A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

Cuiyan Wang, Riyu Pan, Xiaoyang Wan, Yilin Tan, Linkang Xu, Roger S McIntyre, Faith N Choo, Bach Tran, Roger Ho, Vijay K Sharma, Cyrus Ho, Cuiyan Wang, Riyu Pan, Xiaoyang Wan, Yilin Tan, Linkang Xu, Roger S McIntyre, Faith N Choo, Bach Tran, Roger Ho, Vijay K Sharma, Cyrus Ho

Abstract

In addition to being a public physical health emergency, Coronavirus disease 2019 (COVID-19) affected global mental health, as evidenced by panic-buying worldwide as cases soared. Little is known about changes in levels of psychological impact, stress, anxiety and depression during this pandemic. This longitudinal study surveyed the general population twice - during the initial outbreak, and the epidemic's peak four weeks later, surveying demographics, symptoms, knowledge, concerns, and precautionary measures against COVID-19. There were 1738 respondents from 190 Chinese cities (1210 first-survey respondents, 861 s-survey respondents; 333 respondents participated in both). Psychological impact and mental health status were assessed by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21), respectively. IES-R measures PTSD symptoms in survivorship after an event. DASS -21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. This study found that there was a statistically significant longitudinal reduction in mean IES-R scores (from 32.98 to 30.76, p < 0.01) after 4 weeks. Nevertheless, the mean IES-R score of the first- and second-survey respondents were above the cut-off scores (>24) for PTSD symptoms, suggesting that the reduction in scores was not clinically significant. During the initial evaluation, moderate-to-severe stress, anxiety and depression were noted in 8.1%, 28.8% and 16.5%, respectively and there were no significant longitudinal changes in stress, anxiety and depression levels (p > 0.05). Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. As countries around the world brace for an escalation in cases, Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, teaching correct containment methods, ensuring availability of essential services/commodities, and providing sufficient financial support.

Keywords: Anxiety; COVID-19; Coronavirus; Depression; Epidemic; Longitudinal; Pandemic; Post-traumatic stress disorder; Precaution; Stress.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2020 Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
National epidemic trend of 2019 coronavirus disease (COVID-19) outbreak in China from January 7 to March 1, 2020.
Fig. 2
Fig. 2
Comparison of the mean scores of DASS-stress, anxiety and depression subscales as well as IES-R scores between the first (T1) and second (T2) survey.

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