{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:41:34Z","timestamp":1780620094789,"version":"3.54.1"},"reference-count":49,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bergesen foundation, Norway","award":["BF-34138"],"award-info":[{"award-number":["BF-34138"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The COVID-19 pandemic has induced demanding work situations in intensive care units (ICU). The objective of our study was to survey psychological reactions, the disturbance of social life, work effort, and support in ICU nurses, physicians, and leaders. Methods: From May to July 2020, this cross-sectional study included 484 ICU professionals from 27 hospitals throughout Norway. Symptoms of anxiety and depression were measured on Hopkins Symptom Checklist-10 (HSCL-10). Symptoms of post-traumatic stress disorder (PTSD) were measured on the PCL-5. Results: The study population were highly educated and experienced professionals, well prepared for working with COVID-ICU patients. However, 53% felt socially isolated and 67% reported a fear of infecting others. Probable cases of anxiety and depression were found in 12.5% of the registered nurses, 11.6% of the physicians, and 4.1% of the leaders. Younger age and &lt;5 years previous work experiences were predictors for high HSCL-10 scores. Reported symptom-defined PTSD for nurses 7.1%; the leaders, 4.1%; and 2.3% of physicians. Conclusions: ICU health care professionals experienced talking with colleagues as the most helpful source of support. The COVID-ICU leaders reported a significantly higher mean score than physicians and nurses in terms of pushing themselves toward producing high work effort.<\/jats:p>","DOI":"10.3390\/ijerph19127010","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T02:25:33Z","timestamp":1654827933000},"page":"7010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0154-6358","authenticated-orcid":false,"given":"Siv Karlsson","family":"Stafseth","sequence":"first","affiliation":[{"name":"Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"MEVU, Lovisenberg Diaconal University College, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"Skogstad","sequence":"additional","affiliation":[{"name":"Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"R\u00e6der","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingvild Strand","family":"Hovland","sequence":"additional","affiliation":[{"name":"Department of Acute Medicine, Division of Medicine, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haakon","family":"Hovde","sequence":"additional","affiliation":[{"name":"The Norwegian Association for Critical Care Nurses, 0152 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8ivind","family":"Ekeberg","sequence":"additional","affiliation":[{"name":"Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-7812","authenticated-orcid":false,"given":"Irene","family":"Lie","sequence":"additional","affiliation":[{"name":"Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, 0424 Oslo, Norway"},{"name":"Department of Health Sciences in Gj\u00f8vik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 2815 Gj\u00f8vik, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,8]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2022, April 22). Coronavirus Disease (COVID-19) Pandemic. Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019."},{"key":"ref_2","unstructured":"(2021, February 10). Control ECfDPa. ECDC Statistics: European Centre for Disease Prevention and Control. Available online: www.Ecdc.europa.eu\/en\/geographical-distrubution-Covid-19."},{"key":"ref_3","unstructured":"(2022, April 28). The Norwegian Government\u2019s Management of the Coronavirus Pandemic-Part 2-Summary in English. NOU 2022:5, Oslo, Norway. Available online: https:\/\/www.regjeringen.no\/en\/dokumenter\/nou-2022-5\/id2910055\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/aas.13785","article-title":"Characteristics, management and survival of ICU patients with coronavirus disease-19 in Norway, March\u2013June 2020. A prospective observational study","volume":"65","author":"Laake","year":"2021","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Trumello, C., Bramanti, S.M., Ballarotto, G., Candelori, C., Cerniglia, L., Cimino, S., Crudele, M., Lombardi, L., Pignataro, S., and Viceconti, M.L. (2020). Psychological Adjustment of Healthcare Workers in Italy during the COVID-19 Pandemic: Differences in Stress, Anxiety, Depression, Burnout, Secondary Trauma, and Compassion Satisfaction between Frontline and Non-Frontline Professionals. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17228358"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.genhosppsych.2020.03.011","article-title":"Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan","volume":"66","author":"Du","year":"2020","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1159\/000507639","article-title":"Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China","volume":"89","author":"Zhang","year":"2020","journal-title":"Psychother. Psychosom."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"113441","DOI":"10.1016\/j.psychres.2020.113441","article-title":"The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review","volume":"293","author":"Muller","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"110299","DOI":"10.1016\/j.pnpbp.2021.110299","article-title":"The impact of the COVID-19 pandemic in an intensive care unit (ICU): Psychiatric symptoms in healthcare professionals","volume":"110","author":"Barbosa","year":"2021","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/08039480310000932","article-title":"Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36)","volume":"57","author":"Strand","year":"2003","journal-title":"Nord. J. