Relationship between cognition and emotions caused by the COVID-19 infection, and depression and anxiety

Background Although negative cognition and emotions are known to develop with experiences of COVID-19 infection, it remains unclear whether such cognitions and emotions contribute to depression and anxiety as post-acute symptoms of COVID-19. We aimed to investigate the relationships between cognition and emotions caused by COVID-19 infection and depression and anxiety. Methods A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following cognition and emotions strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings. Results A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading to others and depression or anxiety. Conclusion Negative cognition and emotions, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Countermeasures for preventing or decreasing the cognition and emotions may be needed to mitigate these symptoms.