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      Impact of the intersection of anaesthesia and gender on burnout and mental health, illustrated by the COVID‐19 pandemic

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          Summary

          Physician burnout and poor mental health are prevalent and often stigmatised. Anaesthetists may be at particular risk and this is further increased for women anaesthetists due to biases and inequities within the specialty. However, gender‐related risk factors for and experiences of burnout and poor mental health remain under‐researched and under‐reported. This negatively impacts individual practitioners, the anaesthesia workforce and patients and carries significant financial implications. We discuss the impact of anaesthesia and gender on burnout and mental health using the COVID‐19 pandemic as an example illustrating how women and men differentially experience stressors and burnout. COVID‐19 has further accentuated the gendered effects of burnout and poor mental health on anaesthetists and brought further urgency to the need to address these issues. While both personal and organisational factors contribute to burnout and poor mental health, organisational changes that recognise and acknowledge inequities are pivotal to bolster physician mental health.

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          Most cited references65

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          Is Open Access

          Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

          Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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            Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States.

            Estimates of 12-month and lifetime prevalence and of lifetime morbid risk (LMR) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) anxiety and mood disorders are presented based on US epidemiological surveys among people aged 13+. The presentation is designed for use in the upcoming DSM-5 manual to provide more coherent estimates than would otherwise be available. Prevalence estimates are presented for the age groups proposed by DSM-5 workgroups as the most useful to consider for policy planning purposes. The LMR/12-month prevalence estimates ranked by frequency are as follows: major depressive episode: 29.9%/8.6%; specific phobia: 18.4/12.1%; social phobia: 13.0/7.4%; post-traumatic stress disorder: 10.1/3.7%; generalized anxiety disorder: 9.0/2.0%; separation anxiety disorder: 8.7/1.2%; panic disorder: 6.8%/2.4%; bipolar disorder: 4.1/1.8%; agoraphobia: 3.7/1.7%; obsessive-compulsive disorder: 2.7/1.2. Four broad patterns of results are most noteworthy: first, that the most common (lifetime prevalence/morbid risk) lifetime anxiety-mood disorders in the United States are major depression (16.6/29.9%), specific phobia (15.6/18.4%), and social phobia (10.7/13.0%) and the least common are agoraphobia (2.5/3.7%) and obsessive-compulsive disorder (2.3/2.7%); second, that the anxiety-mood disorders with the earlier median ages-of-onset are phobias and separation anxiety disorder (ages 15-17) and those with the latest are panic disorder, major depression, and generalized anxiety disorder (ages 23-30); third, that LMR is considerably higher than lifetime prevalence for most anxiety-mood disorders, although the magnitude of this difference is much higher for disorders with later than earlier ages-of-onset; and fourth, that the ratio of 12-month to lifetime prevalence, roughly characterizing persistence, varies meaningfully in ways consistent with independent evidence about differential persistence of these disorders. Copyright © 2012 John Wiley & Sons, Ltd.
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              Prevalence and predictors of PTSS during COVID-19 Outbreak in China Hardest-hit Areas: Gender differences matter

              Highlights • The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%. • Hierarchical regression analysis and non-parametric test suggested that women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. • Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.
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                Author and article information

                Contributors
                Role: Assistant Professor/Staff Anaesthetistgianni.lorello@uhn.ca , @GianniLorelll
                Role: Staff Psychiatrist@PEAKMD
                Role: Bioethicist/Associate Researcher
                Role: Scientific Associate
                Journal
                Anaesthesia
                Anaesthesia
                10.1111/(ISSN)1365-2044
                ANAE
                Anaesthesia
                John Wiley and Sons Inc. (Hoboken )
                0003-2409
                1365-2044
                07 March 2021
                April 2021
                : 76
                : Suppl 4 , The importance of women’s health in peri‐operative care ( doiID: 10.1111/anae.v76.s4 )
                : 24-31
                Affiliations
                [ 1 ] Department of Anesthesiology and Pain Medicine University of Toronto Toronto ON Canada
                [ 2 ] Department of Anesthesiology and Pain Medicine University Health Network Toronto Western Hospital Toronto ON Canada
                [ 3 ] Department of Psychiatry University of Ottawa Ottawa ON Canada
                [ 4 ] University Health Network Toronto Western Hospital Toronto ON Canada
                [ 5 ] Pragmatic Health Ethics Research Unit Institut de recherches cliniques de Montreal Montreal QC Canada
                [ 6 ] Department of Anesthesiology and Pain Medicine University Health Network Toronto Western Hospital Toronto ON Canada
                Author notes
                [*] [* ] Correspondence to: G. R. Lorello

                Email: gianni.lorello@ 123456uhn.ca

                Author information
                https://orcid.org/0000-0003-1387-1748
                Article
                ANAE15360
                10.1111/anae.15360
                8251311
                33682104
                8def0304-06c1-4ced-952c-156eb398982d
                © 2021 Association of Anaesthetists

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 16 November 2020
                Page count
                Figures: 1, Tables: 0, Pages: 8, Words: 5929
                Categories
                Review Article
                Special Issue: The importance of women’s health in peri‐operative care
                Review Articles
                Custom metadata
                2.0
                April 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.4 mode:remove_FC converted:02.07.2021

                Anesthesiology & Pain management
                anaesthesia,burnout,covid‐19,gender,gender equity,mental health,women
                Anesthesiology & Pain management
                anaesthesia, burnout, covid‐19, gender, gender equity, mental health, women

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