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1.
Epidemiol Psychiatr Sci ; 31: e69, 2022 Sep 27.
Article in English | MEDLINE | ID: covidwho-2050234

ABSTRACT

AIMS: COVID-19 has long-term impacts on public mental health, while few research studies incorporate multidimensional methods to thoroughly characterise the psychological profile of general population and little detailed guidance exists for mental health management during the pandemic. This research aims to capture long-term psychological profile of general population following COVID-19 by integrating trajectory modelling approaches, latent trajectory pattern identification and network analyses. METHODS: Longitudinal data were collected from a nationwide sample of 18 804 adults in 12 months after COVID-19 outbreak in China. Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 and Insomnia Severity Index were used to measure depression, anxiety and insomnia, respectively. The unconditional and conditional latent growth curve models were fitted to investigate trajectories and long-term predictors for psychological symptoms. We employed latent growth mixture model to identify the major psychological symptom trajectory patterns, and ran sparse Gaussian graphical models with graphical lasso to explore the evolution of psychopathological network. RESULTS: At 12 months after COVID-19 outbreak, psychological symptoms generally alleviated, and five psychological symptom trajectories with different demographics were identified: normal stable (63.4%), mild stable (15.3%), mild-increase to decrease (11.7%), mild-decrease to increase (4.0%) and moderate/severe stable (5.5%). The finding indicated that there were still about 5% individuals showing consistently severe distress and approximately 16% following fluctuating psychological trajectories, who should be continuously monitored. For individuals with persistently severe trajectories and those with fluctuating trajectories, central or bridge symptoms in the network were mainly 'motor abnormality' and 'sad mood', respectively. Compared with initial peak and late COVID-19 phase, aftermath of initial peak might be a psychologically vulnerable period with highest network connectivity. The central and bridge symptoms for aftermath of initial peak ('appetite change' and 'trouble of relaxing') were totally different from those at other pandemic phases ('sad mood'). CONCLUSIONS: This research identified the overall growing trend, long-term predictors, trajectory classes and evolutionary pattern of psychopathological network of psychological symptoms in 12 months after COVID-19 outbreak. It provides a multidimensional long-term psychological profile of the general population after COVID-19 outbreak, and accentuates the essentiality of continuous psychological monitoring, as well as population- and time-specific psychological management after COVID-19. We believe our findings can offer reference for long-term psychological management after pandemics.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Adult , Depression/psychology , Disease Outbreaks , Humans , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology
2.
Engineering (Beijing) ; 2022 Apr 20.
Article in English | MEDLINE | ID: covidwho-1796875

ABSTRACT

The rapid spread of the coronavirus disease (COVID-19) pandemic in over 200 countries poses a substantial threat to human health. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, can be discharged with feces into the drainage system. However, a comprehensive understanding of the occurrence, presence, and potential transmission of SARS-CoV-2 in sewers, especially in community sewers, is still lacking. This study investigated the virus occurrence by viral nucleic acid testing in vent stacks, septic tanks, and the main sewer outlets of community where confirmed patients had lived during the outbreak of the epidemic in Wuhan, China. The results indicated that the risk of long-term emission of SARS-CoV-2 to the environment via vent stacks of buildings was low after confirmed patients were hospitalized. SARS-CoV-2 were mainly detected in the liquid phase, as opposed to being detected in aerosols, and its RNA in the sewage of septic tanks could be detected for only four days after confirmed patients were hospitalized. The surveillance of SARS-CoV-2 in sewage could be a sensitive indicator for the possible presence of asymptomatic patients in the community, though the viral concentration could be diluted more than 10 times, depending on the sampling site, as indicated by the Escherichia coli (E. coli) test. The comprehensive investigation of the community sewage drainage system is helpful to understand the occurrence characteristics of SARS-CoV-2 in sewage after excretion with feces and the feasibility of sewage surveillance for COVID-19 pandemic monitoring.

