{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T09:07:11Z","timestamp":1793696831277,"version":"4.5.1"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute of Research and Counselling Studies at King Khalid University, Abha, Saudi Arabia.","award":["4-N-20\/21"],"award-info":[{"award-number":["4-N-20\/21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.<\/jats:p>","DOI":"10.3390\/ijerph18116076","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T11:12:13Z","timestamp":1622805133000},"page":"6076","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9149-7726","authenticated-orcid":false,"given":"Hasan S.","family":"Alamri","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine, King Khalid University, Abha 62527, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-2311","authenticated-orcid":false,"given":"Wesam F.","family":"Mousa","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Tanta, Tanta 31512, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1477-4379","authenticated-orcid":false,"given":"Abdullah","family":"Algarni","sequence":"additional","affiliation":[{"name":"Ministry of Health, Abha 62523, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-6633","authenticated-orcid":false,"given":"Shehata F.","family":"Megahid","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia"},{"name":"Biostatistics Department, High Institute of Public Health, Alexandria University, 65 Garidet St., El Horeya Rd., El Shatby, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0974-7226","authenticated-orcid":false,"given":"Ali","family":"Al Bshabshe","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, King Khalid University, Abha 62527, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9962-9217","authenticated-orcid":false,"given":"Nada N.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, King Khalid University, Abha 62527, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awad","family":"Alsamghan","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2352-8249","authenticated-orcid":false,"given":"Abdullah","family":"Alsabaani","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha T.","family":"Mirdad","sequence":"additional","affiliation":[{"name":"Armed Forces Hospital Southern Region, Khamis Mushait 62413, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asrar M.","family":"Alshahrani","sequence":"additional","affiliation":[{"name":"King Fahad Medical City, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alya A.","family":"Gadah","sequence":"additional","affiliation":[{"name":"King Abdulaziz Medical City, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almah A.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Ministry of Health, Abha 62523, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"ref_1","unstructured":"WHO (2020, April 30). Situation Report-101 of Coronavirus Disease 2019 (COVID-19). Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/situation-reports\/20200430-sitrep-101-covid-19.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.comppsych.2018.10.003","article-title":"Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients","volume":"87","author":"Lee","year":"2018","journal-title":"Compr. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Raven, J., Wurie, H., and Witter, S. (2018). Health workers\u2019 experiences of coping with the Ebola epidemic in Sierra Leone\u2019s health system: A qualitative study. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3072-3"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1017\/S0033291704002247","article-title":"Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: Stress and psychological impact among frontline healthcare workers","volume":"34","author":"Tam","year":"2004","journal-title":"Psychol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s40249-020-00724-0","article-title":"Psychological impact of COVID-19 on medical care workers in China","volume":"9","author":"Si","year":"2020","journal-title":"Infect. Dis. Poverty"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e000471","DOI":"10.1136\/bmjgh-2017-000471","article-title":"Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015","volume":"3","author":"Jalloh","year":"2018","journal-title":"BMJ Glob. Health"},{"key":"ref_8","first-page":"1677","article-title":"Differences in maladaptive schemas between patients suffering from chronic and acute posttraumatic stress disorder and healthy controls","volume":"11","author":"Ahmadian","year":"2015","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.genhosppsych.2019.11.006","article-title":"Trajectories of posttraumatic stress in patients with confirmed and rule-out acute coronary syndrome","volume":"62","author":"Meli","year":"2020","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e19160","DOI":"10.2196\/19160","article-title":"Knowledge and perceptions of COVID-19 among health care workers: Cross-sectional study","volume":"6","author":"Bhagavathula","year":"2020","journal-title":"JMIR Public Health Surveill."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1176\/ps.2008.59.1.91","article-title":"Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak","volume":"59","author":"Lancee","year":"2008","journal-title":"Psychiatr. Serv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"180","DOI":"10.5114\/hpr.2020.101249","article-title":"Predictive risk factors for post-traumatic stress symptoms among nurses during the Italian acute COVID-19 outbreak","volume":"9","author":"Ranieri","year":"2021","journal-title":"Health Psychol. Report"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1176\/appi.ps.55.9.1055","article-title":"Survey of stress reactions among health care workers involved with the SARS outbreak","volume":"55","author":"Bai","year":"2004","journal-title":"Psychiatr. Serv."