 high risk HCPs and 113 low risk HCPs) | Perceived stress Anxiety, depression and stress PTS symptoms | PSS-10 DASS-21 IES-R | |||
LA Nickell et al. [34]†◈ | Canada (SARS) | Concurrent (Cross-sectional) | 510 HCPs | emotional distress | GHQ-12 | |||
JS Park et al. [35] | South Korea (MERS) | Concurrent (Cross-sectional) | 187 nurses | Mental health Perceived stress | SF-36 form (mental health subscale) PSS-10 | |||
DH Phua et al. [36]† | Singapore (SARS) | Long (Cross-sectional) | 96 HCPs (38 doctors and 58 nurses) (from the method looks like the same sample as Tham et al. (2004). However, this is not stated in the study.) | psychiatric morbidity PTSD (psychological reactions) Coping strategies | GHQ-28 IES COPE | |||
E Poon et al. [37]†◈ | Hong Kong (SARS) | Concurrent (Cross-sectional) | 1926 hospital staff (534 high risk hospital staff and 1392 low risk hospital staff) | Burnout (emotional exhaustion) Anxiety | MBI-EE C-STAI | |||
K Sim et al. [38]◈ | Singapore (SARS) | Concurrent5 (Cross-sectional) | 277 HCPs (97 high risk HCPs and 180 low risk HCPs) | PTS symptoms Psychiatric morbidity Coping | IES-R GHQ-28 Brief COPE questionnaire | |||
H Son et al. [39] | South Korea (MERS) | Concurrent (Cross-sectional) | 280 hospital staff (153 HCPs and 127 non-HCPs) | Coping ability PTSD | K-CD-RISC IES-RK | |||
R Styra et al. [40]†◈ | Canada (SARS) | Concurrent (Cross-sectional) | 248 HCPs (160 high risk HCPs and 88 low risk HCPs) | PTS symptoms | IES-R | |||
T-P Su et al. [41] | Taiwan/ SARS | Concurrent (Longitudinal) | 102 nurses (70 nurses from SARS units and 32 nurses from non-SARS units) | Anxiety Depression PTS symptoms Sleep disturbance (insomnia) | STAI BDI DTS-C DSM IV and PSQI | |||
H Sun and X Ren [42] | China (SARS) | Concurrent (Cross-sectional) | 73 HCPs (35 infected HCPs and 38 uninfected HCPs) | Mental health | SCL-90 Chinese version | |||
CW Tam et al. [43]†◈ | Hong Kong (SARS) | Concurrent (Cross-sectional) | Study design | Psychological morbidty | GHQ-12 Chinese version | |||
KY Tham et al. [44] | Singapore (SARS) | Long (Cross-sectional) | Cross-sectional2b | Psychiatry morbidity PTS symptoms | GHQ-28 IES | |||
S Verma et al. [45]†◈ | Singapore (SARS) | Concurrent6 (Cross-sectional) | Cross-sectional2b | Psychological distress PTS symptoms | GHQ-28 IES | |||
TW Wong et al. [46]†◈ | Hong Kong (SARS) | Concurrent7 (Cross-sectional) | Cross-sectional2b | Coping strategies | Brief COPE questionnaire | |||
P Wu et al. [47]†◈ | China (SARS) | Long | Longitudinal1b | PTS symptoms | IES-R | |||
H Xiao et al. [48] | China (COVID-19) | Concurrent (Cross-sectional) | Cross-sectional2b | Anxiety Sleep (quality) Stress | SAS PSQI SASR | |||
Intervention Studies | ||||||||
Author (year) | Sample size | Country | Cross-sectional2b | Brief description of intervention | Impact on Mental Health (yes/no) | Which MH outcome? | Format of intervention | Timing of intervention |
R Chen et al. [49]◈ | 116 | Taiwan | Cross-sectional2b | SARS prevention programme (based on information provided by WHO and CDC): In-service training, manpower allocation, gathering sufficient protective equipment, and establishment of a mental health team for patients and professionals | yes | Anxiety Depression Sleep quality | No information | Before first patient with SARS was seen |
R Marrs et al. [50] | 31 | USA | Longitudinal1b | High consequence infectious diseases training using interprofessional simulation and TeamSTEPPS (based on Jeffries Simulation Theory): simulation of real life events such as patients vomiting, bleeding, having diarrhea, or respirator battery dying when caring for patients with a highly infectious disease | yes | State anxiety | 2 computerised simulation sessions including interprofessional TeamSTEPPS training | Before disease outbreak |
RG Maunder et al. [51] | 158 | Canada | Cross-sectional2b | Computer-assisted resilience training (interactive reflective exercises) | yes | Coping strategies: problem-solving and seeking support | Computer-assisted interactive reflective exercises of varying length: 1.75 h, 3 h and 4.5 h | Before disease outbreak |
M Sijbrandij et al. [52] | 408 | Sierra Leone | Cross-sectional2b | One-day PFA training: (1) explaining important terms (mental health, mental disorder, psychosocial support and psychosocial disorder); (2) understanding reactions to traumatic and stressful events; (3) understanding PFA; (4) understanding sources and signs of stress; (5) self-care; (6) providing PFA-prepare for your role, look, listen and link; (7) ending your assistance; (8) practicing PFA with role-play | no | Professional quality of life: burnout and compassion fatigue | One-day training | Acute aftermath of disease outbreak |
S Waterman et al. [53] | 3273 | Sierra Leone | Cross-sectional2a | CBT–based group intervention for HCPs with MH symptoms. Phase 1: PFA (discussion of challenges linked with work and the impact of this, ways of coping, and their achievements). Phase 2: Psychoeducation: information about a specific mental health problem and discussion of coping strategies based on behavioural and cognitive approaches (self-help). Phase 3: group CBT: behavioural activation, decreasing avoidance, problem solving, and coping with anxiety. | yes | PTSD, depression, anxiety, sleep, perceived stress, anger, relationship problems | Stepped intervention: 2-h workshop on psychological first aid + 2-h workshop on psychoeducation + 6 weekly sessions of brief CBT group programme | Towards the end of disease outbreak |
Reviews | ||||||||
First author (year) | Disease outbreak | Sample | Design | Mental health outcomes | ||||
SK Brooks et al. [6]◈ | SARS | HCPs | Cross-sectional | Psychological wellbeing; perceived stress; work/job-related stress; overall and emotional distress; panic; anxiety; PTSD; fatigue; sleep; health worries; fear of social contact; health fear; social isolation; depression; acute stress disorder; alcohol intake; anger; concerns for personal or family health; psychological support; social support; neurosis; stigmatisation; adjustment disorder; resilience; coping (including avoidance behaviour); burnout (including emotional exhaustion). | ||||
PJ Gardner and P Moallef [54] | SARS | SARS survivors, including HCPs | Cross-sectional | Psychotic symptomatology; fear of survival; fear of infecting others; perceived stigmatisation; quality of life; psychological/emotional distress; PTSD | ||||
M Kunin et al. [1] | SARS; H1N1 | GPs | Cross-sectional | Psychological distress; anxiety; PTSD | ||||
KJ Vyas et al. [5]† | SARS; H1N1 | HCPs | Cross-sectionnal | Psychological distress; insomnia; alcohol/drug misuse; PTSD; depression; anxiety. | ||||