3.
Evid Based Complement Alternat Med ; 2022: 2266023, 2022.
Article in English | MEDLINE | ID: covidwho-1794383

ABSTRACT

Objective: Zuojin pill (ZJP) is used as the classical prescription for a wide variety of digestive diseases. However, there is a lack of direct evidence for its use in the treatment of chronic nonatrophic gastritis (CNG). In particular, there is a lack of rigorous trials of randomized controlled designs. In this study, a randomized active-controlled clinical trial was performed to verify the efficacy and safety of ZJP in detail. Methods: Patients with CNG were divided into the ZJP group and the Marzulene-S granule group. Patients were enrolled from September 2019 to February 2021 (ChiCTR2000040549). Endoscopy and histology scores were evaluated as the primary outcome measure. The Helicobacter pylori positive rate and the disappearance rate of symptoms were also measured to reflect the outcomes. Finally, adverse events were also calculated as the index of safety. Results: A total of 68 eligible patients were enrolled in this trial and randomly divided into two groups with baseline comparability. ZJP was able to improve the red plaques as well as bile reflux scores compared with Marzulene-S granule (P=0.043 and P=0.019, respectively). Moreover, it also remarkably alleviated the active chronic inflammation score (P=0.043). However, there was no difference between the Helicobacter pylori positivity rate (P=0.752). The symptom scores of abdominal distension (P=0.004), belching (P=0.010), and loss of appetite (P=0.019) were alleviated by ZJP, but nausea and vomiting were not (P=0.616). ZJP can also be considered safe with no obvious adverse effects. Conclusion: ZJP might decrease mucosal injury and alleviate symptoms in CNG. In addition, more large-scale clinical trials should be carried out to further confirm its clinical efficacy and safety.

4.
Nat Commun ; 13(1): 1839, 2022 04 05.
Article in English | MEDLINE | ID: covidwho-1778601

ABSTRACT

India as a hotspot for air pollution has heavy black carbon (BC) and dust (DU) loadings. BC has been identified to significantly impact the Indian climate. However, whether BC-climate interactions regulate Indian DU during the premonsoon season is unclear. Here, using long-term Reanalysis data, we show that Indian DU is positively correlated to northern Indian BC while negatively correlated to southern Indian BC. We further identify the mechanism of BC-dust-climate interactions revealed during COVID-19. BC reduction in northern India due to lockdown decreases solar heating in the atmosphere and increases surface albedo of the Tibetan Plateau (TP), inducing a descending atmospheric motion. Colder air from the TP together with warmer southern Indian air heated by biomass burning BC results in easterly wind anomalies, which reduces dust transport from the Middle East and Sahara and local dust emissions. The premonsoon aerosol-climate interactions delay the outbreak of the subsequent Indian summer monsoon.


Subject(s)
Air Pollutants , COVID-19 , Aerosols/analysis , Air Pollutants/analysis , COVID-19/epidemiology , Carbon/analysis , Communicable Disease Control , Dust , Environmental Monitoring/methods , Humans , India/epidemiology , Seasons
5.
Int J Environ Res Public Health ; 19(6)2022 03 17.
Article in English | MEDLINE | ID: covidwho-1760592

