Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-28T14:17:19.079Z Has data issue: false hasContentIssue false

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*
Affiliation:
Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
Ru Gao
Affiliation:
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Jing-Xia Lin
Affiliation:
School of Nursing, University of Hong Kong, Hong Kong SAR, China
Tian-Ming Zhang
Affiliation:
Department of Social Work, Shanghai University, Shanghai, China
Sherry Kit Wa Chan
Affiliation:
Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
Xiao-Peng Deng
Affiliation:
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
Bing-Zhi Zhang
Affiliation:
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Xin-Feng Zhang
Affiliation:
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
Guo-Ping Huang
Affiliation:
School of Mental Health, North Sichuan Medical College, Sichuan 637000, China
Dao-Shen Pu
Affiliation:
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Jing-Zhen Bai
Affiliation:
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Liu-Xiu Xu
Affiliation:
Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
Bo Liu*
Affiliation:
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: msran@hku.hk; Bo Liu, E-mail: drliubo2011@163.com
Author for correspondence: Mao-Sheng Ran, E-mail: msran@hku.hk; Bo Liu, E-mail: drliubo2011@163.com

Abstract

Background

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

Methods

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.

Results

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.

Conclusions

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.

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

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

References

Angst, J., & Dobler-Mikola, A. (1985). The Zurich study. V. Anxiety and phobia in young adults. European Archives of Psychiatry and Clinical Neuroscience, 235, 171178.Google ScholarPubMed
Ansseau, M., Fischler, B., Cierick, M., Albert, A., Leyman, S., & Mignon, A. (2008). Socioeconomic correlates of generalized anxiety disorder and major depression in primary care: The GADIS II study. Depression and Anxiety, 25, 506513.CrossRefGoogle ScholarPubMed
Bruce, S. E., Yonkers, K. A., Otto, M. W., Eisen, J. L., Weisberg, R. B., Pagano, M., … Keller, M. B. (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: A 12-year prospective study. American Journal of Psychiatry, 162, 11791187.CrossRefGoogle ScholarPubMed
Burch, M. A., & Walker, J. L. (1978). Effects of population density and information overload on state anxiety and crowding perception. Psychological Record, 28, 207214.CrossRefGoogle Scholar
Campbell, A., Walker, J., & Farrel, G. (2003). Confirmatory factor analysis of the GHQ-12: Can I see that again. Australian and New Zealand Journal of Psychiatry, 37, 475483.CrossRefGoogle Scholar
Cano, A., Sprafkin, R. P., Scaturo, D. J., Lantinga, L. J., Fiese, B. H., & Brand, F. (2001). Mental health screening in primary care: A comparison of 3 brief measures of psychological distress primary care companion. Journal of Clinical Psychiatry, 3, 206210.Google Scholar
Chen, S. B., Hu, H., Gao, Y. S., He, H. Y., Jin, D. X., & Zhang, C. Q. (2015). Prevalence of clinical anxiety, clinical depression and associated risk factors in Chinese young and middle-aged patients with osteonecrosis of the femoral head. PLoS One, 10, e0120234.CrossRefGoogle Scholar
Cheng, C., Liu, X., Fan, W., Bai, X., & Liu, Z. (2018). Comprehensive rehabilitation training decreases cognitive impairment, anxiety, and depression in poststroke patients: A randomized, controlled study. Journal of Stroke & Cerebrovascular Diseases, 27, 26132622.CrossRefGoogle ScholarPubMed
Gao, R., Chan, S. K., Zhang, B. Z., Lin, J. X., Peng, S. R., Yang, C. G., … Ran, M. S. (2020a). An epidemiological survey of mental disorders 5 years after the Lushan earthquake in Ya'an, China. Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-020-01974-x.Google Scholar
Gao, Y. Q., Pan, B. C., Sun, W., Wu, H., Wang, J. N., & Wang, L. (2012). Anxiety symptoms among Chinese nurses and the associated factors: A cross sectional study. BMC Psychiatry, 12, 141.CrossRefGoogle ScholarPubMed
Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., … Dai, J. (2020b). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15, e0231924. https://doi.org/10/1371/journal/pone.0231924.Google Scholar
Ge, M., Gao, W., Dong, L., Xu, A., Wang, C., Dong, J., … Gao, J. (2018). The epidemiological study of mental disorders in the population aged 18 or above in Weifang city. Chinese Journal of Neurological and Psychiatric Diseases, 44, 589593.Google Scholar
Hammen, C. (2018). Risk factors for depression: An autobiographical review. Annual Review of Clinical Psychology, 14, 128.CrossRefGoogle Scholar
He, Y., Liu, J., Luo, S., Deng, S., Zhou, H., Zhou, L., … Wang, D. (2019). Ya'an statistical year book. http://tjj.yaan.gov.cn/xinwen/show/7ee07651-84c6-4744-805f-2e02398cd18e.html.Google Scholar
Hong Kong Red Cross. (2018). Five years on from 2013 Sichuan Ya'an earthquake. https://reliefweb.int/report/china/five-years-2013-sichuan-ya-earthquake.Google Scholar
