Analysis of the prevalence and influencing factors of anxiety and depression in the Chinese population: A cross-sectional survey.

To explore the prevalence and influencing factors of anxiety and depression symptoms among Chinese people in 2021. Investigation teams were recruited in 120 cities across the country. Based on the data from "the Seventh National Population Census in 2021″, quota sampling was conducted on the residents of these cities to obtain samples that conformed to population characteristics. Next, baseline information on research objects was collected, and the questionnaire survey was conducted through the online questionnaire Wenjuanxing platform. The Patient Health Questionnaire-9 (PHQ-9) rating scale was used to evaluate the mental state of the subjects. The correlation between baseline information and different PHQ-9 risk intervals was analyzed using the Chi-square test and Logit model. The impact of relevant risk factors on PHQ-9 scores was analyzed using the decision tree. The Chi-square test results revealed that place of residence (p = 0.438) and obesity (p = 0.443) was not significantly correlated with PHQ-9 risk intervals. According to Logit model analysis, age (p = 0.001, 95%CI 0.84-0.96), marital status (p < 0.001, 95%CI 0.71-0.89), drinking (p < 0.001, 95%CI 1.07-1.18), diabetes or hypertension (p = 0.001, 95%CI 1.11-1.47), health care (p < 0.001, 95%CI 0.53-0.66), economic welfare (p = 0.022, 95%CI 0.85-0.99), COVID-19 vaccine (p < 0.001, 95%CI 1.28-1.72), and HPV vaccine (p < 0.001, 95%CI 0.46-0.57) were potential influencing factors of PHQ-9 risk intervals. Decision tree analysis results showed that the grouping strategy in the PHQ-9 two-side groups had a better classification effect on the questionnaire population according to the PHQ-9 score characteristics. The prevalence rate of moderate to severe depression among Chinese people was about 8.29%. Age, marital status, drinking, diabetes or hypertension, health care, economic well, COVID-19 vaccine, and HPV vaccine were potential influencing factors of anxiety and depression symptoms in Chinese people.

Time map and predictors of on-spot emotional responses of Chinese people during COVID-19 outbreak: From January 27 to February 20, 2020

Background: The impact of the Coronavirus Disease 2019 (COVID-19) pandemic on people's mental health has been gradually revealed. Emotional responses under this pandemic have been a focus. This study aimed to observe the time map and predictors of transient daily emotions (on-spot emotional responses) during the COVID-19 outbreak in Chinese people. Methods: A total of 133,027 Chinese people from all cities and areas of China took part in this 25-day online investigation from January 27 to February 20, 2020. Hierarchical regression was carried out. Results: Chinese people reported mild positive and negative emotions during COVID-19, and the trend was that negative emotions declined and happy emotion increased in a curvilinear style. Females reported stronger on-spot negative emotions. Young and unmarried people, and individuals with lower risk perception reported lower negative emotions and higher happiness, while people with postgraduate or higher education, medical staff and patients, and individuals coming from areas with more confirmed cases, experienced stronger positive and negative emotions. In the regression model, risk predictors of negative emotions were being female, being older in age, having postgraduate or higher education, living in a city with more confirmed cases, being a patient or medical staff, and having higher risk perception, while protective predictors of negative emotions were being unmarried, having high-school or college education, and later investigating date. Notably, been married was negative predictor of happiness. Conclusions: This large sample, 25-day successive online investigation is among the first to reveal the time map of on-spot emotions in Chinese people under the COVID-19 pandemic. The risk and protective predictors of on-spot negative emotions help to recognize vulnerable people under pandemic conditions and further develop more targeted early interventions for future crises. © 2021 The Authors

Network analysis of COVID-19-related PTSD symptoms in China: the similarities and differences between the general population and PTSD sub-population.

Background and Objectives: Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods: We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results: In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion: Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers.

