Li Y, Yu JL, Wang SY, Xie LX, Hong JL, Liu S. Effect of insomnia on anxiety and depression: Mediation of cognitive failures and moderated mediation of neuroticism. World J Psychiatry 2025; 15(2): 101026 [DOI: 10.5498/wjp.v15.i2.101026]
Corresponding Author of This Article
Sha Liu, PhD, Doctor, Researcher, Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan 030001, Shanxi Province, China. liusha1984114@163.com
Research Domain of This Article
Psychology, Clinical
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yue Li, Sha Liu, Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Yue Li, Sha Liu, Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Jia-Long Yu, Lu-Xin Xie, Jia-Long Hong, Department of Humanities and Social Science, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Shu-Yi Wang, Department of Medical Sciences, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Li Y was responsible for investigation and writing original draft preparation; Yu JL was responsible for software and methodology; Wang SY and Xie LX were responsible for investigation; Hong JL was responsible for visualization and validation; Liu S was responsible for conceptualization and data curation; all of the authors read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 82271546 and No. 82301744; The Shanxi Province Science and Technology Innovation Think Tank Construction Research Project, No. KXKT202317; Fundamental Research Program of Shanxi Province, No. 202303021222346 and No. 202103021223224; and The Research Foundation of The First Hospital of Shanxi Medical University, No. YQ2208.
Institutional review board statement: This study was approved by the First Hospital of Shanxi Medical University (No. KYLL-2023-269).
Informed consent statement: All participants provided informed consent to participate in the present study.
Conflict-of-interest statement: The authors declare no competing interests relevant to the content of this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sha Liu, PhD, Doctor, Researcher, Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan 030001, Shanxi Province, China. liusha1984114@163.com
Received: September 2, 2024 Revised: December 1, 2024 Accepted: December 25, 2024 Published online: February 19, 2025 Processing time: 133 Days and 22.8 Hours
Abstract
BACKGROUND
The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention. Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.
AIM
To investigate the prevalence of anxiety, depression, and insomnia and explore the relationship among neuroticism, cognitive failures, and mental health.
METHODS
A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants. The neuroticism, subjective cognitive function, and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version, cognitive failures questionnaire, generalized anxiety disorder-7, patient health questionnaire-9, and insomnia severity index. Pearson's correlation analysis, independent samples t-tests, one-way analysis of variance, and structural equation model were used to examine the relationship between mental health indicators.
RESULTS
A total of 1011 valid questionnaires were collected, of which 343 were completed by male (33.93%) respondents and 668 were completed by female (66.07%) respondents. The rates of anxiety, depression, and insomnia were 41.3%, 44.6%, and 36.3%, respectively, most cases of which were mild. Among the mental health indicators, there were significant differences by age and between those with siblings and those who were only children. Neuroticism and cognitive failures were significantly positively correlated with mental health indicators. Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression, with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.
CONCLUSION
Cognitive failures and neuroticism play important roles in mental health. Therefore, enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.
Core Tip: The coronavirus disease 2019 pandemic has had a significant and ongoing impact on public mental health. A cross-sectional survey involving 1011 participants revealed that approximately 40% reported symptoms of anxiety, depression, and insomnia, with the majority being mild. Cognitive failures mediated the relationship between insomnia and anxiety, as well as between insomnia and depression, and neuroticism moderated the first half of the pathway. Consequently, interventions aimed at enhancing subjective cognitive function and regulating emotional stability in individuals could significantly contribute to the improvement of mental health.
