The SARS-CoV-2 health emergency has led to a restructuring of health care systems and the reassignment of medical specialists from their usual duties to attend COVID-19 patients. The aim of this paper is to describe the levels of insomnia, anxiety, depression, and the impact on quality of life of doctors who were on the frontline of COVID-19 during the first two waves of the pandemic. Self-report surveys were conducted on said physicians during both waves, with 83 and 61 responses in the first and second waves, respectively. The reported presence of insomnia was frequent (71.8%), although it decreased in the second survey. Anxiety was moderate, decreasing from 57.1% to 43.1% between measurements. Overall, depression rates decreased between the two surveys. Substance use was found to have an indirect correlation with personal and professional satisfaction. In the light of the unforeseeable evolution of the pandemic and the medium- to long-term repercussions on professionals, we believe the adaptation of health resources is crucial to meet the new unpredictable mental health needs of this group.

The PHQ-9 questionnaire is a screening test worldwide used to measure depression. But it cannot be used in Costa Rica, due to the fact that it has not previously been validated for its population. The present study aims to show the validation of the PHQ-9 questionnaire and its variants (PHQ-2, PHQ-4, PHQ-8) in a population sample of adults residing in Costa Rica. A sample was collected (n = 1162) using a self-administered questionnaire. Confirmatory Factor Analysis (CFA), Receiver Operating Characteristic (ROC) curve, and Multiple Group Confirmatory Factor Analysis (MGCFA) were tested. One factor was found that explained 73.33% of the variance with excellent internal consistency (α = 0.928). Goodness-of-fit measures were adequate (RMSEA = 0.107; CFI = 0.948), as was diagnostic power at a cut-off of 10 (78.60 for Sensitivity and 27.95 for 1-Specificity). External validation indices were good (r = 0.843 with GAD-7, r = − 0.647 with RS14, and r = 0.301 with FCV19S), and the model showed invariance by sex (∆χ² = 27.90; df = 27; p < 0.001). Additionally, new cut-off points were proposed for PHQ-9 and its variants for Costa Rican male, female, and general populations. The PHQ-9 and its variants (PHQ-2, 4, and 8) are valid tools for detecting depression (and anxiety for PHQ-4) in Costa Rican population. In addition, new cut-off points differentiated by sex are proposed.

Background: Insomnia significantly impairs healthcare worker (HCW) well-being, particularly amid COVID-19 sequelae and shift work demands. We aimed to assess the prevalence of insomnia among HCWs, identify those needing clinical intervention, analyze shift work as a potential risk factor, and explore associations with COVID-19 sequelae and psychiatric comorbidities. Methods: A cross-sectional online survey was administered at the University of Salamanca University Care Complex (CAUSA) from March 2023 to January 2024. Validated scales (Insomnia Severity Index, Patient Health Questionnaire-4, Generalized Anxiety Disorder Scale-2) were used to measure insomnia, depression, and anxiety. Participants scoring ISI ≥ 7 were invited for Occupational Medicine follow-up. Descriptive and inferential analyses were performed. Results: Overall, 1121 HCWs participated (mean age 44.59 ± 11.78, 78.3% women). The mean ISI score was 10.5 ± 5.8 (subclinical insomnia), with 22.7% reporting moderate and 3% reporting severe insomnia. Depression and anxiety affected 28.4% and 33% of respondents, respectively. Shift workers had poorer sleep (mean ISI 11.3 ± 0.9 vs. 8.8 ± 0.3, p < 0.001). Individuals reporting COVID-19 sequelae were 3.1 times more likely to have insomnia than those who did not (mean ISI 13.89 ± 5.9 vs. 10.33 ± 5.7, p < 0.001). Over one-quarter reported at least the monthly use of sleep or psychiatric medications. Conclusions: Insomnia remains prevalent among HCWs, influenced by shift work, COVID-19 sequelae, and mental health factors. Targeted, multidisciplinary interventions, e.g., workplace policy changes, mental health programs, and shift schedule adjustments are urgently needed to safeguard well-being, reduce burnout, and maintain quality patient care. Ensuring adequate sleep is central to minimizing errors and preserving professional performance. Future studies should investigate the impact of coordinated workplace strategies to effectively address insomnia.

Since the beginning of the COVID-19 pandemic, the need to implement protocols that respond to the mental health demands of the population has been demonstrated. The PASMICOR programme started in March 2020, involving a total of 210 requests for treatment. Out of those subjects, the intervention was performed in 53 patients with COVID-19 without history of past psychiatric illness, 57 relatives and 60 health professionals, all of them within the area of Salamanca (Spain). Interventions were carried out by professionals of the public mental health service mostly by telephone. Depending on clinical severity, patients received basic (level I) or complex psychotherapeutic care combined with psychiatric care (level II). The majority of attended subjects were women (76.5%). Anxious-depressive symptoms were predominant, although sadness was more frequent in patients, insomnia in relatives and anxiety and fear in health professionals. 80% of the sample, particularly most of the health professionals, required a high-intensity intervention (level II). Nearly 50% of the people treated were discharged after an average of 5 interventions. Providing early care to COVID-19 patients, relatives and professionals by using community mental health resources can help to reduce the negative impact of crises, such as the pandemic, on the most affected population groups.

Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population.

Introducción. Los problemas emocionales como la ansiedad, la depresión y el estrés constituyen un problema de salud pública. Mientras tanto, la evidencia científica nos alerta de la importancia de mantener hábitos de vida saludables para prevenir e intervenir frente a los síntomas ansiosos, depresivos y el estrés. En los últimos años se ha planteado el uso de la tecnología para este fin, siendo las herramientas tecnológicas más utilizadas las aplicaciones móviles conocidas como mHealth. Objetivo: Analizar el potencial del uso de apps móviles basadas en hábitos saludables (ejercicio, dieta y hábitos de sueño) como herramientas eficaces para reducir los síntomas de ansiedad, depresión y estrés autopercibido en población adulta. Método. Se realizó una revisión sistemática siguiendo las directrices PRISMA. La revisión incluyó los ensayos clínicos aleatorizados encontrados en PubMed, Medli-ne y PsycINFO, con un total final de 10 estudios. Los criterios de inclusión solicitaron ensayos clínicos aleatorizados (ECA) escritos en inglés, con población adulta, que utilizaran apps móviles relacionadas con hábitos saludables y analizaran sus efectos sobre los síntomas ansiosos, depresivos y de estrés. Resultados y conclusiones. Los resultados sugieren que el uso de apps que influyen en la adherencia a hábitos saludables parece reducir las puntuaciones de ansiedad, depresión y estrés percibido. Sin embargo, se necesita más investigación para identificar los hábitos específicos que mejoran los factores psicológicos indicados a través de la mHealth.