Stress, Anxiety, and Depression: Prevalence and Associations to Electroencephalography and Cognitive Performance in Healthcare Professionals

Maharaj, Shamona

Stress, Anxiety, and Depression: Prevalence and Associations to Electroencephalography and Cognitive Performance in Healthcare Professionals

Maharaj, Shamona

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Publication Type:: Thesis
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Maharaj, Shamona
dc.date.accessioned	2020-11-11T04:10:41Z
dc.date.available	2020-11-11T04:10:41Z
dc.date.issued	2020
dc.identifier.uri	http://hdl.handle.net/10453/143900
dc.description	University of Technology Sydney. Faculty of Science.	en_AU
dc.description.abstract	Healthcare remains one of the most demanding careers available. Psychological distress is widespread among healthcare professionals. However, few studies have investigated the prevalence of stress and common mental health issues such as anxiety, and depression in Australian healthcare professionals, and their associations with electroencephalography (EEG) and cognitive performance. The present study assessed the prevalence of stress, anxiety and depression, and the relationships between these mental states and cognitive performance in healthcare professionals. It also investigated associations between cortisol and mental health/cognitive performance measures. Data was obtained from 154 participants divided into four groups: nurses (n=81), allied health professionals (n=31), doctors (n=20), and non-healthcare professionals (n=22). The experimental protocol involved pre-study and post-study blood pressure measurements and the collection of salivary cortisol. A questionnaire battery obtained lifestyle, demographic, and work-related data. Mental health data was obtained using the Depression, Anxiety, Stress Scale, and the General Health Questionnaire. A 32-lead monopolar EEG was recorded over two five-minute phases (a resting baseline phase followed by an active phase involving the Stroop task). Finally, cognitive performance was assessed using the Mini-Mental State Examination and the Cognistat. Prevalence rates in healthcare providers ranged between 26-60% for depression, 26-44% for anxiety, and 29-60% for stress. Stress was associated with decreases in repetition (r=-0.46, p=0.039), memory (r=-0.49, p=0.029), and attention (r=-0.51, p=0.021) in doctors, while anxiety was linked to decreased memory (r=-0.23, p=0.047) in nurses and global cognition (r=-0.36, p=0.049) in allied health professionals. Depression was also related to declines in memory (r=-0.27, p=0.019) in nurses. Conversely, stress was associated with better judgement (r=0.61, p=0.004) in doctors. Stress, anxiety, and depression were also associated with mixed findings in both high and low-frequency brain activities (decreased theta, increased delta, decreased alpha, increased beta, decreased gamma). No associations were found between cortisol and mental health/cognitive performance measures. These findings provide insight into the prevalence of mental health symptomology in Australian health professionals and suggest that negative mental states are associated with both improvements and impairments in cognitive performance. Unique variations in electroencephalographic changes were also linked to stress, anxiety, and depression; giving insight into what brain rhythms may underlie stress, anxiety, and depression, and how they may relate to various cognitive processes. Further research exploring the effects of negative mental states on personal wellbeing and cognition could enable the development of industry-specific management, monitoring, and/or intervention strategies aimed at preserving the health and performance of health professionals.	en_AU
dc.format	Thesis (PhD)
dc.language.iso	en_US	en_US
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/143900/2/02whole.pdf
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	au.edu.uts.lib/ppc
dc.title	Stress, Anxiety, and Depression: Prevalence and Associations to Electroencephalography and Cognitive Performance in Healthcare Professionals	en_AU
dc.type	Thesis
utslib.copyright.status	open_access	*

Abstract:

Healthcare remains one of the most demanding careers available. Psychological distress is widespread among healthcare professionals. However, few studies have investigated the prevalence of stress and common mental health issues such as anxiety, and depression in Australian healthcare professionals, and their associations with electroencephalography (EEG) and cognitive performance. The present study assessed the prevalence of stress, anxiety and depression, and the relationships between these mental states and cognitive performance in healthcare professionals. It also investigated associations between cortisol and mental health/cognitive performance measures. Data was obtained from 154 participants divided into four groups: nurses (n=81), allied health professionals (n=31), doctors (n=20), and non-healthcare professionals (n=22). The experimental protocol involved pre-study and post-study blood pressure measurements and the collection of salivary cortisol. A questionnaire battery obtained lifestyle, demographic, and work-related data. Mental health data was obtained using the Depression, Anxiety, Stress Scale, and the General Health Questionnaire. A 32-lead monopolar EEG was recorded over two five-minute phases (a resting baseline phase followed by an active phase involving the Stroop task). Finally, cognitive performance was assessed using the Mini-Mental State Examination and the Cognistat. Prevalence rates in healthcare providers ranged between 26-60% for depression, 26-44% for anxiety, and 29-60% for stress. Stress was associated with decreases in repetition (r=-0.46, p=0.039), memory (r=-0.49, p=0.029), and attention (r=-0.51, p=0.021) in doctors, while anxiety was linked to decreased memory (r=-0.23, p=0.047) in nurses and global cognition (r=-0.36, p=0.049) in allied health professionals. Depression was also related to declines in memory (r=-0.27, p=0.019) in nurses. Conversely, stress was associated with better judgement (r=0.61, p=0.004) in doctors. Stress, anxiety, and depression were also associated with mixed findings in both high and low-frequency brain activities (decreased theta, increased delta, decreased alpha, increased beta, decreased gamma). No associations were found between cortisol and mental health/cognitive performance measures. These findings provide insight into the prevalence of mental health symptomology in Australian health professionals and suggest that negative mental states are associated with both improvements and impairments in cognitive performance. Unique variations in electroencephalographic changes were also linked to stress, anxiety, and depression; giving insight into what brain rhythms may underlie stress, anxiety, and depression, and how they may relate to various cognitive processes. Further research exploring the effects of negative mental states on personal wellbeing and cognition could enable the development of industry-specific management, monitoring, and/or intervention strategies aimed at preserving the health and performance of health professionals.

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