The overall incidence of psychosomatic syndrome among pharmacy staff was 21.7% during the COVID-19. The outbreak of COVID-19 was a serious public health event. Normally, people were encountered with huge psychological pressure during a serious public health event. Pharmacy staff faced great occupational risks and customer anxiety, they were more likely to be fearful, anxious, irritable, and sensitive. The present results suggested that more than 1/5 pharmacy staff showed psychosomatic symptoms. The incidence of anxiety was 20.2% according to an investigation into the general public during the epidemic . People who engaged in work related to epidemic had significantly worse mental health condition than the general population during the COVID-19 epidemic .
This study also found that subjects with the characters of females, aged, lower education background, widowed and divorced, and history of somatic and psychological disease had a higher rate of psychosomatic syndromes. Female showed higher incidence of psychosomatic symptoms than the male, it might lie in women were more susceptible to stress . In a survey on individuals' psychosomatic state caused by overtime work, psychological syndromes were found, the health risk of women caused by overtime work was higher than men. Some researchers investigated the mental health of front-line medical staff and found that the anxiety rate of female medical workers was higher than men . By investigating the anxiety and depression of the elderly during the epidemic period and found that the anxiety and depression of women was much higher than men .
Age was also a crucial factor, our study showed that age was the most important risk factor of the observed psychosomatic syndrome and somatic symptoms. The older individuals adapted to the gradual weakening of social supports with more difficulties, coupled with the decline of physical functions. Older people were more likely to produce psychosomatic symptoms in many extreme situations. This research result was consistent with the development trend of individual . Another study showed that 37.1% of the elderly experienced emotional reactions during the epidemic period.
Education affected psychosomatic symptoms. The incidence of psychosomatic symptoms was the lowest in the postgraduate group and the highest was primary group. Pu et al. showed that in the overall health model, people with higher education were more inclined to have a healthier lifestyle. They were relatively calm when an acute stress event occurred and less likely to have psychosomatic symptoms. Our results also showed that education background played an important role in psychological factors. Stewart-Brown et al.  found that the prevalence of mental health problems was the highest among the less educated population, and better education might improve mental health through better labor market outcomes and health inputs (such as more physical activity, earlier detection, and better access to psychotherapy).
Widowed and divorced people might take more pressure, such as economic pressure and social pressure. A research found that good marital status could significantly increase happiness, allowing people to face adversity, then promote the individual's physical and mental health . Divorced and widowed individuals had more psychosomatic symptoms during the epidemic period . For those who lack a warm family environment were susceptible to negative environment and had difficulty in adapting to changes, so they were more likely to develop psychosomatic symptoms.
In the present study, the most common psychosomatic symptoms were sleep problems (dyscoimesis) and mood problems (irritability). Mood and sleep problems affect each other mutually. Poor sleep leads to negative mood, and it in turn affected sleep quality. Some researchers investigated the psychological health of the public during the epidemic, and found that the most common psychosomatic symptoms respectively were fatigue and unhappiness . Under the pressure of the COVID-19, sleep difficulties, lack of interest, and avoidance of anxiety were the most common symptoms of ordinary people according the research of Yue et al.. During the outbreak of Ebola virus in 2014, Mohammed et al.  investigated that one of the most common symptoms of survivors was lack of sleep. Du et al. found that poor sleep quality was related to the aggravation of depression and anxiety symptoms among medical personals in hospitals in Wuhan. Sang et al. investigated the emotions of medical staff during the outbreak of Middle East respiratory syndrome coronavirus in South Korea, and found that many medical staff experienced severe emotional stress, mainly including traumatic stress, anxiety and depressive symptoms . During the COVID-19, the overall prevalence of dyscoimesis was 18.2% among the Chinese public. Early negative emotions such as fatigue and irritability might be caused by high-intensity work and lack of sleep . Taken together, we should emphasize the importance of assessment and management of existing persistent sleep and mood symptoms for the pharmacy staff even after the acute period.
Severe psychosomatic symptoms caused by a traumatic event were difficult to mitigate automatically[29, 30]. Psychological counseling was particularly important for pharmacy staff. Understanding the psychosomatic symptoms could help pharmacy staff better response to a catastrophic public health emergency. The present research provided a good perspective. The psychotherapy should be considered for the common symptoms of mood and sleep. Due to the high contagious risk, it was difficult to interview face to face, so the remote written counseling might become a new psychological counseling model in this situation[31, 32]. Online psychological counseling may be a viable option
However, there were some limitations on this study. Firstly, this was a cross-sectional study with a significant difference in sample size in different subgroups. It may undermine the results of the study. Most of the subjects are self-tested through Wechat platform, so it was difficult to ensure the balance of the samples at all levels. Secondly, when we investigated the influencing factors of psychosomatic syndromes among pharmacy staff, normal demographic variables were taken into account. In fact, the influencing factors may include personality characteristics and environmental factors. Finally, the research method was unitary, we only used quantitative studies and few qualitative considerations.