scholarly journals Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Maria Pavlova ◽  
Jennifer Ference ◽  
Megan Hancock ◽  
Melanie Noel
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Pediatric Chronic Pain ◽  
Pain Outcomes

Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders.Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain.Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms.Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships.Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.

scholarly journals ASSOCIATIONS OF GENERAL MENTAL HEALTH SYMPTOMS WITH SUBJECTIVE SLEEP QUALITY AND INDIVIDUAL DAYTIME SLEEPINESS

2019 ◽  
Vol 6 (4) ◽  
pp. 192-199
Author(s):  
R.S. Schierholz ◽  
I. Zavgorodniy ◽  
S. Darius ◽  
I. Böckelmann
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
General Health Questionnaire ◽  
Poor Sleep ◽  
Mental Health Symptoms ◽  
Subjective Sleep Quality ◽  
Health Symptoms ◽  
General Mental Health ◽  
Subjective Sleep

ASSOCIATIONS OF GENERAL MENTAL HEALTH SYMPTOMS WITH SUBJECTIVE SLEEP QUALITY AND INDIVIDUAL DAYTIME SLEEPINESS Schierholz RS, Zavgorodniy I., Darius S., Böckelmann I. Purpose: Sufficient sleep quality plays a significant role for long-term physical and mental health. The aim of this study was to examine the associations of general mental health symptoms with sleep quality and daytime sleepiness. Materials and Methods: A cross-sectional survey with 84 included participants (female: n = 42, male: n = 42) was conducted. General mental health symptoms were assessed using the 12-item General Health Questionnaire (GHQ-12), sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and daytime sleepiness was evaluated with the Epworth Sleepiness Scale (ESS). Statistical differences were calculated using two-sample t-test and Mann-Whitney U test. For correlation analyses Spearman’s rank correlation was used. Results: Subjects with poor sleep quality reached higher scores in the GHQ-12 and in the ESS than subjects with good sleep quality, but the difference regarding the ESS was not significant. Higher GHQ-12 scores were associated with higher PSQI scores but not with higher ESS scores. Conclusions: Major findings show strong evidence of an association between general mental health symptoms and sleep quality with poor sleepers having a more disturbed mental health than good sleepers. Further evidence of the interrelationship between subjective sleep quality and general mental health symptoms was found. Keywords: Mental health, Work ability, Stress, Sleep, Insomnia   Абстракт ЗВ’ЯЗОК ЗАГАЛЬНИХ СИМПТОМІВ ПСИХІЧНОГО ЗДОРОВ'Я З СУБ'ЄКТИВНОЮ ЯКІСТЮ СНУ ТАІНДИВІДУАЛЬНОЮ ДЕННОЮ СОНЛИВІСТЮ Робін Себастьян Шірхольц*, Ігор Завгородній, Сабіна Даріус, Ірина Беккельман Мета: Достатня якість сну відіграє важливу роль для тривалого фізичного та психічного здоров’я. Метою цьогодослідження було вивчення залежності загальних симптомів психічного здоров’я від якісті сну та денноїсонливості. Матеріали та методи: Було проведено перехресне опитування за участю 84 учасників (жінки: n = 42, чоловіки: n= 42). Загальні симптоми психічного здоров’я оцінювали за допомогою Анкети загального здоров’я (GHQ-12), яка містить 12 пунктів; якість сну оцінювали за допомогою Пітсбургського опитувальника якості сну (PSQI), а денну сонливість оцінювали за Шкалою сонливості Епворта (ESS). Статистичні відмінності розраховувались за допомогою двопробного t-тесту та U-тесту Манна-Вітні. Для кореляційного аналізу було використано рангову кореляцію Спірмена. Результати: Суб'єкти з низькою якістю сну показали більш високі показники у GHQ-12 та ESS, ніж суб'єкти із хорошою якістю сну, але різниця щодо ESS була несуттєвою. Більш високі показники GHQ-12 були пов'язані з більш високими показниками PSQI, але не з більш високими показниками ESS. Висновки: Основні результати виявляють вагомі докази зв'язку між загальними симптомами психічного здоров’я та якістю сну людей, які погано сплять, та людей з міцним сном. У людей з поганим сном більш виражені порушення психічного здоров’я. Були знайдені додаткові докази взаємозв'язку між суб'єктивною якістю сну та загальними симптомами психічного здоров'я. Ключові слова: Психічне здоров'я, працездатність, стрес, сон, безсоння    Абстракт СВЯЗЬ ОБЩИХ СИМПТОМОВ ПСИХИЧЕСКОГО ЗДОРОВЬЯ С СУБЪЕКТИВНЫМ КАЧЕСТВОМ СНА И ИНДИВИДУАЛЬНОЙ ДНЕВНОЙ СОНЛИВОСТЬЮ Робин Себастьян Ширхольц, Игорь Завгородний, Сабина Дариус, Ирина Беккельманн Цель: Достаточное качество сна играет важную роль для долгосрочного физического и психического здоровья. Целью данного исследования было изучение связи общих симптомов психического здоровья с качеством сна и дневной сонливостью. Материалы и методы. Было проведено перекрестное исследование с 84 участниками (женщины: n = 42, мужчины: n = 42). Общие симптомы психического здоровья оценивали с использованием Общего опросника здоровья (GHQ-12), содержащего 12 пунктов; качество сна оценивали с помощью Питтсбургского опросника качества сна (PSQI), а дневную сонливость оценивали по Шкале сонливости Эпворта (ESS). Статистические различия рассчитывали с использованием двухпробного t-теста и U-теста Манна-Уитни. Для корреляционного анализа была использована ранговая корреляция Спирмена. Результаты: Субъекты с плохим качеством сна показали более высокие баллы в GHQ-12 и в ESS, чем субъекты с хорошим качеством сна, но разница в отношении ESS не была значительной. Более высокие показатели GHQ-12 были связаны с более высокими показателями PSQI, но не с более высокими показателями ESS. Выводы: Основные результаты обнаруживают убедительные доказательства связи между общими симптомами психического здоровья и качеством сна людей, которые плохо спят, и людей с крепким сном. У людей с плохим сном более выражены нарушения психического здоровья. Были найдены дополнительные доказательства взаимосвязи между субъективным качеством сна и общими симптомами психического здоровья. Ключевые слова: психическое здоровье, трудоспособность, стресс, сон, бессонница

