Background: The COVID-19 pandemic has profoundly impacted global mental health, exacerbating anxiety, depression, and insomnia, with prevalence rates of 25–30%, 27–32%, and 30–45%, respectively—2–3 times higher than pre-pandemic levels. Neuroticism, a key personality trait from the Big Five model, characterized by heightened negative emotions and stress reactivity, has been linked to increased vulnerability. Meta-analyses show neuroticism triples anxiety risk (OR=3.21; 95% CI: 2.35–4.39) and correlates strongly with insomnia (r=0.46, p<0.001) and depression during the pandemic. In Mongolia, empirical data on neuroticism's role remains limited. Objective: This study examines whether neuroticism acts as a risk factor for anxiety, depression, and insomnia among hospitalized patients during COVID-19. Methods: A cross-sectional descriptive study enrolled 552 patients (72.3% COVID-19 cases, 27.7% controls) from tertiary hospitals in Mongolia (2024). Participants (mean age 52.8±15.5 years; 60.5% female) completed self-reported questionnaires: Eysenck Personality Inventory (EPI) for neuroticism, PHQ-9 for depression, GAD 7 for anxiety, ISI for insomnia, and PCL 5 for PTSD. Sociodemographics were assessed. Data were analyzed using SPSS 26.0 with chi-square tests (p<0.05 significance). Instruments showed high reliability (Cronbach’s α=0.81–0.89). Ethical approval was obtained from MNUMS Ethics Committee (No. 2024-Psy-17). Results: Overall, 79.5% were depression free, 84.8% anxiety-free, and 77.5% insomnia-free. High neuroticism (n=381) was significantly associated with depression (24.4% vs. 11.7%, p<0.001), anxiety (18.6% vs. 7.6%, p<0.001), insomnia (28.3% vs. 9.4%, p<0.001), and any mental disorder (21.3% vs. 7%, p<0.001), but not PTSD (p=0.472). Cholerics (n=200) showed elevated risks (depression 29.5%, insomnia 34.5%, p<0.001), while sanguines/phlegmatics were protective. Verbal expression and trust levels showed no significant associations. Conclusion Neuroticism significantly heightens risks for anxiety, depression, and insomnia during COVID-19, underscoring the need for targeted psychological interventions. Temperament-informed screening could enhance prevention strategies in crisis settings.

Background: The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized patients affiliated with MNUMS, compared to a control group. Aim: To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD), and to identify their associated risk factors. Materials and Methods: The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital, Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia (ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted for group, age, and sex. Results: In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%, p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%, p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms (difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]). Conclusion Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic, clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.

Background: COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways (e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al., BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and PTSD among COVID-19 patients over 12 months, compared to a control group. Aim: To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD) among individuals who have had COVID-19 Materials and Methods: In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021 and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12 months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and multivariable logistic regression (p < 0.05). Results: Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12 months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p = 0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19 group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and individuals aged 40–59 years were at elevated risk. Conclusions 1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control group. 2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected after 12 months; this resolution is posited to be associated with the adaptive capacity of the population. 3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.