Background: The outbreak of novel coronavirus disease (COVID-19) has brought serious psychological pressure to people, especially medical health staff. At present, there are few studies on insomnia and related factors of medical health staff in the middle and late stage of the epidemic of COVID-19. Therefore, the purpose of this study was to investigate the prevalence of insomnia and its related risk factors among medical workers in China in the middle and later stage of COVID-19 epidemic, as well as the relationship between insomnia and psychological resilience.Methods: From February 14 to March 29, 2020, a cross-sectional survey was conducted among 606 medical staff in China through Ranxing Technology's “SurveyStar” network platform. All subjects were assessed with the Insomnia Severity Index (ISI) and simplified Chinese version of Connor-Davidson Resilience scale (CD-RISC-10).Results: In the middle and later stages of the COVID-19 outbreak, the incidence of insomnia among medical staff was 32.0%. Compared with non-insomnia group, the insomnia group had younger age, lower education level, longer daily working hours and less psychological resilience. In addition, the prevalence of insomnia was higher in medical staff with a history of somatic diseases. The severity of insomnia of Chinese medical staff was associated with age, education level, daily working hours, psychological resilience and somatic diseases.Conclusions: Our study shows that nearly 1/3 of Chinese medical workers suffer from insomnia nearly a month after the COVID-19 outbreak. Compared with the general population, medical staff who are working with COVID are more prone to insomnia. Risk factors for insomnia include younger age, lower education level, longer working hours per day, and physical illness. The tenacious dimension of psychological resilience is a protective factor for insomnia.

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Objective Insomnia is the most common complaint in adolescents with mood disorders (MD). However, the psychopathological mechanisms associated with insomnia remain unclear. Therefore, we aimed to explore anxiety’s mediating role in the effect of rumination on insomnia in MD adolescents. Methods A total of 569 MD patients were recruited. Participants completed the Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7) scale, and Insomnia Severity Index (ISI) to self-assess their mood and insomnia symptoms. In addition, the 21-item Chinese version of the Ruminative Response Scale (RRS) was used to assess rumination specifically. Results The prevalence of insomnia in MD patients was 60.63%, with a higher prevalence in females (63.32%) vs. male patients(54.39%). MD patients with insomnia symptoms also scored higher on depression and anxiety symptom scales, as well as rumination, when compared to MD patients without insomnia. Depression-related rumination and anxiety were correlated with insomnia in MD patients. The AUCROC showed that the combination of depression-related rumination and anxiety could effectively distinguish patients with and without insomnia in MD adolescents. Furthermore, in adolescents with MD, depression-related rumination positively predicted anxiety and insomnia, and anxiety positively predicted insomnia. Finally, anxiety partially mediated the association between depression-related rumination and insomnia. Conclusion Our results suggest that depression-related rumination and anxiety are key riskfactors for insomnia in adolescents with MD. Furthermore, anxiety can exacerbate the effects of depression-related rumination on insomnia, suggesting that clinical interventions to reduce depression-related rumination and anxiety may be a viable consideration for insomnia in adolescents with MD.

BackgroundSexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.MethodsA total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.ResultsOverall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.ConclusionsThis study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.