{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:16Z","timestamp":1787028616417,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T00:00:00Z","timestamp":1615680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic highlighted the serious problems of health care systems but also threatened the mental and physical health of patients worldwide. The goal of this study was to assess psychological health and insomnia in people with chronic diseases in the time of elevated stress associated with the pandemic. The study involved 879 people from Zachodniopomorskie province in Poland. Each participant provided basic demographic data, data on symptoms of insomnia, depression, anxiety and information on concomitant diseases such as hypertension, diabetes mellitus, coronary heart disease, heart failure, dyslipidemia, chronic obstructive pulmonary disease, Hashimoto\u2019s disease and smoking cigarettes. Chronic diseases included in this study showed a strong correlation between Hashimoto\u2019s disease and increase scores according to the Insomnia Severity Index (ISI, r = 0.797, p &lt; 0.001), the Generalized Anxiety Disorder scale (GAD-7, r = 0.766, p &lt; 0.001) and the Patient Health Questionnaire (PHQ-9, r = 0.767, p &lt; 0.001). After the results were corrected for age, gender, diagnosed hypertension, dyslipidemia and cigarette smoking, it was confirmed that the diagnosis of Hashimoto\u2019s disease was associated with an increased risk of anxiety (odds ratio (OR) = 2.225; p &lt; 0.001), depression (OR = 2.518; p &lt; 0.001) and insomnia (OR = 3.530; p &lt; 0.001). Our study showed that during the SARS-CoV-2 pandemic patients with Hashimoto\u2019s disease show a higher risk of insomnia, anxiety and depression.<\/jats:p>","DOI":"10.3390\/jcm10061206","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T22:13:10Z","timestamp":1615759990000},"page":"1206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["The Impact of the COVID-19 Pandemic on Psychological Health and Insomnia among People with Chronic Diseases"],"prefix":"10.3390","volume":"10","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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102434","DOI":"10.1016\/j.jaut.2020.102434","article-title":"The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China","volume":"109","author":"Yang","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11307","DOI":"10.1038\/s41598-017-10402-1","article-title":"Impact of Comorbidity on Fatality Rate of Patients with Middle East Respiratory Syndrome","volume":"7","author":"Yang","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_3","unstructured":"CDC (2021, January 25). Coronavirus Disease 2019 (COVID-19), Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html."},{"key":"ref_4","first-page":"82","article-title":"Clinical manifestations of neuropsychiatric systemic lupus erythematosus: A single-center study from West Pomerania Province in Poland","volume":"130","author":"Nowacki","year":"2020","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_5","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_6","unstructured":"Mincer, D.L., and Jialal, I. (2020). Hashimoto Thyroiditis. StatPearls, StatPearls Publishing."},{"key":"ref_7","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_8","doi-asserted-by":"crossref","first-page":"eabd4585","DOI":"10.1126\/science.abd4585","article-title":"Auto-antibodies against type I IFNs in patients with life-threatening COVID-19","volume":"370","author":"Bastard","year":"2020","journal-title":"Science"},{"key":"ref_9","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_10","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3389\/fpsyt.2020.00306","article-title":"Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak","volume":"11","author":"Zhang","year":"2020","journal-title":"Front. Psychiatry"},{"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":"Lai","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_12","first-page":"190","article-title":"COVID-19 Pandemic: Stress Exposure of Healthcare Workers [COVID-19 Pandemic: Stress Experience of Healthcare Workers\u2014A Short Current Review]","volume":"47","author":"Bohlken","year":"2020","journal-title":"Psychiatry Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S0140-6736(20)30309-3","article-title":"2019-nCoV epidemic: Address mental health care to empower society","volume":"395","author":"Bao","year":"2020","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"575","DOI":"10.2147\/RMHP.S293471","article-title":"The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review","volume":"14","author":"Kendzerska","year":"2021","journal-title":"Risk Manag. Healthc. Policy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.dsx.2020.12.019","article-title":"Psychological impact of COVID-19 pandemic on chronic disease patients in Dessie town government and private hospitals, Northeast Ethiopia","volume":"15","author":"Addis","year":"2021","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_16","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_17","unstructured":"Morin, C.M. (1993). Insomnia: Psychological Assessment and Management, Guilford Press."