ABSTRACT

Digital mental health services (DMHSs) have great potential for mitigating the mental health burden related to COVID-19, but public accessibility (ease of acquiring services when needed) to DMHSs during the pandemic is largely unknown. Accessibility to DMHSs was tracked longitudinally among a nationwide sample of 18,804 adults in China from before to one year after COVID-19 outbreak. Unconditional and conditional latent growth curve models and latent growth mixture models were fitted to explore the overall growth trend, influencing factors, and latent trajectory classes of accessibility to DMHSs throughout COVID-19. Generalized estimating equation models and generalized linear mixed models were employed to explore the association between accessibility to DMHSs and long-term mental health symptoms. We found that people generally reported increased difficulty in accessing DMHSs from before to one year after COVID-19 outbreak. Males, youngsters, individuals with low socioeconomic status, and individuals greatly affected by COVID-19 reported greater difficulty in accessing DMHSs. Four DMHS accessibility trajectory classes were identified: "lowest-great increase" (6.3%), "moderate low-slight increase" (44.4%), "moderate high-slight decrease" (18.1%) and "highest-great decrease" (31.2%). Trajectory classes reporting greater difficulty in accessing DMHSs were at higher risk for long-term mental symptoms. In conclusion, an overall increase in difficulty in accessing DMHSs is observed throughout COVID-19, and heterogeneity exists in DMHS accessibility trajectories. Our results suggest that easy access to DMHSs should be consistently facilitated. Moreover, access gaps should be reduced across demographic groups, and target populations for service allocation should alter as the pandemic evolves.


Subject(s)
COVID-19 , Mental Disorders , Mental Health Services , Adult , COVID-19/epidemiology , Health Services Accessibility , Humans , Male , Mental Disorders/epidemiology , Mental Health
6.
Water Res ; 215: 118241, 2022 May 15.
Article in English | MEDLINE | ID: covidwho-1713026

ABSTRACT

Information regarding water clarity at large spatiotemporal scales is critical for understanding comprehensive changes in the water quality and status of ecosystems. Previous studies have suggested that satellite observation is an effective means of obtaining such information. However, a reliable model for accurately mapping the water clarity of global lakes (reservoirs) is still lacking due to the high optical complexity of lake waters. In this study, by using gated recurrent units (GRU) layers instead of full-connected layers from Artificial Neural Networks (ANNs) to capture the efficient sequence information of in-situ datasets, we propose a novel and transferrable hybrid deep-learning-based recurrent model (DGRN) to map the water clarity of global lakes with Landsat 8 Operational Land Imager (OLI) images. We trained and further validated the model using 1260 pairs of in-situ measured water clarity and surface reflectance of Landsat 8 OLI images with Google Earth Engine. The model was subsequently utilized to construct the global pattern of temporal and spatial changes in water clarity (lake area>10 km2) from 2014 to 2020. The results show that the model can estimate water clarity with good performance (R2 = 0.84, MAE = 0.55, RMSE = 0.83, MAPE = 45.13%). The multi-year average of water clarity for global lakes (16,475 lakes) ranged from 0.0004 to 9.51 m, with an average value of 1.88 ± 1.24 m. Compared to the lake area, elevation, discharge, residence time, and the ratio of area to depth, water depth was the most important factor that determined the global spatial distribution pattern of water clarity. Water clarity of 15,840 global lakes between 2014 and 2020 remained stable (P ≥ 0.05); while there was a significant increase in 243 lakes (P < 0.05) and a decrease in 392 lakes (P < 0.05). However, water clarity in 2020 (COVID-19 period) showed a significant increase in most global lakes, especially in China and Canada, suggesting that the worldwide lockdown strategy due to COVID-19 might have improved water quality, espically water clarity, dueto the apparent reduction of anthropogenic activities.


Subject(s)
COVID-19 , Deep Learning , Communicable Disease Control , Ecosystem , Environmental Monitoring/methods , Humans , Lakes , Water Quality
7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318908

ABSTRACT

During the COVID-19 pandemic, conflicting opinions on physical distancing swept across social media, affecting both human behavior and the spread of COVID-19. Inspired by such phenomena, we construct a two-layer multiplex network for the coupled spread of a disease and conflicting opinions. We model each process as a contagion. On one layer, we consider the concurrent evolution of two opinions -- pro-physical-distancing and anti-physical-distancing -- that compete with each other and have mutual immunity to each other. The disease evolves on the other layer, and individuals are less likely (respectively, more likely) to become infected when they adopt the pro-physical-distancing (respectively, anti-physical-distancing) opinion. We develop approximations of mean-field type by generalizing monolayer pair approximations to multilayer networks;these approximations agree well with Monte Carlo simulations for a broad range of parameters and several network structures. Through numerical simulations, we illustrate the influence of opinion dynamics on the spread of the disease from complex interactions both between the two conflicting opinions and between the opinions and the disease. We find that lengthening the duration that individuals hold an opinion may help suppress disease transmission, and we demonstrate that increasing the cross-layer correlations or intra-layer correlations of node degrees may lead to fewer individuals becoming infected with the disease.

