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Frontline health care workers responding to the COVID-19 pandemic can benefit from a transdiagnostic, symptom-based approach to links between their acute psychopathology and burnout and functional difficulties.
The researchers supported the recommendation of this approach based on the results of a symptom analysis published in the Journal of Clinical Psychiatry.
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“The characterization of specific psychiatric symptoms most strongly associated with burnout and functional aspects, especially in the early onset of the COVID-19 pandemic, can help develop more targeted, transdiagnostic and symptom-oriented approaches to the potential for long-term development -Burnout and functional difficulties after trauma exposure in [frontline health care workers]” Lorig K. Kachadourian, PhD, of the Psychiatric Department of the Yale School of Medicine in Connecticut and colleagues wrote. “In the current study, we examined the cross-sectional relationship between individual symptoms of COVID-19-associated PTSD, [major depressive disorder] and generalized anxiety disorder (GAD) and burnout and [two] Aspects of functioning (ie job difficulties and relationship difficulties) in a large sample of 2,579 [frontline health care workers] to work in NYC during the COVID-19 pandemic. “
Researchers rated symptoms of COVID-19-related PTSD using the four-part PTSD Checklist 5, MDD using Patient Health Questionnaire-8, GAD using Generalized Anxiety Disorder-7, burnout using the single-item Mini-Z Burnout Assessment, and functional difficulties using the short inventory of psychosocial functions. They performed relative importance analyzes to pinpoint symptoms of PTSD, MDD, and GAD related to burnout and functional difficulties.
The results showed the strongest associations with burnout for feeling tired / low on energy, being easily annoyed or irritable, and feeling nervous, anxious, or nervous. Kachadourian and colleagues found the greatest amount of explained variance, which was greater than 15%, because they felt tired / low on energy. They also observed the strongest associations between work difficulties and difficulty concentrating, feeling easily angry or irritable, and negative expectations about themselves or the world, with the latter making up the largest of the explained variances at more than 9%. In addition, relationship difficulties were most strongly associated with negative expectations about oneself or the world, feeling bad about oneself and feeling easily annoyed or irritable, with the latter accounting for the largest amount of the explained variance at more than 10%.
“The current study complements the emerging literature on ‘psychiatric symptoms’ by examining how individual symptoms of PTSD, MDD and GAD can be linked to clinical outcomes of high relevance to health professionals at the forefront of the COVID-19 pandemic “Said Kachadourian and colleagues wrote. “This approach sheds light on how the more nuanced clinical manifestations of these disorders can affect burnout risk and work and relationship difficulties during the acute phase of a large-scale traumatic event. Further research using network analysis can be useful to further elucidate key psychiatric symptoms that may be involved in the manifestation and maintenance of stress-related psychopathology in [frontline health care workers] and other population groups affected by the COVID-19 pandemic. “
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