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The impacts of COVID-19 outbreak on mental health in general population in different areas in China

Published online by Cambridge University Press:  10 December 2020

Mao-Sheng Ran*
Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
Ru Gao
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Jing-Xia Lin
School of Nursing, University of Hong Kong, Hong Kong SAR, China
Tian-Ming Zhang
Department of Social Work, Shanghai University, Shanghai, China
Sherry Kit Wa Chan
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
Xiao-Peng Deng
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
Bing-Zhi Zhang
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Xin-Feng Zhang
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
Guo-Ping Huang
School of Mental Health, North Sichuan Medical College, Sichuan 637000, China
Dao-Shen Pu
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Jing-Zhen Bai
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Liu-Xiu Xu
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Bo Liu*
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
Author for correspondence: Mao-Sheng Ran, E-mail:; Bo Liu, E-mail:
Author for correspondence: Mao-Sheng Ran, E-mail:; Bo Liu, E-mail:



This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.


This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.


There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.


The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.

Original Article
Copyright © The Author(s), 2020. Published by Cambridge University Press

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First-authors: Mao-Sheng Ran, Ru Gao, and Jing-Xia Lin.


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