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/jts.22059","article-title":"The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J. Trauma. Stress"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13613-021-00880-y","article-title":"PsyCOVID-ICU Trial Investigators and the CRICS TRIGGERSEP Group (Clinical Research in Intensive Care and Sepsis Trial Group for Global Evaluation and Research in Sepsis). Mental health and stress among ICU healthcare professionals in France according to intensity of the COVID-19 epidemic","volume":"11","author":"Helms","year":"2021","journal-title":"Ann. Intensive Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.aucc.2020.12.004","article-title":"Impact of the coronavirus disease 2019 pandemic on critical care healthcare workers\u2019 depression, anxiety, and stress levels","volume":"34","author":"Hammond","year":"2021","journal-title":"Aust. Crit. Care"},{"key":"ref_14","first-page":"717","article-title":"Psychological Impact of COVID-19 on ICU Caregivers","volume":"39","author":"Caillet","year":"2020","journal-title":"Anaesth. Crit. Care Pain Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1164\/rccm.202006-2568OC","article-title":"Symptoms of anxiety, depression, and peritraumatic dissociation in critical care clinicians managing patients with COVID-19. A cross-sectional study","volume":"10","author":"Azoulay","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103034","DOI":"10.1016\/j.iccn.2021.103034","article-title":"The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study","volume":"65","author":"Heesakkers","year":"2021","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1136\/emermed-2020-210438","article-title":"Psychological distress during the acceleration phase of the COVID-19 pandemic: A survey of doctors practising in emergency medicine, anaesthesia and intensive care medicine in the UK and Ireland","volume":"38","author":"Roberts","year":"2021","journal-title":"Emerg. Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1093\/occmed\/kqaa220","article-title":"Mental health of staff working in intensive care during COVID-19","volume":"71","author":"Greenberg","year":"2021","journal-title":"Occup. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102999","DOI":"10.1016\/j.iccn.2020.102999","article-title":"The effect of COVID-19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study","volume":"63","author":"Crowe","year":"2020","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100017","DOI":"10.1016\/j.sleepx.2020.100017","article-title":"Insomnia and stress of physicians during COVID-19 outbreak","volume":"2","author":"Abdulah","year":"2020","journal-title":"Sleep Med. X"},{"key":"ref_21","unstructured":"World Health Organization (2022, April 22). Mental Health and Psychosocial Considerations during the COVID-19 Outbreak, 18 March 2020 (No. WHO\/2019-nCoV\/MentalHealth\/2020.1). Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/mental-health-considerations.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Huang, L., Lei, W., Xu, F., Liu, H., and Yu, L. (2020). Emotional responses and coping strategies in nurses and nursing students during COVID-19 outbreak: A comparative study. PLoS ONE, 15.","DOI":"10.1101\/2020.03.05.20031898"},{"key":"ref_23","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_24","doi-asserted-by":"crossref","unstructured":"Binnie, A., Moura, K., Moura, C., D\u2019Aragon, F., and Tsang, J.L.Y. (2021). Psychosocial distress amongst Canadian intensive care unit healthcare workers during the acceleration phase of the COVID-19 pandemic. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254708"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e049135","DOI":"10.1136\/bmjopen-2021-049135","article-title":"Health care professionals in COVID-19 Intensive Care Units in Norway. Preparedness and working conditions: A cohort study","volume":"11","author":"Lie","year":"2021","journal-title":"BMJ Open"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Stuijfzand, S., Deforges, C., Sandoz, V., Sajin, C.T., Jaques, C., Elmers, J., and Horsch, A. (2020). Psychological impact of an epidemic\/pandemic on the mental health of healthcare professionals: A rapid review. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09322-z"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00406-020-01183-2","article-title":"Subjective burden and perspectives of German healthcare workers during the COVID-19 pandemic","volume":"271","author":"Kramer","year":"2021","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.genhosppsych.2020.06.007","article-title":"Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic","volume":"66","author":"Shechter","year":"2020","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"713251","DOI":"10.3389\/fpsyt.2021.713251","article-title":"The Rapid Implementation of a Psychological Support Model for Frontline Healthcare Workers During the COVID-19 Pandemic: A Case study and Process Evaluation","volume":"12","author":"Appelbom","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4037\/ajcc2022312","article-title":"Critical Care Nurses\u2019 Experiences during the COVID-19 Pandemic: A US National Survey","volume":"31","author":"Guttormson","year":"2022","journal-title":"Am. J. Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e012904","DOI":"10.1136\/bmjopen-2016-012904","article-title":"Finding consensus on frailty assessment in acute care through Delphi method","volume":"6","author":"Soong","year":"2016","journal-title":"BMJ Open"},{"key":"ref_32","unstructured":"Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., and Schnurr, P.P. (2022, April 22). The PTSD Checklist for dsm-5 (pcl-5). Scale Available from the National Center for PTSD, Available online: https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult-sr\/ptsd-checklist.asp."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1080\/19012276.2015.1071204","article-title":"Norwegian translation and validation of a routine outcomes monitoring measure: The treatment outcome package","volume":"68","author":"Nordberg","year":"2016","journal-title":"Nord. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1037\/pas0000254","article-title":"Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans","volume":"28","author":"Bovin","year":"2016","journal-title":"Psychol. Assess"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Pedersen, M.J., Gjerland, A., Rund, B.R., Ekeberg, O., and Skogstad, L. (2016). Emergency Preparedness and Role Clarity among Rescue Workers during the Terror Attacks in Norway July 22, 2011. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0156536"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1093\/occmed\/kqw063","article-title":"Post-traumatic stress among rescue workers after terror attacks in Norway","volume":"66","author":"Skogstad","year":"2016","journal-title":"Occup. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1002\/sim.2271","article-title":"Quantile Regression Methods for Reference Growt Charts","volume":"25","author":"Wei","year":"2006","journal-title":"Stat. Med."},{"key":"ref_38","first-page":"90","article-title":"Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey","volume":"1","author":"Alonso","year":"2020","journal-title":"Rev. Psiquiatr. Salud. Ment."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1007\/s12630-021-02175-z","article-title":"The impact of the COVID-19 pandemic on intensive care unit workers: A nationwide survey","volume":"69","author":"Mehta","year":"2022","journal-title":"Can. J. Anesth.\/J. Can. Anesth."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Van der Velden, P.G., Hyland, P., Contino, C., von Gaudecker, H.-M., Muffels, R., and Das, M. (2021). Anxiety and depression symptoms, the recovery from symptoms, and loneliness before and after the COVID-19 outbreak among the general population: Findings from a Dutch population-based longitudinal study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245057"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s13613-021-00900-x","article-title":"Mental health outcomes of ICU and non-ICU healthcare workers during the COVID-19 outbreak: A cross-sectional study","volume":"11","author":"Wozniak","year":"2021","journal-title":"Ann. Intensive Care"},{"key":"ref_42","unstructured":"(2022, April 22). COVID-19 Update [Report]. International Council of Nurses. Available online: https:\/\/www.icn.ch\/sites\/default\/files\/inline-files\/ICN%20COVID19%20update%20report%20FINAL.pdf."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bonsaksen, T., Heir, T., Schou-Bredal, I., Ekeberg, O., Skogstad, L., and Grimholt, T.K. (2020). Post-Traumatic Stress Disorder and Associated Factors during the Early Stage of the COVID-19 Pandemic in Norway. Int. J. Environ. Res. Public Health, 17.","DOI":"10.20944\/preprints202011.0617.v1"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1002\/cpp.2564","article-title":"The influence of risk perception for COVID-19 pandemic on posttraumatic stress disorder in healthcare workers: A survey from four designated hospitals","volume":"28","author":"Geng","year":"2021","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.genhosppsych.2007.03.004","article-title":"Performance characteristics of the posttraumatic stress disorder checklist and SPAN in Veterans Affairs primary care settings","volume":"29","author":"Yeager","year":"2007","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11920-020-01166-z","article-title":"The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence","volume":"22","author":"Preti","year":"2020","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/aje\/kwab252","article-title":"Pressure on the Health-Care System and Intensive Care Utilization During the COVID-19 Outbreak in the Lombardy Region of Italy: A Retrospective Observational Study in 43,538 Hospitalized Patients","volume":"191","author":"Trentini","year":"2022","journal-title":"Am. J. Epidemiol."},{"key":"ref_48","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_49","first-page":"CD013779","article-title":"Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: A mixed methods systematic review","volume":"11","author":"Pollock","year":"2020","journal-title":"Cochrane Database Syst. Rev."}],"updated-by":[{"DOI":"10.3390\/ijerph192315424","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000}}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/12\/7010\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T13:49:17Z","timestamp":1754228957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/12\/7010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,8]]},"references-count":49,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19127010"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19127010","relation":{"correction":[{"id-type":"doi","id":"10.3390\/ijerph192315424","asserted-by":"object"}]},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,8]]}}}