Status and influential factors of anxiety depression and insomnia symptoms in the work resumption period of COVID-19 epidemic: A multicenter cross-sectional study

Abstract

Objective In this study, the authors analyzed the status of anxiety depression and insomnia symptoms and influential factors in the work resumption period of Coronavirus disease 2019 (COVID-19). Methods A multicenter cross-sectional survey was conducted from March 2, 2020 to March 8, 2020 in Shandong Province, China, using quota sampling combined with snowball sampling. The Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index (ISI) were used to assess the anxiety, depression, and insomnia symptoms. The multivariate logistic regression analysis was used to explore the influential factors. Results A total of 4000 invitations were sent from three centers, 3237 valid questionnaires were received. Based on GAD-7, PHQ-9, and ISI scales, 19.5%–21.7% of the participants had anxiety, depression, or insomnia symptoms; 2.9%–5.6% had severe symptoms. Besides, 2.4%, 4.8%, and 4.5% of the participants had anxiety-depression, anxiety-insomnia, or depression-insomnia combined symptoms. The scores of anxiety and insomnia symptoms, along with scores of depression and insomnia symptoms were positively correlated in these samples. Aged 50–64 years and outside activities once in ≥30 days were risk factors of anxiety, depression, and insomnia symptoms in common. During the epidemic, 17.4% of the participants had received psychological interventions, and only 5.2% had received individual interventions. Conclusions The incidence of psychological distress increased during the outbreak of COVID-19 in the work resumption period than the normal period. Current psychological interventions were insufficient; target psychological interventions should be conducted in time.

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

“…People with loved ones who contracted or died from COVID-19 has been reported to significantly contribute to pandemic stress and psychological symptoms, which should receive timely interventions [ 42 , 43 ]. In contrast, a large number of participants with psychological problems were noncontacts of confirmed patients, which was not reported in previous studies [ 6 , 13 ]. For participants indicating epidemic status E6 (i.e., noncontacts), having experienced no psychological intervention and having engaged in outside activity once in ≥ 30 days were risk factors for depression (OR = 2.128; OR = 1.916).…”

“…The first study in this research series was a nationwide study for the outbreak period [ 6 ]. The second study was a provincial-wide study for the preliminary work resumption period with a resumption proportion of 69.9% [ 13 ]. The current nationwide study was the third stage of this research series, which was conducted for a further return-to-work period with a resumption proportion of 86.6%.…”

“…The current research team conducted a series of studies using similar sampling strategies and geographic areas [ 6 , 13 ]. The prevalence values for anxiety, depression, and insomnia symptoms in these studies were 12.2, 11.0, and 13.3% during the outbreak; 20.8, 19.5, and 21.7% during the preliminary work resumption period (the resumption proportion was 69.9%); and 18.3, 14.9, and 17.9% during the further return-to-work period (in this study, the resumption proportion was 86.6%).…”

“…Cross-regional outside activities and nonessential outside activities are still restricted [ 12 ]. During the return-to-work period of COVID-19, people are experiencing multiple pressures of concern related to infection, interpersonal isolation, and work resumption, which might have different influences on psychological and sleep problems [ 13 ]. However, there is a lack of studies on psychological conditions during the return-to-work period [ 13 , 14 ].…”

“…During the return-to-work period of COVID-19, people are experiencing multiple pressures of concern related to infection, interpersonal isolation, and work resumption, which might have different influences on psychological and sleep problems [ 13 ]. However, there is a lack of studies on psychological conditions during the return-to-work period [ 13 , 14 ]. Moreover, most previous cross-sectional studies on mental health only conducted online surveys for web users or applied only snowball or convenient sampling, and some studies did not perform sampling nationwide, which may decrease their representativeness for the entire Chinese population [ 7 , 9 , 15 , 16 ].…”