Qi Zhou|Zhenyu Hu|Guolin Bian|Hui Yu|Xingxing Li|Yin Lu|Chang Yu|Xianglan Li|Qunyan Yao|Wenhua Zhou|Ti?Fei Yuan|Dongsheng Zhou
Mental health and psychosocial function of general population during the COVID?19 epidemic in China
Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo Kangning Hospital|Ningbo University|Shanghai Mental Health Center|Shanghai Jiao Tong University|Nantong University|Ningbo Kangning Hospital
clinical translational medicinevolume 10 issue 2 e103 letter editoropen access mental health psychosocial function general population covid19 epidemic china qi zhou qi zhou orcidorg0000000276160313 ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorzhenyu hu zhenyu hu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorguolin bian guolin bian ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorhaihang yu haihang yu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorxingxing li xingxing li ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authoryin lu yin lu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorchang yu chang yu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorxianglan li xianglan li ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorqin yao qin yao ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorwenhua zhou corresponding author wenhua zhou email protected ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang china laboratory behavioral neuroscience ningbo addiction research treatment center school medicine ningbo university ningbo china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers authortifei yuan corresponding author tifei yuan email protected orcidorg000000030510715x shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china coinnovation center neuroregeneration nantong university nantong china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers authordongsheng zhou corresponding author dongsheng zhou email protected ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers author qi zhou qi zhou orcidorg0000000276160313 ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorzhenyu hu zhenyu hu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorguolin bian guolin bian ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorhaihang yu haihang yu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorxingxing li xingxing li ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authoryin lu yin lu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorchang yu chang yu ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorxianglan li xianglan li ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorqin yao qin yao ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang chinasearch papers authorwenhua zhou corresponding author wenhua zhou email protected ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang china laboratory behavioral neuroscience ningbo addiction research treatment center school medicine ningbo university ningbo china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers authortifei yuan corresponding author tifei yuan email protected orcidorg000000030510715x shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china coinnovation center neuroregeneration nantong university nantong china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers authordongsheng zhou corresponding author dongsheng zhou email protected ningbo key laboratory sleep medicine ningbo kangning hospital ningbo zhejiang china correspondence wenhua zhou ningbo kangning hospital ningbo zhejiang china email email protected tifei yuan shanghai key laboratory psychotic disorders shanghai mental health center shanghai jiao tong university school medicine shanghai china email email protected dongsheng zhou ningbo kangning hospital ningbo zhejiang china email email protectedsearch papers author first published 11 june 2020 httpsdoiorg101002ctm2103citations 6 qi zhou zhenyu hu guolin bian haihang yu contributed equally study aboutsectionspdf toolsrequest permissionexport citationadd favoritestrack citation shareshare give accessshare full text accessshare fulltext accessplease review terms conditions use check box share fulltext version articlei read accept wiley online library terms conditions useshareable linkuse link share fulltext version article friends colleagues learn morecopy url dear editor since december 2019 covid19 caused severe acute respiratory syndrome coronavirus 2 sarscov2 emerged rapidly spread many countries1 2 10 april 2020 number confirmed cases china3 increased 83 307 confirmed cases world increased 1 439 5164 covid19 epidemic resulted serious threats health safety well various psychological problems high levels perceived stress insomnia anxiety depression symptoms5 previous studies reported medical workers experiencing tremendous pressure factors high risk infection overwork depression emotionally impacted negative patients lack protection families shown exhibit longterm psychological implications6 7 study utilized online survey method measure incidence severity psychological disturbances general public conducted crosssectional study online survey 23 february 2020 1 march 2020 using questionnaire star platform provided qr code questionnaire survey online general public nationwide investigation period corresponded decreasing period maximum point covid19 outbreak china 2 months covid19 epidemic outbreak wuhan subjects participated survey asked whether would like participate survey prior enrollment online survey includes questions sociodemographic clinical variables addition selfreporting questionnaire20 srq20 athens insomnia scale ais chinese version perceived stress scale cpss used evaluate stress responses ie 7 srq20 insomnia ie 6 ais stress ie 29 cpss among respondents 784 male 322 1651 female 678 observe gender differences srq20 ais scales perceived stress cpss score higher male female 2726 vs 2703 p 009 people younger 20 years lowest ais scores mean sd 285 331 cpss scores mean sd 2647 948 60 years old showed highest score ais scores mean sd 402 480 cpss scores mean sd 3009 108 divorced individuals showed highest score ais scores mean sd 357 451 cpss scores mean sd 2762 893 14 different occupations farmers scored highest ais scores mean sd 656 799 civil servants highest score cpss scores mean sd 3059 854 participants low literacy highest ais scores mean sd 1067 1222 cpss scores mean sd 