8.
Mathematical Models & Methods in Applied Sciences ; 31(12), 2021.
Article in English | ProQuest Central | ID: covidwho-1627308

ABSTRACT

During the COVID-19 pandemic, conflicting opinions on physical distancing swept across social media, affecting both human behavior and the spread of COVID-19. Inspired by such phenomena, we construct a two-layer multiplex network for the coupled spread of a disease and conflicting opinions. We model each process as a contagion. On one layer, we consider the concurrent evolution of two opinions — pro-physical-distancing and anti-physical-distancing — that compete with each other and have mutual immunity to each other. The disease evolves on the other layer, and individuals are less likely (respectively, more likely) to become infected when they adopt the pro-physical-distancing (respectively, anti-physical-distancing) opinion. We develop approximations of mean-field type by generalizing monolayer pair approximations to multilayer networks;these approximations agree well with Monte Carlo simulations for a broad range of parameters and several network structures. Through numerical simulations, we illustrate the influence of opinion dynamics on the spread of the disease from complex interactions both between the two conflicting opinions and between the opinions and the disease. We find that lengthening the duration that individuals hold an opinion may help suppress disease transmission, and we demonstrate that increasing the cross-layer correlations or intra-layer correlations of node degrees may lead to fewer individuals becoming infected with the disease.

9.
Vaccines (Basel) ; 9(10)2021 Oct 13.
Article in English | MEDLINE | ID: covidwho-1623740

ABSTRACT

The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants' refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy.

10.
Front Psychiatry ; 12: 774504, 2021.
Article in English | MEDLINE | ID: covidwho-1581154

ABSTRACT

Background: The COVID-19 pandemic is our generation's greatest global challenge to our public health system. Vaccines are considered one of the most effective tools available for preventing COVID-19 infection and its complications and sequelae. Understanding and addressing the psychological stress related to COVID-19 vaccination may promote acceptance of these vaccines. Methods: We conducted an online survey from January 29 to April 26, 2021 to explore stress levels related to COVID-19 vaccination among the general public in China. Participants were asked to evaluate their psychological stress of considering whether or not to get vaccinated at the beginning period of the COVID-19 mass vaccination, after getting access to the information about the vaccine, as well as after getting vaccinated, using visual analog stress scale. Multiple linear regression analysis was performed to explore factors potentially associated with COVID-19-related psychological stress levels before and after getting vaccinated. Results: A total of 34,041 participants were included in the final analysis. The mean stress score concerning COVID-19 vaccination was 3.90 ± 2.60 among all participants, and significantly decreased over time. In addition, the vaccine-related stress level significantly decreased after accessing information about the COVID-19 vaccine (N = 29,396), as well as after getting vaccinated (N = 5,103). Multivariable regression analysis showed higher stress levels related to COVID-19 vaccination in participants who were younger, having lower education level, having history of chronic diseases, mistrusting vaccine's efficacy, experience of vaccine allergy events, being affected by the COVID-19 epidemic, and having mental illness symptoms. Moreover, mistrust in vaccine efficacy and experience of vaccine allergy events had a long-term impact on psychological stress levels about COVID-19 vaccination even after getting vaccinated. Conclusions: The current findings profiled the COVID-19 vaccine-related psychological stress among the general public in China. Population-specific management and interventions targeting the stress related to COVID-19 vaccination are needed to help governments and policy makers promote individual's willingness to get vaccinations for public well-being during the COVID-19 pandemic.

