Abstract
OBJECTIVE: 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. METHODS: 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). RESULTS: 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. CONCLUSION: 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.