How widespread were depression and anxiety among Latvian medical professionals during COVID-19?
The prevalence and risk factors of depression and anxiety among medical professionals in Latvia during the COVID-19 pandemic was the subject of a dissertation by Laura Valaine, a PhD student at Rīga Stradiņš University (RSU).
The aim of the study was to determine the prevalence of symptoms of depression and generalised anxiety disorder among medical professionals during the state of emergency in Latvia, track changes in these symptoms over time, and identify associated risk factors.
‘For the first time in Latvia, a comprehensive study of the mental health of medical professionals has been conducted. The study identified the prevalence of depression and generalised anxiety disorder in Latvian medical professionals at the beginning of the COVID-19 pandemic and again 19 months after the first state of emergency had ended,’ explains Valaine, the author of the thesis.
The study sample included staff from a variety of healthcare institutions whose personnel were at higher risk of direct contact with COVID-19 patients during the early phase of the pandemic: hospital admissions and intensive care units, the Emergency Medical Service, general practitioners, and the RSU Institute of Stomatology.
The first phase of data collection took place during the first wave of COVID-19, from 28 April to 2 June 2020. Despite the challenging circumstances, a total of 844 medical professionals participated in the study. The findings revealed that 25% of respondents experienced symptoms of depression and 17% symptoms of anxiety during the first wave. While similar rates were observed in other European countries, it is important to note that Latvia was less severely affected by COVID-19 at the time. The country was even referred to as a success story in limiting the virus’s spread, with relatively few infections and hospitalisations. However, the high prevalence of depression and anxiety suggested a prolonged psycho-emotional overload that existed even prior to the pandemic.
Dynamics of the prevalence of depression and anxiety symptoms among medical professionals, and incidence of COVID-19 in the general population during the pandemic in Latvia. Image from Laura Valaine's dissertation
The study is notable for its regular and long-term data collection: participants were surveyed seven times over a 19-month period. Of the original 844 participants, 627 agreed to take part in at least one follow-up survey. Participation was voluntary, and respondents chose whether to complete each subsequent questionnaire. ‘I am deeply grateful for every questionnaire we received, as colleagues had to find time in their already busy schedules for this,’ notes Laura Valaine.
The study found that the increased prevalence of clinically significant symptoms of depression and anxiety was associated with rising COVID-19 incidence. Symptoms of depression peaked following the second wave in March 2021, reaching 43%. Anxiety symptoms were most prevalent in September 2021, when COVID-19 incidence rose sharply. Even after infection rates declined, the prevalence of depression and anxiety among medical professionals remained high and did not return to baseline levels until the very end of the study—suggesting the long-lasting psychological impact of such emergencies.
The study also explored the incidence and progression of factors influencing depression and anxiety. Special attention was given to the role of self-esteem as a contributing factor in the development of mental health conditions. Unique data were obtained on the impact of self-esteem, adding valuable insights both locally and internationally. For example, respondents with low self-esteem had an 82% higher risk of depression than those with high self-esteem. Anger and stress at work increased the risk of depression by 29%, while experiencing pleasant emotions at work reduced it by 28%.
When examining socio-demographic and work environment factors, the key risk indicators for depression and anxiety during the COVID-19 pandemic included younger age, female gender, employment in general practice, and working more than 40 hours per week. The study highlights both the groups at risk and the factors that must be considered when supporting healthcare workers—so they, in turn, can care for their patients.
To enhance their resilience and maintain high standards of care, both government and organisational support are essential. This includes increasing staffing levels, securing adequate funding, and ensuring the availability of mental health prevention and treatment services. Special attention must be given to new doctors, with support integrated into their training—such as psychotherapy, Balint groups, and mental health education sessions.
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