Interaction of Insomnia and Somatization with Post-Traumatic Stress Disorder in Pregnant Women During the COVID-19 Pandemic

Shu Zhang; Yongjie Zhou; Li-Kun Ge; Lingyun Zeng; Zhengkui Liu; Wei Qian; Jiezhi Yang; Xin Zhou; Gao-Xia Wei; Xiangyang Zhang

doi:10.2147/NDT.S310300

Interaction of Insomnia and Somatization with Post-Traumatic Stress Disorder in Pregnant Women During the COVID-19 Pandemic

Neuropsychiatr Dis Treat. 2021 Aug 6:17:2539-2547. doi: 10.2147/NDT.S310300. eCollection 2021.

Authors

Shu Zhang^#¹, Yongjie Zhou^#^{2

3}, Li-Kun Ge^{1

4}, Lingyun Zeng², Zhengkui Liu¹, Wei Qian¹, Jiezhi Yang⁵, Xin Zhou⁶, Gao-Xia Wei^{1

4}, Xiangyang Zhang¹

Affiliations

¹ CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China.
² Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, People's Republic of China.
³ Shenzhen Kangning Hospital, Shenzhen, Guangdong, People's Republic of China.
⁴ Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
⁵ Shenzhen Health Development Research Center, Shenzhen, People's Republic of China.
⁶ Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, People's Republic of China.

^# Contributed equally.

Abstract

Introduction: Post-traumatic stress disorder (PTSD) has an adverse impact on the emotional health of prenatal maternal women and their offspring. During the Coronavirus Disease 2019 (COVID-19) pandemic, pregnant women are vulnerable to traumatic events and are prone to PTSD symptoms. The aim of the study was to explore the predictive effects of insomnia and somatization on PTSD in pregnant women by utilizing generalized additive model (GAM).

Materials and methods: A total of 1638 pregnant women from three local cities in China underwent online survey on sleep quality, somatization, and PTSD symptoms tested by the Insomnia Severity Index (ISI), the subscale somatization of Symptom Checklist-90 (SCL-90-S) and the Checklist for DSM-5 (PCL-5), respectively.

Results: Insomnia was positively correlated with PTSD symptoms in pregnant women (p = 1.79×10^-5). Interestingly, insomnia and somatization showed a complex non-primary linear interaction in predicting PTSD (p = 2.00×10^-16).

Conclusion: Our results suggest that insomnia is a prominent predictor of PTSD symptoms in pregnant women in the context of public emergencies. In addition, the effects of insomnia and somatization on PTSD symptoms are characterized by complex non-primary linear relationships.

Keywords: COVID-19; emotion; insomnia; pregnant; somatization.

Grants and funding

This work was supported by the National Natural Science Foundation of China (Grant number 31671163) and the CAS Key Laboratory of Mental Health, Institute of Psychology (grant number KLMH2011ZK07), as well as the Open Research Fund of the CAS Key Laboratory of Behavioral Science, Institute of Psychology.