The non-linear association of physical fatigue with depression and anxiety among mental health professionals who recovered from COVID-19 infection : a national survey in China

Abstract

Background: The COVID-19 pandemic took a toll on everyone’s health and mental health professionals were no exception. This study examined the trajectory of the relationship between levels of physical fatigue and each of depression and anxiety in mental health professionals (MHPs) recovering from COVID-19. Methods: A national survey of 9,858 MHPs who had recovered from COVID-19 was conducted between January and February 2023. The nine-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and a numerical rating scale were used to measure depression, anxiety and physical fatigue, respectively. Logistic regression with restricted cubic spline (RCS) models were created to examine the association of physical fatigue with depression and anxiety. Results: The prevalence of depression and anxiety in MHPs who recovered from COVID-19 infection were 47.0% (95%CI: 46.0-48.0%) and 28.9% (95%CI: 28.0-29.8%) respectively. The prevalence of moderate to severe physical fatigue was 44.2% (95%CI: 43.2-45.2%). The RCS models revealed a significant nonlinear relationship between physical fatigue and both depression and anxiety, with an inflection point at a fatigue score of 4. Above this threshold, the risk of both conditions increased significantly. Participants with poor perceived health and lower socioeconomic status had a significantly greater increase in depression and anxiety when fatigue levels were higher. Conclusions: Moderate to severe physical fatigue was associated with depression and anxiety in MHPs recovering from COVID-19. Interventions aimed at alleviating fatigue may play a critical role in improving mental health outcomes in this vulnerable population.