The Association between Stress and Illness Anxiety during the Corona-Virus Outbreak in China in 2019

Department of Psychology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Guest Professor, Shanghai University of Political Science and Law, AND Beratung und Coaching, Hofestr, Bochum, Germany


Background: The Corona-virus (COVID-19) outbreak in China in 2019 can cause psychological traumatic reaction; it can be a risk factor for illness anxiety. The predictors of severe illness anxiety have not yet been explored.

Methods: The present research was a cross-sectional study. The Impact of Event Scale-Revised (IES-R) was used to evaluate stress reaction, and Whiteley Index-7 (WI-7) was applied to measure illness anxiety. Participants with scores above the median WI-7 score were categorized as severe illness anxiety and those with scores lower than the median WI-7 score were categorized as non-severe illness anxiety. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Stress level was divided into mild, moderate, and severe, which were included in the logistic model to estimate the association of stress and illness anxiety.

Results: After adjusting for covariates, the OR of mild, moderate, and severe stress reaction level was 3.32 (95% CI: 2.21, 4.99), 6.01 (95% CI: 2.99, 12.05), and 14.54 (95% CI: 7.99, 26.47), respectively. The P for trend was less than 0.001 across the levels of stress reaction.

Conclusion: Severe stress reaction has been associated with severe illness anxiety during the outbreak of COVID-19 in China. The corona crisis intensifies the experience of personal stress that in turn increases the fear of the COVID-19 illness in China. Further qualitative and follow-up studies are essential to illustrate the development of illness anxiety.


  • Stress
  • Anxiety
  • COVID-19 outbreak

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