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

Stress Anxiety COVID-19 outbreak


  • Cui Feihuan
    Department of Psychology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • Ulrich Sollmann Guest Professor, Shanghai University of Political Science and Law, AND Beratung und Coaching, Hofestr, Bochum, Germany
Vol 7, No 1: 2020
Quantitative Study(ies)
June 2, 2020


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.

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