Insomnia plays a key role in mental health problems of COVID-19 patients in Square Cabin Hospitals: a network analysis

Abstract

Background: While the emergence of the Coronavirus Disease 2019 (COVID-19) has greatly affected the mental health and wellbeing of people everywhere, the core symptoms of common syndromes of psychological distress remain unclear, especially among COVID-19 patients who have been quarantined in Square Cabin Hospitals. Using the method of network analysis, the current study explored the relations between stress, depression, anxiety and insomnia symptoms among COVID-19 patients in Shanghai Four-Leaf Clover Cabin Hospital. Method: The study used an online survey to gauge the mental health issues of COVID-19 patients at Shanghai Four-Leaf Clover Cabin Hospital from April 18 to May 19, 2022. The Perceived Stress Scale, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Insomnia Severity Index were used to assess perceived stress symptoms, depressive symptoms, anxiety symptoms, and insomnia symptoms, respectively. The central symptoms and bridge symptoms were determined using a regularized partial correlation network. Results: A total of 1014 patients was included in this study. Overall, 61.5%, 49.2% , and 56.1% of all patients reported symptoms of depressive, anxiety, and insomnia, respectively. “Distress caused by the sleep difficulties” had the highest expected influence, followed by “Excessive worry”, “Severity of sleep onset”, “Overburden”, “Uncontrollable worry”, “Trouble relaxing”, “Restlessness”. Seven bridge symptoms were identified: “Sad Mood”, “Severity of sleep onset”, “Sleep”, “Motor”, “Feeling afraid”, “Nervousness”, “Appetite”. In addition, significant differences in network global strength were found between women and men. Conclusions: Psychological distress was prevalent among COVID-19 patients and insomnia symptoms played a key role in the network of psychological distress symptoms. As a result, specific insomnia symptoms should be closely monitored as potential intervention targets in alleviating or preventing common, frequently co-occurring psychiatric syndromes.