A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19

Hosein Mahmoudi, Mohsen Saffari, Mahmoud Movahedi, Hormoz Sanaeinasab, Hojat Rashidi-Jahan, Morteza Pourgholami, Ali Poorebrahim, Jalal Barshan, Milad Ghiami, Saman Khoshmanesh, Marc N Potenza, Chung-Ying Lin, Amir H Pakpour, Hosein Mahmoudi, Mohsen Saffari, Mahmoud Movahedi, Hormoz Sanaeinasab, Hojat Rashidi-Jahan, Morteza Pourgholami, Ali Poorebrahim, Jalal Barshan, Milad Ghiami, Saman Khoshmanesh, Marc N Potenza, Chung-Ying Lin, Amir H Pakpour

Abstract

Introduction: Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep.

Methods: Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables.

Results: Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life.

Conclusion: Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.

Keywords: COVID-19; coronavirus; quality of life; sleep disorders; stigmatization; stress.

Conflict of interest statement

Dr. Potenza has consulted for and advised Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, and the Addiction Policy Forum; has received research support from the Mohegan Sun Casino, the Connecticut Council on Problem Gambling, and the National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders, or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders. The other authors report no financial relationships with commercial interests.

© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC.

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