Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study

Abstract

Background Insomnia and suicidal thoughts are two of the negative impacts that have been caused by the COVID-19 pandemic. Identifying the factors that contribute to these psychological problems may help develop strategies to sustain the mental health of the public. The present study examined the psychosocial impacts caused by the COVID-19 pandemic among different populations in Taiwan, and investigated the relationships between these psychosocial variables, insomnia, and suicidal thoughts. Methods Between September 2020 and May 2021, online questionnaires including psychometrically validated scales were distributed to a convenience sample of outpatients (n = 205), healthcare workers (HCWs) (n = 500), and individuals in the general population (n = 1200) in Taiwan to collect data regarding their insomnia severity, suicidal thoughts, fear of COVID-19, trust of information, and resilience. Multivariate logistic regression methods were used to identify variables associated with suicidal thoughts and insomnia. Results Greater fear of COVID-19 was significantly associated with suicidal thoughts: odds ratios (ORs) with 95% confidence interval (CI) = 1.155 (1.002–1.330) for outpatients; 1.127 (1.035–1.228) for HCWs; and 1.100 (1.130–1.222) for those in the general population. Higher resilience was significantly associated with lower insomnia: OR (95% CI) = 0.819 (0.725–0.926) for outpatients; 0.803 (0.728–0.887), for HCWs; 0.829 (0.785–0.875), and for those in the general population. In addition, there was a statistically significant association between insomnia diagnosis and greater fear of COVID-19 among HCWs (OR [95% CI] = 1.102 [1.062–1.144]) and those in the general population (OR [95% CI] = 1.079 [1.053–1.106]). Among outpatients, there was a statistically significant association between suicidal thoughts and lower trust of information (OR [95% CI] = 0.794 [0.646–0.976]), while among those in the general population there was a statistically significant association between suicidal thoughts and higher insomnia severity (OR [95% CI] = 1.175 [1.13–1.222]). A statistically significant association was also found between insomnia diagnosis and higher suicidal thoughts among those in the general population (OR [95% CI] = 3.455 [2.338–5.106]). Conclusions Trust of information, fear, and resilience were important factors for suppressing suicidal thoughts and insomnia among the three study populations. Health policies that monitor psychological status and build resiliency of the public are recommended to help develop tailored strategies for different populations affected by the COVID-19 pandemic.

Suicidal behavior during the Covid-19 pandemic: Results from cross-sectional surveys of Brazilian adults from 2020 to 2022

“…Another finding in this study indicated that a severe or moderate level of fear of Covid-19, when added alongside the pandemic year in the logistic regression model, increased the probability of being in the group with suicidal ideation. Initially, the data found in this study confirmed the literature by suggesting that a greater fear of Covid-19 appears to be associated with suicidal behaviors [19] [20]. Other studies found that fear can have detrimental effects when it persists and intensifies [17] [49] [18], as is the case with the Covid-19 pandemic, which resulted in prolonged exposure to the fear of infection and the presentation of severe forms of the disease.…”

“…Even with exposure, it is important to understand how capable, skilled, or confident a person feels in dealing with the fear-inducing event. For example, a higher level of fear of Covid-19 has been associated with a higher likelihood of exhibiting suicidal behavior in Taiwan and Spain [19] [20], as well as symptoms of anxiety and depression [17] as evidenced in a systematic review conducted in over 30 countries.…”

Insomnia, Suicidal Thoughts, and Mental Health Among Health-Care Workers During COVID-19

“…The results of this study resonate with our recent findings in Taiwan, as reported in BMC Public Health , 2 where we investigated the factors contributing to insomnia and suicidal thoughts among different populations during the COVID-19 pandemic. We found that greater fear of COVID-19 was significantly associated with suicidal thoughts across outpatients, health-care workers, and the general population.…”

Perceived stigma among discharged patients of COVID-19 in Wuhan, China: A latent profile analysis

“…Resilience is not a linear path toward happiness, but a combination of behaviors that encourages individuals and communities to persevere and move forward confronting difficult situations ( 24 , 25 ). Higher level of resilience might decrease the risk of developing psychological distress, and suppress suicidal thoughts and insomnia ( 26 , 27 ). Resilience might be influenced by job stress, perceived stress, and mindfulness, and be promoted by brief resilience interventions based on positive psychology ( 28–30 ).…”