Antecedentes y Objetivos: El Trastorno de Estrés Postraumático (TEPT) prevalente afectó negativamente a los individuos durante la pandemia del COVID-19. Usando análisis de redes, este estudio exploró el constructo de síntomas de TEPT durante la pandemia de COVID-19 en China para identificar las similitudes y diferencias en la conectividad de red de síntomas de TEPT entre la población general china y los individuos que reportan TEPT.Métodos: Realizamos una encuesta en línea que reclutó 2.858 adultos chinos. Los síntomas de TEPT se midieron usando el PCL-5 y el TEPT se determinó de acuerdo a los criterios del DSM-5.Resultados: En la población general, las conductas autodestructivas/ imprudentes fueron, en promedio, las más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) evitación de pensamientos y evitación de recordatorios, 2) dificultades en la concentración y trastornos del sueño, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes y 5) hipervigilancia y respuestas de sobresalto exageradas. Además, se encontraron conexiones negativas entre pensamientos intrusivos y amnesia relacionada con el trauma y entre pensamientos intrusivos y conductas autodestructivas/ imprudentes. Entre los individuos que reportaron TEPT, los síntomas como flashbacks y conductas autodestructivas/ imprudentes estuvieron, en promedio, más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) dificultades en la concentración y trastornos del sueño, 2) pensamientos intrusivos y reactividad emocional a ciertas señales, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes, y 5) desapego y afecto restringido. Además, se encontró una conexión negativa entre pensamientos intrusivos y conductas autodestructivas/ imprudentes.Conclusión: Nuestros resultados indican conexiones igualmente positivas entre dificultades en la concentración y trastornos del sueño, creencias negativas y emociones negativas relacionadas con el trauma, e irritabilidad/ ira y conductas autodestructivas/ imprudentes en la población general y la que reporto TEPT. Argumentamos que las conductas autodestructivas/imprudentes son un síntoma central de TEPT relacionado con COVID-19, que merece más atención en futuros programas psiquiátricos.

Fear in the Chinese Population: Influential Patterns in the Early Stage of the COVID-19 Pandemic.

Major global public health emergencies challenge public mental health. Negative emotions, and especially fear, may endanger social stability. To better cope with epidemics and pandemics, early emotional guidance should be provided based on an understanding of the status of public emotions in the given circumstances. From January 27 to February 11, 2020 (during which the cases of COVID-19 were increasing), a national online survey of the Chinese public was conducted. A total of 132,482 respondents completed a bespoke questionnaire, the Emotion Regulation Questionnaire, and the Berkeley Expressivity Questionnaire (BEQ). Results showed that at the early stage of the COVID-19 epidemic, 53.0% of the Chinese population reported varying degrees of fear, mostly mild. As seen from regression analysis, for individuals who were unmarried and with a relatively higher educational level, living in city or area with fewer confirmed cases, cognitive reappraisal, positive expressivity and negative inhibition were the protective factors of fear. For participants being of older age, female, a patient or medical staff member, risk perception, negative expressivity, positive impulse strength and negative impulse strength were the risk factors for fear. The levels of fear and avoidant behavior tendencies were risk factors for disturbed physical function. Structural equation modeling suggested that fear emotion had a mediation between risk perception and escape behavior and physical function disturbance. The findings help to reveal the public emotional status at the early stage of the pandemic based on a large Chinese sample, allowing targeting of the groups that most need emotional guidance under crisis. Findings also provide evidence of the need for psychological assistance in future major public health emergencies.

Prediction of putative epitope-based vaccine against all corona virus strains for the Chinese population: Approach toward development of vaccine.

Currently, the whole world is facing the coronavirus disease-19 pandemic. As of now, approximately 0.15 million people around the globe are infected with the novel coronavirus. In the last decade, two strains of the coronavirus family, severe acute respiratory syndrome-related coronavirus and Middle East respiratory syndrome coronavirus, also resulted in epidemics in south Asian and the Middle Eastern countries with high mortality rate. This scenario demands the development of a putative vaccine which may provide immunity against all current and new evolving coronavirus strains. In this study, we designed an epitope-based vaccine using an immunoinformatic approach. This vaccine may protect against all coronavirus strains. The vaccine is developed by considering the geographical distribution of coronavirus strains and host genetics (Chinese population). Nine experimentally validated epitopes sequences from coronavirus strains were used to derive the variants considering the conservancy in all strains. Further, the binding affinities of all derived variants were checked with most abundant human leukocyte antigen alleles in the Chinese population. Three major histocompatibility complex (MHC) Class I epitopes from spike glycoprotein and nucleoprotein showed sufficient binding while one MHC Class II epitope from spike glycoprotein was found to be an effective binder. A cocktail of these epitopes gave more than 95% population coverage in the Chinese population. Moreover, molecular dynamics simulation supported the aforementioned predictions. Further, in vivo studies are needed to confirm the immunogenic potential of these vaccines.