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4088\/JCP.09r05072blu","article-title":"Acute stress disorder as a predictor of posttraumatic stress disorder: A systematic review","volume":"72","author":"Bryant","year":"2011","journal-title":"J. Clin. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"608413","DOI":"10.3389\/fpsyg.2021.608413","article-title":"Prolonged COVID 19 Outbreak and Psychological Response of Nurses in Italian Healthcare System: Cross-Sectional Study","volume":"12","author":"Ranieri","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12991-017-0155-1","article-title":"An arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample","volume":"16","author":"AlHadi","year":"2017","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3399\/bjgp08X263794","article-title":"Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care","volume":"58","author":"Cameron","year":"2008","journal-title":"Br. J. Gen. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s10862-016-9571-9","article-title":"Psychometric Properties of the Generalized Anxiety Disorder Scale-7 (GAD-7) in Outpatients with Anxiety and Mood Disorders","volume":"39","author":"Rutter","year":"2017","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1177\/070674370905400504","article-title":"The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk","volume":"54","author":"Wu","year":"2009","journal-title":"Can. J. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.bbi.2020.04.049","article-title":"A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak","volume":"88","author":"Chew","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/S2215-0366(20)30077-8","article-title":"Online mental health services in China during the COVID-19 outbreak","volume":"7","author":"Liu","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1038\/s41398-019-0673-5","article-title":"Pharmacological prevention and early treatment of post-traumatic stress disorder and acute stress disorder: A systematic review and meta-analysis","volume":"9","author":"Sijbrandij","year":"2019","journal-title":"Transl. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/alcalc\/agn073","article-title":"Alcohol abuse\/dependence symptoms among hospital employees exposed to a SARS outbreak","volume":"43","author":"Wu","year":"2008","journal-title":"Alcohol Alcohol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S0140-6736(20)30309-3","article-title":"2019-nCoV epidemic: Address mental health care to empower society","volume":"395","author":"Bao","year":"2020","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Li, X., Guan, L., Chang, H., and Zhang, B. (2014). Core self-evaluation and burnout among Nurses: The mediating role of coping styles. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0115799"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/S2215-0366(20)30078-X","article-title":"Mental health care for medical staff in China during the COVID-19 outbreak","volume":"7","author":"Chen","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13674676.2020.1768725","article-title":"COVID-19, mental health and religion: An agenda for future research","volume":"23","author":"Dein","year":"2020","journal-title":"Ment. Health Relig. Cult."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.bbi.2020.05.026","article-title":"Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"88","author":"Pappa","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.4103\/IJPC.IJPC_155_20","article-title":"Concerns of Health Care Professionals Managing non-COVID Patients during the COVID-19 Pandemic: A Descriptive Cross-Sectional Study","volume":"26","author":"Sarma","year":"2020","journal-title":"Indian J. Palliat. Care"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.4081\/hpr.2015.1984","article-title":"The Impact of Healthcare Workers Job Environment on Their Mental-emotional Health. Coping Strategies: The Case of a Local General Hospital","volume":"3","author":"Koinis","year":"2015","journal-title":"Health Psychol. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1001\/jama.2020.5893","article-title":"Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic","volume":"323","author":"Shanafelt","year":"2020","journal-title":"JAMA"},{"key":"ref_34","first-page":"1245","article-title":"The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital","volume":"168","author":"Maunder","year":"2003","journal-title":"CMAJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/JOM.0000000000001235","article-title":"A Systematic, Thematic Review of Social and Occupational Factors Associated with Psychological Outcomes in Healthcare Employees During an Infectious Disease Outbreak","volume":"60","author":"Brooks","year":"2018","journal-title":"J. Occup. Environ. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/pcn.13004","article-title":"Mental health during and after the COVID-19 emergency in Italy","volume":"74","author":"Sani","year":"2020","journal-title":"Psychiatry Clin. Neurosci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6076\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:10:59Z","timestamp":1760163059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,4]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ijerph18116076"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18116076","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,4]]}}}