11.
PLoS One ; 16(11): e0259308, 2021.
Article in English | MEDLINE | ID: covidwho-1505876

ABSTRACT

The risk spillover among financial markets has been noticeably investigated in a burgeoning number of literature. Given those doctrines, we scrutinize the impact persistence of volatility spillover and illiquidity spillover of Chinese commodity markets in this paper. Based on the sample from 2010 to 2020, we reveal that there is a cross-market spillover of volatility and illiquidity in China and also, interactions between volatility and illiquidity in different financial markets are pronounced. More importantly, we demonstrate that different commodity markets have different responsiveness to stock market shocks, which embeds their market characteristics. Specifically, we discover that the majority of the traders in gold market might be hedger and therefore gold market is more sensitive to stock market illiquidity shock and thus the shock impact in persistent. On the other hand, agricultural markets like corn and soybean markets might be dominated by investors and thus those markets respond to the stock market volatility shocks and the shock impact in persistent over 10 periods given the first period of risk shock happening. In fact, different Chinese commodity markets' responsiveness towards Chinese stock market risk shocks indicates the stock market risk impact persistence in Chinese commodity markets. This result can help policymakers to understand the policy propagation effect according to this risk spillover channel and risk impact persistence mechanism in China.


Subject(s)
Agriculture/economics , Commerce/economics , Investments/economics , Marketing/economics , Metals/supply & distribution , Policy , China , Humans , Models, Statistical , Risk Factors
12.
Transl Psychiatry ; 11(1): 499, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1447296

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has caused large-scale economic and social losses and worldwide deaths. Although most COVID-19 patients have initially complained of respiratory insufficiency, the presence of neuropsychiatric manifestations is also reported frequently, ranging from headache, hyposmia/anosmia, and neuromuscular dysfunction to stroke, seizure, encephalopathy, altered mental status, and psychiatric disorders, both in the acute phase and in the long term. These neuropsychiatric complications have emerged as a potential indicator of worsened clinical outcomes and poor prognosis, thus contributing to mortality in COVID-19 patients. Their etiology remains largely unclear and probably involves multiple neuroinvasive pathways. Here, we summarize recent animal and human studies for neurotrophic properties of severe acute respiratory syndrome coronavirus (SARS-CoV-2) and elucidate potential neuropathogenic mechanisms involved in the viral invasion of the central nervous system as a cause for brain damage and neurological impairments. We then discuss the potential therapeutic strategy for intervening and preventing neuropsychiatric complications associated with SARS-CoV-2 infection. Time-series monitoring of clinical-neurochemical-radiological progress of neuropsychiatric and neuroimmune complications need implementation in individuals exposed to SARS-CoV-2. The development of a screening, intervention, and therapeutic framework to prevent and reduce neuropsychiatric sequela is urgently needed and crucial for the short- and long-term recovery of COVID-19 patients.


Subject(s)
COVID-19 , Animals , Headache , Humans , Pandemics , SARS-CoV-2 , Seizures
13.
Int J Environ Res Public Health ; 18(16)2021 08 20.
Article in English | MEDLINE | ID: covidwho-1367832

ABSTRACT

COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22-1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65-1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14-1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04-1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26-1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61-0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.


Subject(s)
COVID-19 , Mental Health , Adult , Anxiety/epidemiology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Humans , Longitudinal Studies , SARS-CoV-2
14.
Front Public Health ; 9: 643988, 2021.
Article in English | MEDLINE | ID: covidwho-1268315