scholarly journals Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: a web-based cross-sectional survey

2020 ◽  
Author(s):  
Yeen Huang ◽  
Ning Zhao
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Healthcare Workers ◽  
Influence Factors ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based

Abstract Background China has been severely affected by COVID-19 (Corona Virus Disease 2019) since December, 2019. This study aimed to assess the population mental health burden during the epidemic, and to explore the potential influence factors. Methods Using a web-based cross-sectional survey, we collected data from 7,236 self-selected volunteers assessed with demographic information, COVID-19 related knowledge, Generalized Anxiety Disorder-7 (GAD-7), Center for Epidemiology Scale for Depression (CES-D), and Pittsburgh Sleep Quality Index (PSQI). Logistic regressions were used to identify influence factors associated with mental health problem. Results Of the total sample analyzed, the overall prevalence of GAD, depressive symptoms, and sleep quality were 35.1%, 20.1%, and 18.2%, respectively. Young people reported a higher prevalence of GAD and depressive symptoms than older people ( P <0.001). Compared with other occupational group, healthcare workers have the highest rate of poor sleep quality ( P <0.001). Multivariate logistic regression showed that age (< 35 years) and times to focus on the COVID-19 (≥ 3 hours per day) were associated with GAD, and healthcare workers were associated with poor sleep quality. Conclusions Our study identified a major mental health burden of the public during COVID-19 epidemic in China. Young people, people who spent too much time on the epidemic, and healthcare workers were at high risk for mental illness. Continuous surveillance and monitoring of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.

scholarly journals Mental health service use and its associated factors among nurses in China: a cross-sectional survey

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11181
Author(s):  
Yusheng Tian ◽  
Yuchen Yue ◽  
Xiaoli Liao ◽  
Jianjian Wang ◽  
Man Ye ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Mental Health Service ◽  
Health Service ◽  
Sleep Quality ◽  
Service Use ◽  
Mental Health Service Use ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Factors Associated

