• Ivo Kunovski University Clinic for Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Stojan Bajraktarov University Clinic for Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Viktor Isjanovski Health Center - Skopje, Skopje, Republic of North Macedonia


Healthcare workers, Coping, Mental health, COVID-19


Introduction: There is limited research on the factors influencing mental health of healthcare workers during the COVID-19 pandemic. Studies show that coping styles variably influence the severity of mental health symptoms. However, no data is available on the effects of coping styles on mental health of healthcare workers in North Macedonia and the wider region of Southeast Europe.

Materials and methods: A cross-sectional web-based study was conducted with 342 participants during the early period of the COVID-19 pandemic. Participants provided sociodemographic data and were assessed in regard to coping styles, and symptoms of depression, anxiety and stress. Associations between the variables were examined using nonparametric tests, and their additive effects were tested using generalized linear models.  

Results: Identifying as a woman, single, and of younger age was associated with higher levels of mental health symptoms. The coping styles that contributed to poor mental health outcomes included the use of active coping, instrumental support, substance use, venting, behavioral disengagement, self-blame, and the low use of emotional support and humor.

Conclusion: The findings help identify vulnerable populations, and add to the growing research on gender differences in the impact of COVID-19 on healthcare workers. The study may help in the development of mental health prevention programs for populations at risk during health crises.  


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