Psychological Distress and Sleep Problems when People Are Under Interpersonal Isolation During an Epidemic: A Nationwide Multicenter Cross-sectional Study

Background.: During the outbreak of coronavirus disease 2019 (COVID-19), people are under the dual pressure of interpersonal isolation and concerns about infection. An evaluation of people's psychological status and risk factors is needed to conduct target interventions.

Methods.: This was a nationwide, multicenter, cross-sectional study using quota and snowball sampling methods during the COVID-19 epidemic in China. Participants' characteristics and experiences were obtained by an online questionnaire and telephone review. Psychological distress and sleep problems were measured by the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Insomnia Severity Index.

Results.: A total of 23,500 participants were recruited, and 19,372 valid questionnaires were received from 11 centers. Overall, 11.0-13.3% of the participants had anxiety, depression, or insomnia symptoms, and 1.9-2.7% had severe symptoms. The prevalence of psychological and sleep problems has increased. Working as frontline medical staff (Odds Ratio OR = 3.406), living in Hubei Province (OR = 2.237), close contacts with COVID-19 (OR = 1.808), and age 35-49 years (OR = 1.310) were risk factors for anxiety symptoms; no outside activity for 2 weeks (OR = 2.167) and age 35-49 years (OR = 1.198) were risk factors for depression symptoms; and living in Hubei Province (OR = 2.376), no outside activity for 2 weeks (OR = 1.927), and age 35-49 years (OR = 1.262) were risk factors for insomnia symptoms. Only 1.9% of participants received counseling during the epidemic.

Conclusions.: Psychological and sleep problems increased during interpersonal isolation due to COVID-19. Current psychological interventions are far from sufficient.