Background To facilitate mental health service planning for nurses, data on the patterns of mental health service use (MHSU) among nurses are needed. However, MHSU among Chinese nurses has seldom been studied. Our study aimed to explore the rate of MHSU among Chinese nurses and to identify the factors associated with MHSU. Methods A self-designed anonymous questionnaire was used in this study. MHSU was assessed by the question, “Have you ever used any kind of mental health services, such as mental health outpatient services or psychotherapies, when you felt that your health was suffering due to stress, insomnia, or other reasons?” The answer to the question was binary (yes or no). Sleep quality, burnout, and depressive symptoms were assessed using the Chinese version of the Pittsburgh Sleep Quality Index , the Chinese version of the Maslach Burnout Inventory-General Survey and the two-item Patient Health Questionnaire, respectively. Chi-square tests and binary logistic regression were used for univariate and multivariate analyses. Results A total of 10.94% (301/2750) of the nurses reported MHSU. 10.25% (282/2750) of the nurses had poor sleep quality, burnout and depressive symptoms, and only 26.95% of these nurses reported MHSU. Very poor sleep quality (OR 9.36, 95% CI [5.38-16.29]), mid-level professional title (OR 1.48, 95% CI [1.13-1.93]) and depressive symptoms (OR 1.66, 95% CI [1.28-2.13]) were independent factors associated with MHSU. Conclusions Most of the nurses have experienced burnout, poor sleep quality or depressive symptoms and the MHSU rate among them was low. Interventions to improve the mental health of nurses and to promote the use of mental health services are needed.

An assessment of mental health and its associated factors in Indian population during COVID-19 crisis: A cross sectional study (Preprint)

2020 ◽  
Author(s):  
Dr. Laxmi Verma ◽  
Shailendra Chhonkar
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Indian Population ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
High Anxiety ◽  
Cross Sectional

BACKGROUND India has seen a tremendous surge in COVID-19 cases since past few months. This unpredictable disease has threatened people’s mental health as much as their physical health. OBJECTIVE To assess the burden of mental health amid this pandemic, we conducted a cross-sectional study in Indian population. We also assessed the predictors of mental health burden. METHODS A cross-sectional, web based study was adopted using the snowball sampling method. Participants were invited to fill a validated questionnaire that assessed the demographic characteristics, Knowledge of Covid-19, quality of sleep (PSQI), generalized anxiety disorder (GAD) and depressive symptoms (CES-D). RESULTS Findings in our study revealed that participants were having high Anxiety (43.6%), depressive symptoms (43.8%) and poor sleep quality (56.2%). Multivariable logistic regression analysis suggested that people ≥35 years were prone to have GAD, depressive symptoms and poor sleep quality. Healthcare workers were at higher risk to develop anxiety, depressive symptoms and inferior quality of sleep (P<.000) compared to the other occupations. Females tend to have high anxiety and depression (P<.000). Additionally, People having poor understanding about Covid-19 had more sleep related problems. CONCLUSIONS The study findings indicated that the Indian population amid Covid-19 crisis reported to have high anxiety, depressive symptoms and poor sleep quality. Government needs to devise a comprehensive, effective and efficient action plan to address this probing issue.

scholarly journals Acute COVID-19 severity and 16-month mental morbidity trajectories in patient populations of six nations

2021 ◽  
Author(s):  
Ingibjorg Magnusdottir ◽  
Aniko Lovik ◽  
Anna Bara Unnarsdottir ◽  
Daniel L. McCartney ◽  
Helga Ask ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Repeated Measures ◽  
Acute Infection ◽  
Prevalence Ratio ◽  
Poor Sleep ◽  
Depression And Anxiety ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Prevalence Of Depression

BACKGROUND The aim of this multinational study was to assess the development of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. METHODS Participants consisted of 247 249 individuals from seven cohorts across six countries (Denmark, Estonia, Iceland, Norway, Scotland, and Sweden) recruited from April 2020 through August 2021. We used multivariable Poisson regression to contrast symptom-prevalence of depression, anxiety, COVID-19 related distress, and poor sleep quality among individuals with and without a diagnosis of COVID-19 at entry to respective cohorts by time (0-16 months) from diagnosis. We also applied generalised estimating equations (GEE) analysis to test differences in repeated measures of mental health symptoms before and after COVID-19 diagnosis among individuals ever diagnosed with COVID-19 over time. FINDINGS A total of 9979 individuals (4%) were diagnosed with COVID-19 during the study period and presented overall with a higher symptom burden of depression (prevalence ratio [PR] 1.18, 95% confidence interval [95% CI] 1.03-1.36) and poorer sleep quality (1.13, 1.03-1.24) but not with higher levels of symptoms of anxiety or COVID-19 related distress compared with individuals without a COVID-19 diagnosis. While the prevalence of depression and COVID-19 related distress attenuated with time, the trajectories varied significantly by COVID-19 acute infection severity. Individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risks of depression and anxiety (PR 0.83, 95% CI 0.75-0.91 and 0.77, 0.63-0.94, respectively), while patients bedridden for more than 7 days were persistently at higher risks of symptoms of depression and anxiety (PR 1.61, 95% CI 1.27-2.05 and 1.43, 1.26-1.63, respectively) throughout the 16-month study period. CONCLUSION Acute infection severity is a key determinant of long-term mental morbidity among COVID-19 patients.

