Stigma In The Patient’s With Chronic Insomnia:a Clinic Study

Background The rapid development of social economy leads to increasing social competitive pressure.As a result,the incidence of insomnia is increasing.Due to the chronic course of disease,long-term insomnia will lead to mild anxiety and/or depression in patients,causing headache,fatigue,cognitive impairment,occupational function impairment,etc.,and bring unpleasant emotional experience to patients.Stigma commonly exists in people suffering from diseases,and this subjective feeling is more and more intensified with the generation and development of a certain disease.The generation of stigma will lead to social avoidance behavior,aggravation of bad emotional experience(such as anxiety,depression,decreased self-esteem and inferiority complex)and even self-injury and suicide.At present,no studies have been recorded on the stigma and its related influencing factors in patients with chronic insomnia(CID).Objective The purpose of this study was to investigate the current situation of stigma in patients with chronic insomnia,and identify the risk factors by analyzing the relationship between general social information,subjective sleep quality,depression,overall cognitive function and quality of life and the development of stigma,in order to provide ideas for medical staff to formulate targeted health intervention plans.Method A total of 72 consecutive patients with CID in the outpatient or ward of Department of Sleep Disorders,Chaohu Hospital Affiliated to Anhui Medical University were collected,the control group was selected as 72 people who had physical examination in the physical examination center of our hospital at the same time.Collect general information of all subjects,including age,gender,educational year,and disease course;The stigma of chronic disease(SSCI),Pittsburgh sleep quality index(PSQI),Hamilton depression rating scale(HAMD),Chinese version of Montreal cognitive assessment scale(Mo CA-C)and short form for health survey(SF-36)were used to assess all subjects’ stigma,subjective sleep quality,depressive status,overall cognitive function and quality of life(QOL)in nine domains.Physiological function(PF),physiological function(RP),somatic pain(BP),overall health(GH),activity(VT),social function(SF),emotional function(RE),mental health(MH),Health changes(HT).Data for normal distribution were expressed as mean standard deviation,while data of non-state distribution were expressed as quartile[M(Q1,Q3)].Results(1)General data: Among all the research subjects,we found that there was no statistically significant difference in general information(age,gender,and educational level)between the chronic insomnia group and the control group(P>0.05).The CID group had a PSQI score of 16.0(15.0,18.0)compared with the healthy control group,which was 7.0(5.0,8.0)points higher(z=-11.687,P<0.001).The HAMD score of 12.0(10.0,13.0)was increased compared with the control group’s4.0(2.0,5.0)(z=-11.654,P < 0.001).The scores of Mo CA(22.3±4.5)were lower than those of the control group(25.3±2.1)(t=5.168,P<0.001).Besides,The score of health change(45.2±16.0))was lower than that of the control group [physiological function(92.5 ± 11.1),physiological function(92.6 ± 17.3),physical pain(88.6 ± 14.0),general health condition(77.0±17.4),energy(78.1±13.3),social function(89.1±13.0),emotional function(89.1 ± 19.4),mental health(75.8 ± 14.1),and health change(57.9±19.3)](P< 0.001).(2)Stigma: The stigma score of CID patients was(38.6±11.7),which was significantly higher than that of healthy control group(24.2±0.6)(P<0.001).The scores of the internal stigma(25.5±8.4)and the external stigma(14.2±5.3)in patients with CID were higher than those in the control group(13.2±0.6 internal stigma and 11.0± 0 0.1external stigma)(P < 0.001).(3)Correlation between stigma and various clinical parameters: In the CID group,stigma was positively correlated with age(r=0.252,P=0.033),course of disease(r=0.541,P<0.001),PSQI score(r=0.361,P=0.002),HAMD score(r=0.470,P<0.001),and education level(r=-0.293,P=0.013),Mo CA score(r=-0.235,P=0.024),SF-36 score [(Physiological function(r=-0.286,P=0.015),Physiological function(r=-0.518,P<0.001),Somatic pain(r=-0.235,P=0.047),General health(r=-0.393,P=0.001),Energy(r=-0.572,P<0.001),social function(r=-0.562,P<0.001),emotional function(r=-0.439,P<0.001),and mental health(r=-0.658,P<0.001)].(4)Multiple linear regression analysis:The course of disease(β=0.515,P<0.001)and SF-36 mental health domain(β =-0.290,P=0.028)are independent risk factors affecting the level of stigma.