3100 2848 comparison provinces hubei province presented highest ais scores mean sd 463 805 cpss scores mean sd 3263 1227 table 1 figure 1 table 1 sociodemographic characteristics general population n srq ais cpss gender male 784 322 197 336 326 353 2726 1009 female 1651 678 176 289 311 330 2703 803 pvalue 805 766 009 age years 20 377 1548 173 299 285 331 2647 948 2039 1505 6181 173 297 311 332 2685 862 4059 510 2094 216 324 346 343 2807 824 60 43 177 207 373 402 480 3009 1082 pvalue 194 007 001 marital status married 1114 4575 192 302 350 346 2761 866 unmarried 1273 5228 171 303 286 324 2667 876 widowed 6 025 167 207 200 210 2417 1602 divorced 42 172 283 437 357 451 2762 893 pvalue 205 001 001 occupation farmer 9 037 600 733 656 799 2989 1910 enterprise staff 225 924 168 266 303 316 2802 883 business unit personnel 214 879 198 327 324 309 2860 871 selfemployed businessman 18 074 261 374 372 323 2561 1063 soldier 1 004 na na na student 1069 439 166 293 277 318 2647 888 immigrant laborer 5 021 460 422 500 316 2740 439 medical staff 729 2994 190 315 351 355 2707 821 civil servant 27 111 241 258 456 433 3059 854 freelance 24 099 267 317 371 353 2800 848 retiree 41 168 159 243 351 365 2983 872 unemployed 11 045 327 380 400 322 2373 901 others 62 254 196 292 389 343 2714 893 pvalue 578 001 001 education level illiteracy 3 012 667 1155 1067 1222 3100 2848 primary 5 021 660 811 500 381 2260 1455 junior middle school 38 156 258 379 339 365 2895 1128 high school 85 349 195 265 349 331 2572 1068 college 1202 4936 171 299 287 326 2648 895 undergraduate 771 3166 182 292 338 336 2760 791 bachelor degree 331 1359 203 325 350 355 2840 842 pvalue 580 001 001 geographical location hubei province 8 033 338 682 463 805 3263 1227 zhejiang province 1161 4768 186 298 340 342 2752 840 guangdong province 9 037 111 267 133 173 2233 1054 henan province 21 086 367 553 419 435 3005 704 regions country 1232 5060 177 302 292 326 2668 898 abroad 4 016 000 000 275 359 2125 1646 pvalue 495 001 003 note data presented mean sd significant results highlighted p 05 bold mannwhitney u test kruskalwallis test independent samples abbreviations srq20 selfreport questionnaire20 ais athens insomnia scale cpss chinese version perceived stress scale na applicable figure 1open figure viewerpowerpoint distribution different populations critical value different scales scores different populations different scales compared size bubble represents proportion different people scale b scores different populations selfreport questionnaire20 scale srq20 compared c scores different populations athens insomnia scale ais compared scores different populations chinese version perceived stress scale cpss compared spearmans correlation analysis table s1 showed significant correlations srq20 ais cpss scales age marital status geographical location binary logistic regression analysis table s2 showed risk insomnia general population independently associated four variables age occupation marital status geographical location p 05 risk stress general population independently associated three variables gender occupation education level p 05 risk factors associated stress response found general population multiple stepwise regression analyses table s3 showed age associated srq20 scores occupation marital status associated ais scores age education level associated cpss scores present study investigated prevalence psychosocial issues general population covid19 epidemic environment age education profession shown significant risk factors contributing stress vulnerability general population report found people older 60 years reported severe symptoms scales one possibility elderly found highest mortality rates covid19 epidemic another possibility older adults unable go engage normal social interactions therefore may caused greater psychological stress another particularly affected group farmers may concerns regarding inadequate medical skills conditions rural areas noteworthy people lower levels education experienced highest level distress among occupations may due insufficient knowledge reputable sources information concerns whether return work extended working hours reduced expected income may explain high stress level among people different occupations forced suspend work production epidemic meanwhile compared areas outside hubei province people hubei province reported severe symptoms insomnia stress likely due fact hubei province origin center epidemic also found degree public psychological distress decreased significantly time measurement scales reach clinical levels severity two major reasons may explain low psychological stress response general population first covid19 epidemic local national mental health institutions providing psychological counseling intervention various means including telephone internet social media applications8 second chinese government took sweeping measures ensure public education medical security medical isolation control population mobility resource allocation across country9 moreover measures undertaken strengthen individual protection reduce gatherings reduce outings stop spread virus number new cases gradually brought control conclusion found prevalence psychosocial symptoms risk factors higher vulnerable groups elderly farmers individuals low literacy levels order reduce psychosocial distress prevent mental health problems necessary institute proper mental health wellbeing system targeted public author contributions qi zhou guolin bian zhenyu hu haihang yu associated investigation statistical analysis writingoriginal draft xingxing li yin lu xianglan li qin yao chang yu helped technical material support data curation wenhua zhou tifei yuan dongsheng zhou associated conceptualization methodology writingreview editing conflict interest authors declare conflict interest funding information study supported medical health brand discipline ningbo ppxk201808 ningbo municipal innovation team life science health 2015c110026 acknowledgments authors thank participants contributed work supporting information filename description ctm2103sup0001tablesdoc665 kb supporting material please note publisher responsible content functionality supporting information supplied authors queries missing content directed corresponding author article references 1li q gaun x wu p et al early 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