Mental Health Disorders and Associated Risk Factors in Quarantined Adults During the COVID-19 Outbreak in China: Cross-Sectional Study

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Abstract

Background

People undergoing mass home- and community-based quarantine are vulnerable to mental health disorders during outbreaks of coronavirus disease (COVID-19), but few studies have evaluated the associated psychosocial factors.

Objective

This study aimed to estimate the prevalence of anxiety and depressive symptoms and identify associated demographic and psychosocial factors in the general Chinese population during the COVID-19 pandemic quarantine period.

Methods

Participants aged 18 years or above were recruited in a cross-sectional online survey using snowball sampling from February 26-29, 2020. The survey included questions on demographics, family relationships, chronic diseases, quarantine conditions, lifestyle, COVID-19 infection, and anxiety and depressive symptoms. Logistic regression analyses were conducted to identify factors associated with elevated anxiety or depressive symptoms.

Results

Out of 2331 participants, 762 (32.7%) experienced elevated anxiety or depressive symptoms. Nine risk factors associated with anxiety or depressive symptoms included younger age, reduced income, having cancer or other chronic diseases, having family members living with cancer, concerns related to COVID-19 infection for themselves or family members, living alone, having family conflicts, having <3 or >8 hours of sedentary time per day, and worsened sleep quality.

Conclusions

The findings highlight an urgent need for psychological support for populations at high risk for elevated anxiety or depressive symptoms during the COVID-19 pandemic.

Related collections

Most cited references 25

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Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

Cuiyan Wang, Riyu Pan, Xiaoyang Wan … (2020)

Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.

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The psychological impact of the COVID-19 epidemic on college students in China

Wenjun Cao, Ziwei Fang, Guoqiang Hou … (2020)

Highlights • Methods of guiding students to effectively and appropriately regulate their emotions during public health emergencies and avoid losses caused by crisis events have become an urgent problem for colleges and universities. Therefore, we investigated and analyzed the mental health status of college students during the epidemic for the following purposes. (1) To evaluate the mental situation of college students during the epidemic; (2) to provide a theoretical basis for psychological interventions with college students; and (3) to provide a basis for the promulgation of national and governmental policies.

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A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

Jianyin Qiu, Bin Shen, Min Zhao … (2020)

The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.

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Author and article information

Contributors

Chao Cheng:

ORCID: https://orcid.org/0000-0003-3571-8154

Department of Thoracic SurgeryThe First Affiliated Hospital of Sun Yat-sen UniversityNo 58 2nd Zhongshan RoadGuangzhou, 510080China86 87755766drchengchao@163.com

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2020

Publication date (Electronic): 6 August 2020

Publication date PMC-release: 6 August 2020

Volume: 22

Issue: 8

Electronic Location Identifier: e20328

Affiliations

[1 ] Department of Medical Statistics School of Public Health Sun Yat-sen University Guangzhou China

[2 ] Sun Yat-sen Center for Migrant Health Policy Guangzhou China

[3 ] Sun Yat-sen Center for Global Health Guangzhou China

[4 ] Department of Thoracic Surgery The First Affiliated Hospital of Sun Yat-sen University Guangzhou China

[5 ] Department of Global Health University of Washington Seattle, WA United States

Author notes

Corresponding Author: Chao Cheng drchengchao@ 123456163.com

Author information

Yan Guo https://orcid.org/0000-0002-8754-1090

Chao Cheng https://orcid.org/0000-0003-3571-8154

Yu Zeng https://orcid.org/0000-0002-2604-9502

Yiran Li https://orcid.org/0000-0002-4704-8728

Mengting Zhu https://orcid.org/0000-0002-7247-7620

Weixiong Yang https://orcid.org/0000-0002-6916-8253

He Xu https://orcid.org/0000-0002-2593-9861

Xiaohua Li https://orcid.org/0000-0003-4218-1914

Jinhang Leng https://orcid.org/0000-0003-4545-165X

Aliza Monroe-Wise https://orcid.org/0000-0002-8843-3462

Shaomin Wu https://orcid.org/0000-0002-7954-6502

Article

Publisher ID: v22i8e20328

DOI: 10.2196/20328

PMC ID: 7419152

PubMed ID: 32716899

SO-VID: 6248a5d0-5f75-4406-9971-b96787801170

Copyright © ©Yan Guo, Chao Cheng, Yu Zeng, Yiran Li, Mengting Zhu, Weixiong Yang, He Xu, Xiaohua Li, Jinhang Leng, Aliza Monroe-Wise, Shaomin Wu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.08.2020.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 16 May 2020

Date revision requested : 19 June 2020

Date revision received : 3 July 2020

Date accepted : 26 July 2020

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