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med."},{"key":"ref_19","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_20","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jama.1994.03520220043029","article-title":"Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study","volume":"272","author":"Spitzer","year":"1994","journal-title":"JAMA"},{"key":"ref_21","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_22","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A new depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatr. Ann."},{"key":"ref_23","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_24","doi-asserted-by":"crossref","unstructured":"Koyanagi, A., Garin, N., Olaya, B., Ayuso-Mateos, J.L., Chatterji, S., Leonardi, M., Koskinen, S., Tobiasz-Adamczyk, B., and Haro, J.M. (2015). Correction: Chronic Conditions and Sleep Problems among Adults Aged 50 years or over in Nine Countries: A Multi-Country Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138261"},{"key":"ref_25","first-page":"1615","article-title":"Anxiety and depression\u2014Important psychological comorbidities of COPD","volume":"6","author":"Pumar","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.5665\/sleep.1698","article-title":"Insomnia in Patients with COPD","volume":"35","author":"Budhiraja","year":"2012","journal-title":"Sleep"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.4081\/hpr.2015.2123","article-title":"Investigation of Anxiety and Depression in Patients with Chronic Diseases","volume":"3","author":"Gerontoukou","year":"2015","journal-title":"Health Psychol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1526-4637.2010.01044.x","article-title":"Chronic Pain and Psychiatric Morbidity: A Comparison between Patients Attending Specialist Orthopedics Clinic and Multidisciplinary Pain Clinic","volume":"12","author":"Wong","year":"2011","journal-title":"Pain Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Janowski, K., Kurpas, D., Kusz, J., Mroczek, B., and Jedynak, T. (2013). Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0063920"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s11255-011-9975-0","article-title":"Quality of life and mental health in hemodialysis and peritoneal dialysis patients: The role of health beliefs","volume":"44","author":"Theofilou","year":"2011","journal-title":"Int. Urol. Nephrol."},{"key":"ref_31","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_32","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1176\/jnp.13.4.532","article-title":"Affective Disorders Associated With Autoimmune Thyroiditis","volume":"13","author":"Degner","year":"2001","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1745-0179-1-23","article-title":"A case control study on psychiatric disorders in Hashimoto disease and Euthyroid Goitre: Not only depressive but also anxiety disorders are associated with thyroid autoimmunity","volume":"1","author":"Carta","year":"2005","journal-title":"Clin Pract. Epidemiol. Ment Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.genhosppsych.2013.10.002","article-title":"The prevalence of depression and anxiety disorders in patients with euthyroid Hashimoto\u2019s thyroiditis: A comparative study","volume":"36","author":"Uguz","year":"2014","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1507\/endocrj.EJ12-0035","article-title":"Depression in patients with euthyroid chronic autoimmune thyroiditis","volume":"59","author":"Kirim","year":"2012","journal-title":"Endocr. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1385\/ENDO:21:2:153","article-title":"Antithyroid antibody-linked symptoms in borderline personality disorder","volume":"21","author":"Geracioti","year":"2003","journal-title":"Endocrine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.12659\/MSM.914444","article-title":"Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B","volume":"25","author":"Huang","year":"2019","journal-title":"Med. Sci. Monit."},{"key":"ref_38","first-page":"72","article-title":"Anxiety and endocrine disease","volume":"4","author":"Hall","year":"1999","journal-title":"Semin. Clin. Neuropsychiatry"},{"key":"ref_39","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_40","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. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:35:28Z","timestamp":1760160928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,14]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10061206"],"URL":"https:\/\/doi.org\/10.3390\/jcm10061206","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,14]]}}}