The Role of Level and Stability of Self-Esteem in Predicting Depression and Anxiety Symptoms in Health Care Workers during the COVID-19 Pandemic in Latvia

Abstract

The severity of depression and anxiety symptoms in health care workers (HCW) increased during the COVID-19 pandemic. Low self-esteem (SE) is recognised as a risk factor for depression and anxiety. Less is known about the role of individual variations in SE. The aim of this study is to analyse the level and stability of SE as predictors of depression and anxiety symptoms in HCW during COVID-19 pandemic in Latvia. The participants received seven questionnaires. The first questionnaire was available from 28 April to 2 June 2020, and the rest followed after 3, 6, 10, 13, 16, and 19 months. 161 HCW responded to all questionnaires and were included in this study. SE was assessed using the Rosenberg Self-Esteem Scale. Depression and anxiety symptoms were assessed using the PHQ-9 and GAD-7 scales. Data were analysed using chi-squared test and binary logistic regression in IBM SPSS Statistics (v.31.0.1.0). Participants with high and stable SE had significantly lower proportion of depression symptoms (31.3% vs 70.8%) and anxiety symptoms (29.7% vs 60.4%) than participants with high SE at the beginning of the study, which decreased later (p < 0.001/ = 0.001). The median (min – max) coefficient of variation (CV) of SE was 8.5 (0.0 – 30.9)%. CV was a significant predictor of depression symptoms, when controlling for mean SE level (OR = 1.13; p = 0.031), but not for anxiety symptoms (p = 0.258). The stability of SE is an important factor in the assessment of the risk of depression and anxiety symptoms.