A nationwide evaluation of the prevalence of and risk factors associated with anxiety, depression and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China

Abstract

Purpose To evaluate the prevalence of and risk factors associated with anxiety, depression, and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China. Methods The authors conducted a large-scale, nationwide, multicenter, cross-sectional study in China. A population-based quota and snowball sampling were designed to recruit a representative sample. Online questionnaires and telephone reviews were used to collect characteristics and assess psychological and sleep problems. Anxiety, depression, and insomnia symptoms were measured by the generalized anxiety disorder-7, patient health questionnaire-9, and insomnia severity index tools. Results A total of 42,000 participants were recruited from 15 centers, and 36,795 valid questionnaires were received. Generally, 18.3, 14.9, and 17.9% of the participants had anxiety, depression, and insomnia symptoms, respectively, and 2.2–2.7% had severe symptoms. Engaging in outside activity once in ≥ 30 days (OR = 2.719, OR = 2.074, OR = 2.225) and age 50–64 years (OR = 2.431, OR = 1.936, OR = 2.036) were common risk factors for anxiety, depression and insomnia symptoms. Living in Hubei Province (OR = 1.304, OR = 1.242) was a common risk factor for anxiety and insomnia symptoms. Working as frontline medical staff (OR = 2.150) was another risk factor for anxiety symptoms. The health education rate of the samples reached 98.9%. However, the psychological intervention rate was only 16.2%, and 2.5% received targeted interventions. Conclusions An increasing number of people might have psychological and sleep problems. However, the current psychological interventions are not sufficient. Efforts should be made to strengthen interventions for high-risk populations. Supplementary Information The online version contains supplementary material available at 10.1007/s00127-021-02046-4.

Prevalence of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Pandemic: A Meta-Analysis

“…Altogether, nine studies with 27,207 older Chinese adults were eligible and included (Figure 1) (19)(20)(21)(22)(23)(32)(33)(34)(35). All studies assessed the presence of insomnia symptoms in convenient samples of older adults during the outbreak period of COVID-19 in China.…”

“…In China, a few population-based studies have examined the prevalence of insomnia symptoms in older adults amid the pandemic, but these studies varied in terms of screener of insomnia [i.e., PSQI vs. Insomnia Severity Index (ISI)], sample size (i.e., from 35 to 13,964), and prevalence (i.e., from 13.1 to 42.9%) (19)(20)(21)(22)(23). Importantly, nearly all available data on older adults are derived from whole population-based studies, where elderly-specific prevalence data are not easily accessed (i.e., only shown in the main text).…”

Discrepancy Between Desired Time in Bed and Desired Total Sleep Time, Insomnia, Depression, and Dysfunctional Beliefs About Sleep Among the General Population

“…In general, depression is a significant factor influencing insomnia; [ 18 ] additionally, there is a bidirectional relationship between depression and insomnia [ 19 ]. Especially during the COVID- 19 pandemic, individuals have been shown to suffer from sleep disturbance or insomnia [ 20 , 21 ], and depression is one of the most significant predictors for the latter [ 22 ]. Post-pandemic insomnia was reported to be associated with higher levels of depression; [ 23 ] conversely, a change in sleep pattern due to COVID- 19 was significantly associated with depression [ 24 ].…”

“…However, in this study, anxiety regarding viral diseases was not a significant predictor of the insomnia severity of the general population during the COVID-19 pandemic. Previously, a high prevalence of anxiety and insomnia was reported among the general population [ 20 , 21 ]. Although we reported the possibility of the influence of anxiety on sleep disturbance among healthcare workers [ 27 ], the association of viral anxiety, assessed using the viral epidemic-specific rating scale, with insomnia was rarely reported among the general population.…”

COVID-19 pandemic and mental health problems of adults in United States: mediating roles of cognitive concerns and behavioral changes

“…Potential individual and household-level confounding covariates are derived from HPS data, including demographic characteristics, socioeconomic status (SES), self-rated health and healthcare access, socioeconomic hardships, and location of residence as noted by previous COVID-19 studies on mental health determinants during the pandemic [ 30 ], Mergel et al 2021; [ 71 ] (see Supplemental Table 2 for detailed survey questionnaire prompts and answer options). Demographic variables include age group, gender, race and ethnicity, marrital status, household size, and the number of children.…”