Song Jaeeun, Chung Seockhoon
University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Psychiatry Investig. 2025 Jun;22(6):641-649. doi: 10.30773/pi.2024.0342. Epub 2025 Jun 16.
This study aimed to explore the feasibility of the cognitive-behavioral model of COVID-19-related hypochondriasis among participants infected with the virus, with specific consideration of insomnia severity. Additionally, factors predicting post-infection insomnia were examined in participants without pre-existing sleep disturbances pre-COVID-19 infection.
An online study was conducted involving the general population infected with COVID-19. Data were collected on COVID-19 and participants' psychiatric and sleep disorder histories. Self-rating scales utilized included the Insomnia Severity Index (ISI), Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemic-6 items (SAVE-6), Patient Health Questionnaire-2 items (PHQ-2), and Dysfunctional Beliefs about Sleep-2 items (DBS-2).
Among the 260 participants infected with COVID-19, mediation analysis revealed that SAVE-6 had a direct influence on OCS, while CRBS mediated this effect. Furthermore, a separate mediation model demonstrated that the impact of ISI on OCS was mediated by CRBS, PHQ-2, and SAVE-6. Logistic regression analysis conducted on 211 participants without prior sleep disturbances indicated that past psychiatric history, DBS-2, and PHQ-2 served as predictive factors for post-COVID sleep disorders.
This study established a feasible hypochondriasis model, demonstrating the influence of insomnia on preoccupation with COVID-19, mediated by reassurance-seeking behavior, depression, and viral anxiety. Moreover, a history of psychiatric disorders, depression, and dysfunctional beliefs about sleep significantly contributed to the emergence of post-COVID sleep disorders.
本研究旨在探讨新冠病毒感染参与者中与新冠病毒相关的疑病症认知行为模型的可行性，特别考虑失眠严重程度。此外，还对新冠病毒感染前无既往睡眠障碍的参与者中预测感染后失眠的因素进行了研究。
开展了一项针对新冠病毒感染普通人群的在线研究。收集了有关新冠病毒感染情况以及参与者精神和睡眠障碍病史的数据。使用的自评量表包括失眠严重程度指数（ISI）、对新冠病毒的强迫观念量表（OCS）、寻求新冠病毒安慰行为量表（CRBS）、对病毒流行的压力和焦虑-6项量表（SAVE-6）、患者健康问卷-2项量表（PHQ-2）以及关于睡眠的功能失调信念-2项量表（DBS-2）。
在260名新冠病毒感染参与者中，中介分析显示SAVE-6对OCS有直接影响，而CRBS介导了这一效应。此外，另一个中介模型表明，ISI对OCS的影响由CRBS、PHQ-2和SAVE-6介导。对211名既往无睡眠障碍的参与者进行的逻辑回归分析表明，既往精神病史、DBS-2和PHQ-2是新冠病毒感染后睡眠障碍的预测因素。
本研究建立了一个可行的疑病症模型，证明了失眠通过寻求安慰行为、抑郁和病毒焦虑介导，对新冠病毒相关的先占观念产生影响。此外，精神疾病史、抑郁以及对睡眠的功能失调信念显著促成了新冠病毒感染后睡眠障碍的出现。
