COVID-19 measures

The Tokyo Metropolitan Distress Scale for Pandemic (TMDP) was created to measure stress in clinical practice related to COVID-19.

The Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences at Tokyo Medical and Dental University, in collaboration with Professor Takeo Fujiwara of the Department of Global Health Promotion Medicine and Associate Professor Nobuhide Hirai of the Center for Health Management, has developed a new simple assessment scale, the Tokyo Metropolitan Distress Scale for Pandemic (TMDP). This aims to measure the mental and social burdens faced by healthcare professionals in COVID-19 clinical care and it has been published in Psychiatry and Clinical Neurosciences.

A novel brief screening scale, the Tokyo Metropolitan Distress Scale for Pandemic (TMDP), for assessing the mental and social burdens on medical personnel in the COVID-19 pandemic

Tokyo Metropolitan Distress Scale for Pandemic (TMDP)

During the PAST TWO WEEKS:
How frequently were you concerned about the following?		 Never Rarely Occasionally Often Most of the time
1. COVID-19 infection of oneself 0 1 2 3 4
2. You have no control over whether you have COVID-19 or not 0 1 2 3 4
3. Risk of COVID-19 patient care is unacceptable 0 1 2 3 4
4. Safety of the work environment is not maintained in order to avoid being affected by COVID-19 0 1 2 3 4
5. Transmitting COVID-19 to people around you 0 1 2 3 4
6. People around you avoid you because of your occupation 0 1 2 3 4
7. Deteriorating workplace relationships in relation to COVID-19 0 1 2 3 4
8. Deteriorating family relationships in relation to COVID-19 0 1 2 3 4
9. Financial burden associated with COVID-19 0 1 2 3 4

Important points:

  • The Tokyo Metropolitan Distress Scale for Pandemic (TMDP), a new simple evaluation scale, was developed to measure the mental and social burdens faced by healthcare professionals in COVID-19 clinical care.
  • The new TMDP scale accurately detects depression and anxiety among healthcare professionals and identifies COVID-19 and other pandemic-specific phenomena, including the risk of contributing to the spread of infection, anxiety, social stigma, and economic burden.
  • This evaluation scale is expected to offer early interventions that address the risk of a decline in motivation and turnover among medical personnel and support the stability of the medical system for COVID-19 clinical care.

Outline of the study

Interviews were conducted with all staff members working at the Tokyo Medical and Dental University Hospital (TMDU). The new TMDP scale and PHQ-9[1], GAD-7[2], and PSS-10[3] assessments were used to analyze scores for depression, anxiety, and stress in 260 medical staff members assessed between April 20 and April 24, 2020 when the number of infected patients significantly increased in Tokyo under the state of emergency.
The results obtained showed that TMDP scores correlated with PHQ-9, GAD-7, and PSS-10 scores. Moderate or severe depression or anxiety symptoms may be identified by TMDP with high discrimination rates, which are commonly defined by a PHQ-9 score ≥10 and a GAD-7 score ≥10.

[1] PHQ-9: Patient Health Questionnaire-9 to assess the severity of depression

[2] GAD-7: Generalized Anxiety Disorder-7 to assess the severity of anxiety symptoms

[3] PSS-10: The Perceived Stress Scale to assess an individual’s stress level.