Prevalence and factors for anxiety and depression among secondary school teachers from Sfax city of Tunisia in times of the coronavirus disease 2019 pandemic: a cross-sectional study

Introduction: teachers have to adapt during the coronavirus disease 2019 (COVID-19) pandemic to many changes that could potentially make them more vulnerable to psychological distress. We aimed to assess anxiety and depression in Tunisian secondary school teachers during the COVID-19 pandemic and to explore their associated factors. Methods: we conducted a cross-sectional survey concerning Tunisian secondary school teachers between May 1 st , 2021, and June 30 th , 2021, using an online survey platform via Google Forms. Participants were asked to fill in a form including two psychometric tests: the General Anxiety Disorder 7 (GAD -7) and the Patient Health Questionnaire 9 (PHQ-9). We performed both univariable and multivariable logistic regression analyses. Results: a total of 170 secondary school teachers were included, of whom 22.4% (n=38) were males and 77.6% (n=132) were females. The median age was 45.5 years (Q1=39, Q3=49). The overall anxiety prevalence was 34.7% (n=59) while it was 41.7% (n=71) for depression. In multivariable analysis, anxiety was strongly associated with sleep disturbances (aOR: 5.1; 95% CI: 1.80-14.45; p=0.002) and depression (aOR: 33.91; 95% CI: 12.32-93.33; p<0.001) while depression was strongly associated with dissatisfaction with working conditions (aOR: 3.99; 95% CI: 1.49-10.65; p=0.006), the irregular wearing of protective masks (aOR: 3.94; 95% CI: 1.33-11.66; p=0.013) and anxiety (aOR=51.63; 95% CI: 17.74-150.25; p<0.001). Conclusion: secondary school teachers in Tunisia are characterized by a high rate of anxiety and depressive disorders which are related to personal and professional factors on which we can act by supplying of educational institutions by protective masks, the implementation of programs for adjusting working conditions and the practice of nonpharmacological interventions for insomnia management.