ABSTRACT

Background: The novel coronavirus 2019 (COVID-19) pandemic and related compulsory measures have triggered a wide range of psychological issues. However, the effect of COVID-19 on mental health in late-middle-aged adults remains unclear. Methods: This cross-sectional, web-based survey recruited 3,730 participants (≥ 50 years old) between February 28 and March 11 of 2020. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale were used to evaluate depression, anxiety, insomnia, and acute stress symptoms. Multivariate logistic regression analysis was fitted to explore risk factors that were associated with the selected outcomes. Results: The mean age of the participants was 54.44 ± 5.99 years, and 2,026 (54.3%) of the participants were female. The prevalence of depression, anxiety, insomnia, and acute stress symptoms among late-middle-aged adults in China during the COVID-19 pandemic was 20.4, 27.1, 27.5, and 21.2%, respectively. Multivariable logistic regression analyses showed that participants who were quarantined had increased odds ratios for the four mental health symptoms, and those with a good understanding of the COVID-19 pandemic displayed a decreased risk for all mental health symptoms among late-middle-aged adults. In addition, participants with a low income and with a risk of COVID-19 exposure at work had a remarkably high risk of depression, anxiety, and acute stress symptoms. Conclusions: Mental health symptoms in late-middle-aged adults in China during the COVID-19 pandemic are prevalent. Population-specific mental health interventions should be developed to improve mental health outcomes in late-middle-aged adults during this public health emergency.


Subject(s)
COVID-19 , Pandemics , Adult , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Health Status , Humans , Male , Middle Aged , SARS-CoV-2
15.
Eur Psychiatry ; 64(1): e18, 2021 02 03.
Article in English | MEDLINE | ID: covidwho-1123673

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a major threat to the public. However, the comprehensive profile of suicidal ideation among the general population has not been systematically investigated in a large sample in the age of COVID-19. METHODS: A national online cross-sectional survey was conducted between February 28, 2020 and March 11, 2020 in a representative sample of Chinese adults aged 18 years and older. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9. The prevalence of suicidal ideation and its risk factors was evaluated. RESULTS: A total of 56,679 participants (27,149 males and 29,530 females) were included. The overall prevalence of suicidal ideation was 16.4%, including 10.9% seldom, 4.1% often, and 1.4% always suicidal ideation. The prevalence of suicidal ideation was higher in males (19.1%) and individuals aged 18-24 years (24.7%) than in females (14.0%) and those aged 45 years and older (11.9%). Suicidal ideation was more prevalent in individuals with suspected or confirmed infection (63.0%), frontline workers (19.2%), and people with pre-existing mental disorders (41.6%). Experience of quarantine, unemployed, and increased psychological stress during the pandemic were associated with an increased risk of suicidal ideation and its severity. However, paying more attention to and gaining a better understanding of COVID-19-related knowledge, especially information about psychological interventions, could reduce the risk. CONCLUSIONS: The estimated prevalence of suicidal ideation among the general population in China during COVID-19 was significant. The findings will be important for improving suicide prevention strategies during COVID-19.


Subject(s)
COVID-19/epidemiology , Pandemics , Suicidal Ideation , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Quarantine/psychology , Quarantine/statistics & numerical data , Risk Factors , SARS-CoV-2 , Stress, Psychological/epidemiology , Suicide/prevention & control , Suicide/psychology , Suicide/statistics & numerical data , Unemployment/psychology , Unemployment/statistics & numerical data , Young Adult
16.
JAMA Netw Open ; 3(7): e2014053, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-627105

ABSTRACT

Importance: People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. Objective: To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. Design, Setting, and Participants: This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. Main Outcomes and Measures: The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. Results: Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). Conclusions and Relevance: The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.


Subject(s)
Anxiety , Coronavirus Infections , Depression , Pandemics , Pneumonia, Viral , Sleep Initiation and Maintenance Disorders , Stress, Psychological , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/physiopathology , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Depression/diagnosis , Depression/epidemiology , Depression/physiopathology , Female , Humans , Male , Mental Health/statistics & numerical data , Mental Status Schedule/statistics & numerical data , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Prevalence , Quarantine/psychology , Return to Work/psychology , Risk Factors , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathology , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/physiopathology
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