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

•A significant reduction in psychological impact 4 weeks after COVID outbreak.•The mean scores of respondents in both surveys were above PTSD cut-offs.•Female gender, physical symptoms associated with a higher psychological impact.•Hand hygiene, mask-wearing & confidence in doctors reduced psych...

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Published in:	Brain, behavior, and immunity Vol. 87; pp. 40 - 48
Main Authors:	Wang, Cuiyan, Pan, Riyu, Wan, Xiaoyang, Tan, Yilin, Xu, Linkang, McIntyre, Roger S., Choo, Faith N., Tran, Bach, Ho, Roger, Sharma, Vijay K., Ho, Cyrus
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Inc 01-07-2020
Subjects:	Adolescent Adult Anxiety Anxiety - epidemiology Anxiety - psychology Anxiety - therapy Betacoronavirus Child China - epidemiology Coronavirus Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control COVID-19 Depression Depression - epidemiology Depression - psychology Depression - therapy Epidemic Epidemics Female Hand Hygiene Health Behavior Humans Internet-Based Intervention Longitudinal Longitudinal Studies Male Masks Mental Health Middle Aged Pandemic Pandemics - prevention & control Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Post-traumatic stress disorder Precaution Psychotherapy SARS-CoV-2 Stress Stress Disorders, Post-Traumatic - epidemiology Stress Disorders, Post-Traumatic - psychology Stress Disorders, Post-Traumatic - therapy Stress, Psychological - epidemiology Stress, Psychological - psychology Stress, Psychological - therapy Young Adult China COVID-19 Epidemic Precaution Coronavirus Longitudinal Post-traumatic stress disorder Depression Pandemic Anxiety Stress
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Summary:	•A significant reduction in psychological impact 4 weeks after COVID outbreak.•The mean scores of respondents in both surveys were above PTSD cut-offs.•Female gender, physical symptoms associated with a higher psychological impact.•Hand hygiene, mask-wearing & confidence in doctors reduced psychological impact.•Online trauma-focused psychotherapy may be helpful to public during COVID-19. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0889-1591 1090-2139 1090-2139
DOI:	10.1016/j.bbi.2020.04.028