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Long-Term Impact of COVID-19 on Mental Health among the General Public: A Nationwide Longitudinal Study in China

Author

Listed:
  • Le Shi

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China
    These authors contributed equally to this work.)

  • Zheng-An Lu

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China
    These authors contributed equally to this work.)

  • Jian-Yu Que

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Xiao-Lin Huang

    (Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China)

  • Qing-Dong Lu

    (Beijing Key Laboratory of Drug Dependence, National Institute on Drug Dependence, Peking University, Beijing 100191, China
    School of Public Health, Peking University, Beijing 100191, China)

  • Lin Liu

    (Beijing Key Laboratory of Drug Dependence, National Institute on Drug Dependence, Peking University, Beijing 100191, China
    School of Public Health, Peking University, Beijing 100191, China)

  • Yong-Bo Zheng

    (Peking-Tsinghua Center for Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing 100871, China)

  • Wei-Jian Liu

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Mao-Sheng Ran

    (Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China)

  • Kai Yuan

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Wei Yan

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Yan-Kun Sun

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Si-Wei Sun

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China)

  • Jie Shi

    (Beijing Key Laboratory of Drug Dependence, National Institute on Drug Dependence, Peking University, Beijing 100191, China)

  • Thomas Kosten

    (Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA)

  • Yan-Ping Bao

    (Beijing Key Laboratory of Drug Dependence, National Institute on Drug Dependence, Peking University, Beijing 100191, China
    School of Public Health, Peking University, Beijing 100191, China)

  • Lin Lu

    (Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China
    Beijing Key Laboratory of Drug Dependence, National Institute on Drug Dependence, Peking University, Beijing 100191, China
    Peking-Tsinghua Center for Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing 100871, China
    Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Chinese Academy of Medical Sciences, Beijing 100191, China)

Abstract

COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22–1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65–1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14–1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04–1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26–1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61–0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.

Suggested Citation

  • Le Shi & Zheng-An Lu & Jian-Yu Que & Xiao-Lin Huang & Qing-Dong Lu & Lin Liu & Yong-Bo Zheng & Wei-Jian Liu & Mao-Sheng Ran & Kai Yuan & Wei Yan & Yan-Kun Sun & Si-Wei Sun & Jie Shi & Thomas Kosten & , 2021. "Long-Term Impact of COVID-19 on Mental Health among the General Public: A Nationwide Longitudinal Study in China," IJERPH, MDPI, vol. 18(16), pages 1-18, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8790-:d:618183
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    References listed on IDEAS

    as
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    Cited by:

    1. Ruheng Yin & Rui Tian & Jing Wu & Feng Gan, 2022. "Exploring the Factors Associated with Mental Health Attitude in China: A Structural Topic Modeling Approach," IJERPH, MDPI, vol. 19(19), pages 1-15, October.

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