Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter

Nianqi Liu, Fan Zhang, Cun Wei, Yanpu Jia, Zhilei Shang, Luna Sun, Lili Wu, Zhuoer Sun, Yaoguang Zhou, Yan Wang, Weizhi Liu, Nianqi Liu, Fan Zhang, Cun Wei, Yanpu Jia, Zhilei Shang, Luna Sun, Lili Wu, Zhuoer Sun, Yaoguang Zhou, Yan Wang, Weizhi Liu

Abstract

The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no conflicts of interest.

Copyright © 2020 Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Sampling frame.
Fig. 2
Fig. 2
Prevalence differences of PTSS on four Criterion between male and female. Note: 1 symptom represented only one item of all the items in the Criterion that participants rated 2 or higher and 2 symptoms represented 2 items of all the items in the Criterion that participants rated 2 or higher. For example, in the Criterion B, 14.6% of male rated 2 or higher on one item of all the 5 items of Criterion B. Mann-Whitney U test was used to compare the differences in the prevalence of PTSD symptoms on four Criterion between genders. In the Criterion B, U=−4.209, p-value <0.001. In the Criterion C: U=−1.488, p-value =0.112. In the Criterion D. U=−1.994, p-value <0.05. In the Criterion E: U=−2.273, p-value <0.05. So female show more symptoms than male on B, D, and E Criterion.
Fig. 3
Fig. 3
Group Differences of PCL-5 scores by Sleep quality Note: *, p-value < 0.05; **, p-value < 0.01; ***, p-value < 0.001.

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