scholarly journals Effect of COVID-19 Quarantine on the Sleep Quality and the Depressive Symptom Levels of University Students in Jordan During the Spring of 2020

2021 ◽  
Vol 12 ◽  
Author(s):  
Heba Saadeh ◽  
Maha Saadeh ◽  
Wesam Almobaideen ◽  
Assem Al Refaei ◽  
Nour Shewaikani ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
University Students ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Depression Scale ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Online Questionnaire ◽  
Cross Sectional

Objectives: This study was designed to assess the effect of COVID-19 home quarantine and its lifestyle challenges on the sleep quality and mental health of a large sample of undergraduate University students in Jordan. It is the first study applied to the Jordanian population. The aim was to investigate how quarantine for several weeks changed the students' habits and affected their mental health.Methods: A cross-sectional study was conducted using a random representative sample of 6,157 undergraduate students (mean age 19.79 ± 1.67 years, males 28.7%) from the University of Jordan through voluntarily filling an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies-Depression Scale (CES-D) were used to assess sleep quality and depressive symptoms, respectively.Results: The PSQI mean score for the study participants was 8.1 ± 3.6. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. Nearly half of the participants reported poor sleep quality. The prevalence of poor sleep quality among participants was 76% (males: 71.5% and females: 77.8%). Similarly, the prevalence of the depressive symptoms was 71% (34% for moderate and 37% for high depressive symptoms), with females showing higher prevalence than males. The overall mean CES-D score for the group with low depressive symptoms is 9.3, for the moderate group is 19.8, while it is 34.3 for the high depressive symptoms group. More than half of the students (62.5%) reported that the quarantine had a negative effect on their mental health. Finally, females, smokers, and students with decreased income levels during the extended quarantine were the common exposures that are significantly associated with a higher risk of developing sleep disturbances and depressive symptoms.Conclusions: Mass and extended quarantine succeeded in controlling the spread of the COVID-19 virus; however, it comes with a high cost of potential psychological impacts. Most of the students reported that they suffer from sleeping disorders and had a degree of depressive symptoms. Officials should provide psychological support and clear guidance to help the general public to reduce these potential effects and overcome the quarantine period with minimum negative impacts.

scholarly journals Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: a web-based cross-sectional survey

2020 ◽  
Author(s):  
Yeen Huang ◽  
Ning Zhao
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Healthcare Workers ◽  
Influence Factors ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based

AbstractBackgroundChina has been severely affected by COVID-19 (Corona Virus Disease 2019) since December, 2019. This study aimed to assess the population mental health burden during the epidemic, and to explore the potential influence factors.MethodsUsing a web-based cross-sectional survey, we collected data from 7,236 self-selected volunteers assessed with demographic information, COVID-19 related knowledge, Generalized Anxiety Disorder-7 (GAD-7), Center for Epidemiology Scale for Depression (CES-D), and Pittsburgh Sleep Quality Index (PSQI). Logistic regressions were used to identify influence factors associated with mental health problem.ResultsOf the total sample analyzed, the overall prevalence of GAD, depressive symptoms, and sleep quality were 35.1%, 20.1%, and 18.2%, respectively. Young people reported a higher prevalence of GAD and depressive symptoms than older people (P<0.001). Compared with other occupational group, healthcare workers have the highest rate of poor sleep quality (P<0.001). Multivariate logistic regression showed that age (< 35 years) and times to focus on the COVID-19 (≥ 3 hours per day) were associated with GAD, and healthcare workers were associated with poor sleep quality.ConclusionsOur study identified a major mental health burden of the public during COVID-19 epidemic in China. Young people, people who spent too much time on the epidemic, and healthcare workers were at high risk for mental illness. Continuous surveillance and monitoring of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.

Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

2019 ◽  
Vol 2 (2) ◽  
pp. 211-220
Author(s):  
Ahmed Waqas ◽  
Aqsa Iftikhar ◽  
Zahra Malik ◽  
Kapil Kiran Aedma ◽  
Hafsa Meraj ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Medical Students ◽  
Sleep Quality ◽  
Severe Depression ◽  
Dental Students ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cross Sectional ◽  
Medical And Dental Students

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.

scholarly journals The prevalence and risk factors for depressive symptoms in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Psychological Capital ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Sectional Study ◽  
Poor Sleep Quality ◽  
Related Factors ◽  
Cross Sectional

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.

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