![]() Given that people with MDs are often neglected following a disaster, we aimed to investigate the effect of COVID-19 outbreak on stress, anxiety, depression and insomnia in mentally ill patients derived from a national-wide sample in China. Moreover, recently, we found MDs are a risk factor for developing worsened insomnia during the COVID-19 outbreak in China based on a nationwide survey. Given that patients with mental health disorders (MDs) are more vulnerable to stress-related events and need to cope with their original mental illness, they are less likely to utilize active problem-solving strategies when facing life events. Recently, two systematic reviews and meta-analyses further confirmed the negative impacts of COVID-19 outbreak on psychological reactions and insomnia. Increasing surveys have been conducted all over the world to investigate psychological reactions and sleep changes in the general population, medical staff, as well as COVID-19 infected patients and found that prevalence of stress, anxiety, depression and insomnia increased significantly during the COVID-19 pandemic. Psychological problems associated with COVID-19, including anxiety, depression, stress, insomnia as well as negative outcomes have drawn a lot of attention from the public as well as medical community. ![]() As COVID-19 continued spreading, tens of thousands of lives were lost, and most commercial activities were disrupted. Since December 2019, an outbreak of a highly contagious, novel coronavirus that causes respiratory illness and severe pneumonia (the 2019 Coronavirus disease, COVID-19) has spread to 200 countries, areas or territories and became a global pandemic. ![]() Our findings suggest that adverse psychological reactions and insomnia are more pronounced in adults with mental health disorders during the COVID-19 outbreak, thus more attention need to be provided. Moreover, higher COVID-19-related stress and lower levels of pre-COVID-19 anxiety, depressive and insomnia symptoms were predictors for worsened anxiety, depression and insomnia in adults with MDs, respectively. ResultsÄuring the COVID-19 outbreak, we found significantly increased prevalence of anxiety (MDs: 54.9% vs. Worsened symptoms of anxiety, depressive and insomnia were defined when severity levels shifted to a more severe category compared to pre-COVID-19. A total of 244 adults with MDs and 1116 controls matched for age, gender and sites were included. MethodsĪ self-reported psychological and sleep online survey was conducted in China between February 5th to 19th, 2020. We investigated psychological reactions and insomnia during the COVID-19 outbreak in adults with mental health disorders (MDs). The 2019 coronavirus disease (COVID-19) has disrupted millions of lives and commerce.
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