Burnout, anxiety and depression in secondary school teachers in Europe during the COVID-19 pandemic: a systematic scoping review & perspective of preventive occupational medicine.

backgroundThe COVID-19 pandemic added another layer of burden to what is already a demanding occupation; namely, secondary school teacher.

objectiveTo review the published literature concerning burnout, anxiety, and depression in secondary school teachers in Europe during the COVID-19 pandemic and to discuss the findings from the perspective of preventive occupational medicine.

methodsA systematic scoping review using the Medline and Web of Science databases with narrative synthesis of findings.

resultsWe identified 16 articles from seven European countries (Belgium, Bosnia and Herzegovina, Italy, Germany, Greece, Spain, Portugal) though results from one study were uninterpretable. Of the 15 remaining, seven assessed burnout or emotional exhaustion, seven assessed anxiety, and seven assessed depression (there was overlap). Only two studies were longitudinal and they focussed on burnout; the remaining 13 were cross-sectional in design. Questionnaires were used to assess severity scores. Mean severity scores for all outcomes appear to fluctuate across the pandemic, but are always high. Loss-to-follow up – indicated in the longitudinal studies – could mean a healthy worker effect (e.g. workers who fall ill and drop out of the study) biases both severity scores per se and their associations with other factors toward null in studies. Differences in- and associations with- outcome scores are reported for sex, age, job experience, cognitive-, personality-, and emotional intelligence-associated factors (e.g. extraversion, presenteeism, openness, resilience, clarity, repair), work-related factors (e.g. student issues, professional support, technology), and COVID-19 associated factors (e.g. family member vulnerability). There are differences in some findings across studies. DISCUSSION: The COVID-19 pandemic presented a unique situation in which to study factors that contribute to -or provide protection against- burnout, anxiety, and depression. Female teachers may be a higher-risk group for depression. Potential factors that could be modified to mitigate outcomes, albeit identified as associating factors from mostly cross-sectional studies, include emotional intelligence training at the individual level and professional support at a systems level. Given the importance of the teaching profession and the high demands placed on teachers, future studies should consider interventions on such modifiable factors toward reducing health burden.