Huang, G. (2017). Rapid assessment of psychological intervention needs after disasters. Sichuan Mental Health, 30, 297300.Google Scholar
Huang, C., Wang, Y., Wang, Y., Li, X., Ren, L., Zhao, J., … Gao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395, 497506.CrossRefGoogle ScholarPubMed
Huang, G., Zhang, Y., & Xiang, H. (2006). Reliability and validity analysis of incident impact scale (IES-R) in female prisoners. Chinese Mental Health Journal, 20, 14.Google Scholar
Hunt, C., Issakidis, C., & Andrews, G. (2002). DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and well-being. Psychological Medicine, 32(4), 649659.CrossRefGoogle ScholarPubMed
Jingmen Municipal People's Government. (2020). COVID-19 outbreak in Hubei province on 9 Feb 2020. http://www.jingmen.gov.cn/art/2020/2/10/art_9452_648679.html.Google Scholar
Kooraki, S., Hosseiny, M., Myers, L., & Gholamrezanezhad, A. (2020). Coronavirus (COVID-19) outbreak: What the department of radiology should know. Journal of the American College of Radiology, 17, 447451.CrossRefGoogle ScholarPubMed
Leung, G. M. (2003). The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong. Journal of Epidemiology and Community Health, 57, 857863.CrossRefGoogle ScholarPubMed
Leung, K. K., Lue, B. H., Lee, M. B., & Tang, L. Y. (1998). Screening of depression in patients with chronic medical diseases in a primary care setting. Family Practice, 15, 6775.CrossRefGoogle Scholar
Li, X., Liu, C., & Li, J. (2001). Reference value of sf-36 evaluation for urban and rural residents in Sichuan province. Journal of West China Medical University, 32, 4347.Google Scholar
Liao, Y., Knoesen, N. P., Deng, Y., Tang, J., Castle, D. J., Bookun, R., … Liu, T. (2010). Body dysmorphic disorder, social anxiety and depressive symptoms in Chinese medical students. Social Psychiatry and Psychiatric Epidemiology, 45, 963971.CrossRefGoogle ScholarPubMed
Liu, S., Yang, L. L., Zhang, C. X., Xiang, Y. T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry, 7, E17E18.CrossRefGoogle ScholarPubMed
Mak, I. W., Chu, C., Pan, P., Yiu, M., & Chan, V. (2009). Long-term psychiatric morbidities among SARS survivors. General Hospital Psychiatry, 31, 318326.CrossRefGoogle ScholarPubMed
Qi, Y., Chen, L., Zhang, L., Yang, Y., Zhan, S., & Fu, C. (2020). Public cognition, attitude and behavior of covid-19. Journal of Tropical Medicine, 20, 145149.Google Scholar
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry, 33, e100213.CrossRefGoogle ScholarPubMed
Regier, D. A., Narrow, W. E., & Rae, D. S. (1990). The epidemiology of anxiety disorders: The Epidemiologic Catchment Area (ECA) experience. Journal of Psychiatry Research, 24(Supple 2), 314.CrossRefGoogle ScholarPubMed
Shi, M., Liu, L., Wang, Z. Y., & Wang, L. (2015). The mediating role of resilience in the relationship between big five personality and anxiety among Chinese medical students: A cross-sectional study. PLoS ONE, 10, e0119916.CrossRefGoogle Scholar
Shi, L., Lu, Z. A., Que, J. Y., Huang, X. L., Liu, L., Ran, M. S., … Lu, L. (2020). Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA Network Open, 3(7), e2014053. doi: 10.1001/jamanetworkopen.2020.14053CrossRefGoogle ScholarPubMed
The Standing Committee of the People's Congress of Ya'an city. (2020). Information on COVID-19 prevention and control in Ya'an city. http://www.yasrdw.gov.cn/news/zt2020_01/2020210/202101908313635.html.Google Scholar
Sun, L., Li, X., Bai, Y., Li, J., Wang, T., Xiao, C., Pu, J., … Li, J. (2011). Incidence of post-traumatic stress disorder (PTSD) and its related factors in the victims of the Wenchuan earthquake in Anxian county six months after the earthquake. Medical Theory and Practice, 24, 24122415.Google Scholar
Tak, E. C., Van Hespen, A. T., Verhaak, P. F., Eekhof, J., & Hopman-Rock, M. (2016). Development and preliminary validation of an observation list for detecting mental disorders and social problems in the elderly in primary and home care. International Journal of Geriatric Psychiatry, 31, 755764.CrossRefGoogle ScholarPubMed
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., … Peng, Z. (2020a). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 323(11), 10611069.CrossRefGoogle Scholar
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020b). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environment Research and Public Health, 17(5), e1729.CrossRefGoogle Scholar
Yang, Y., Li, W., Zhang, Q., Zhang, L., Cheung, T., & Xiang, Y. (2020). Mental health services during the COVID-19 outbreak: The challenge for older adults. Lancet Psychiatry, 7, E19. https://doi.org/10.1016/S2215-0366(20)30079-1.CrossRefGoogle Scholar
Yao, Y., Chen, N., Chen, Y., Li, X., Wang, W., Li, L., … Chen, F. (2019). Jingzhou Statistical Year Book. http://www.jingzhou.gov.cn/zfwgk/xxgkml/sjfb/tjnj/202008/P020200831588384008528.pdf.Google Scholar
Zhou, B., Zhou, D., Xiao, J., & Yan, B. (2009). Characteristics of post-traumatic stress disorder among victims of the May 12 Wenchuan earthquake. Journal of Clinical Practice Hospital, 6, 3234.Google Scholar
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371379.CrossRefGoogle ScholarPubMed