{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T13:50:11Z","timestamp":1762782611288,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Despite the high number of studies on mental health among healthcare workers, only a few have attempted to assess the mental health of people with chronic diseases during the COVID-19 crisis. Therefore, the aim of this study is to evaluate the symptoms of insomnia, anxiety, and depression among people with chronic diseases working in healthcare and in other professions. The study participants were divided into two groups. The first group consisted of 441 healthcare workers, and the second consisted of 572 non-healthcare professionals. Correlation analysis showed a strong correlation between autoimmune diseases and an increase in GAD-7 scale, ISI score, and PHQ-9 scale. Therefore, only autoimmune diseases were included for further analyses as a predictor of insomnia, depression, and anxiety. After adjusting the results for gender, age, smoking, dyslipidemia, hypertension, and profession, the group with autoimmune diseases showed a more than a 2-fold increase in the risk of anxiety symptoms, a more than 2.5-fold increase in the risk of depressive symptoms, and a 4-fold increase in the risk of insomnia symptoms. This study shows that, during the COVID-19 pandemic, the incidence of insomnia, anxiety disorders, and depressive disorders may depend on the pre-existent health status of an individual rather than on their profession.<\/jats:p>","DOI":"10.3390\/brainsci11081001","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T10:47:46Z","timestamp":1627555666000},"page":"1001","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Insomnia, Anxiety, and Depression Symptoms during the COVID-19 Pandemic May Depend on the Pre-Existent Health Status Rather than the Profession"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7956-1107","authenticated-orcid":false,"given":"Pawe\u0142","family":"Wa\u0144kowicz","sequence":"first","affiliation":[{"name":"Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, \u017bolnierska 48, 71-210 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6105-5329","authenticated-orcid":false,"given":"Aleksandra","family":"Szyli\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, \u017bolnierska 48, 71-210 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4337-6476","authenticated-orcid":false,"given":"Iwona","family":"Rotter","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, \u017bolnierska 48, 71-210 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"(2020, September 21). 1st Known Case of Coronavirus Traced Back to November in China Live Science. Available online: https:\/\/www.livescience.com\/first-case-coronavirus-found.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/qjmed\/hcaa201","article-title":"The psychological impact of COVID-19 on the mental health in the general population","volume":"113","author":"Serafini","year":"2020","journal-title":"QJM"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ijsu.2020.04.018","article-title":"The socio-economic implications of the coronavirus pandemic (COVID-19): A review","volume":"78","author":"Nicola","year":"2020","journal-title":"Int. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"McMahon, D.E., Peters, G.A., Ivers, L.C., and Freeman, E.E. (2020). Global resource shortages during COVID-19: Bad news for low-income countries. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008412"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"103436","DOI":"10.1016\/j.jvb.2020.103436","article-title":"Unemployment in the time of COVID-19: A research agenda","volume":"119","author":"Blustein","year":"2020","journal-title":"J. Vocat. Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.sleep.2020.04.019","article-title":"COVID-19, anxiety, sleep disturbances and suicide","volume":"70","author":"Sher","year":"2020","journal-title":"Sleep Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e05766","DOI":"10.1016\/j.heliyon.2020.e05766","article-title":"Emotional distress, psychosomatic symptoms and their relationship with institutional responses: A survey of Italian frontline medical staff during the Covid-19 pandemic","volume":"6","author":"Marinaci","year":"2020","journal-title":"Heliyon"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Toyoshima, K., Inoue, T., Shimura, A., Uchida, Y., Masuya, J., Fujimura, Y., Higashi, S., and Kusumi, I. (2021). Mediating Roles of Cognitive Complaints on Relationships between Insomnia, State Anxiety, and Presenteeism in Japanese Adult Workers. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094516"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13030-020-00183-x","article-title":"Associations between the depressive symptoms, subjective cognitive function, and presenteeism of Japanese adult workers: A cross-sectional survey study","volume":"14","author":"Toyoshima","year":"2020","journal-title":"Biopsychosoc. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e203976","DOI":"10.1001\/jamanetworkopen.2020.3976","article-title":"Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019","volume":"3","author":"La","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/S2215-0366(20)30078-X","article-title":"Mental health care for medical staff in China during the COVID-19 outbreak","volume":"7","author":"Chen","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102119","DOI":"10.1016\/j.ajp.2020.102119","article-title":"Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review","volume":"51","author":"Spoorthy","year":"2020","journal-title":"Asian J. Psychiatr."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Wa\u0144kowicz, P., Szyli\u0144ska, A., and Rotter, I. (2020). Assessment of Mental Health Factors among Health Professionals Depending on Their Contact with COVID-19 Patients. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17165849"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1097\/j.pain.0000000000001885","article-title":"Managing patients with chronic pain during the COVID-19 outbreak: Considerations for the rapid introduction of remotely supported (eHealth) pain management services","volume":"161","author":"Eccleston","year":"2020","journal-title":"Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1213\/ANE.0000000000005000","article-title":"Emergence From the COVID-19 Pandemic and the Care of Chronic Pain: Guidance for the Interventionalist","volume":"131","author":"Deer","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"CDC (2021, June 05). Coronavirus Disease 2019 (COVID-19), Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html.","DOI":"10.47191\/ijcsrr\/V5-i8-12"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1568-9972(03)00006-5","article-title":"The epidemiology of autoimmune diseases","volume":"2","author":"Cooper","year":"2003","journal-title":"Autoimmun. Rev."},{"key":"ref_19","unstructured":"Mincer, D.L., and Jialal, I. (2020). Hashimoto Thyroiditis. StatPearls, StatPearls Publishing."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1093\/rheumatology\/kex260","article-title":"The worldwide incidence and prevalence of systemic lupus erythematosus: A systematic review of epidemiological studies","volume":"56","author":"Rees","year":"2017","journal-title":"Rheumatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"110345","DOI":"10.1016\/j.mehy.2020.110345","article-title":"The triggering of post-COVID-19 autoimmunity phenomena could be associated with both transient immunosuppression and an inappropriate form of immune reconstitution in susceptible individuals","volume":"145","year":"2020","journal-title":"Med. Hypotheses"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"eabd4585","DOI":"10.1126\/science.abd4585","article-title":"Autoantibodies against type I IFNs in patients with life-threatening COVID-19","volume":"370","author":"Bastard","year":"2020","journal-title":"Science"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wa\u0144kowicz, P., Szyli\u0144ska, A., and Rotter, I. (2020). Evaluation of Mental Health Factors among People with Systemic Lupus Erythematosus during the SARS-CoV-2 Pandemic. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092872"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wa\u0144kowicz, P., Szyli\u0144ska, A., and Rotter, I. (2021). The Impact of the COVID-19 Pandemic on Psychological Health and Insomnia among People with Chronic Diseases. J. Clin. Med., 10.","DOI":"10.3390\/jcm10061206"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1111\/1756-185X.13960","article-title":"Impact of the COVID-19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries","volume":"23","author":"Hmamouchi","year":"2020","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1017\/S1478951520000528","article-title":"Mental health in chronic disease patients during the COVID-19 quarantine in Greece","volume":"18","author":"Louvardi","year":"2020","journal-title":"Palliat. Support. Care"},{"key":"ref_30","first-page":"cer-10-16","article-title":"Making Mental Health a Global Priority","volume":"2016","author":"Marquez","year":"2016","journal-title":"Cerebrum"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.rdc.2015.08.004","article-title":"Infection Risk and Safety of Corticosteroid Use","volume":"42","author":"Youssef","year":"2016","journal-title":"Rheum. Dis. Clin. N. Am."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Bookwalter, D.B., Roenfeldt, K.A., LeardMann, C.A., Kong, S.Y., Riddle, M.S., and Rull, R.P. (2020). Posttraumatic stress disorder and risk of selected autoimmune diseases among US military personnel. BMC Psychiatry., 20.","DOI":"10.1186\/s12888-020-2432-9"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wang, Y., Shi, L., Que, J., Lu, Q., Liu, L., Lu, Z., Xu, Y., Liu, J., Sun, Y., and Meng, S. (2021). The impact of quarantine on mental health status among general population in China during the COVID-19 pandemic. Mol. Psychiatry, 1\u201310.","DOI":"10.1038\/s41380-021-01019-y"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/art.1780270102","article-title":"The psychosocial impact of systemic lupus erythematosus and rheumatoid arthritis","volume":"27","author":"Liang","year":"1984","journal-title":"Arthritis Rheum."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1136\/annrheumdis-2017-211284","article-title":"Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study","volume":"76","author":"Michelsen","year":"2017","journal-title":"Ann. Rheum. 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