Abstract
The 2019 novel coronavirus (COVID-19) pandemic is associated with increases in psychiatric morbidity, including depression. It is unclear if people with depressive symptoms understand or apply COVID-19 information differently to the general population. Therefore, this study aimed to examine associations between depression, health beliefs, and face mask use during the COVID-19 pandemic among the general population in Hong Kong. This study gathered data from 11,072 Hong Kong adults via an online survey. Respondents self-reported their demographic characteristics, depressive symptoms (PHQ-9), face mask use, and health beliefs about COVID-19. Hierarchical logistic regression was used to identify independent variables associated with depression. The point-prevalence of probable depression was 46.5% (n = 5,150). Respondents reporting higher mask reuse (OR = 1.24, 95%CI 1.17–1.34), wearing masks for self-protection (OR = 1.03 95%CI 1.01–1.06), perceived high susceptibility (OR = 1.15, 95%CI 1.09–1.23), and high severity (OR = 1.33, 95%CI 1.28–1.37) were more likely to report depression. Depression was less likely in those with higher scores for cues to action (OR = 0.82, 95%CI 0.80–0.84), knowledge of COVID-19 (OR = 0.95, 95%CI 0.91–0.99), and self-efficacy to wear mask properly (OR = 0.90 95%CI 0.83–0.98). We identified a high point-prevalence of probable major depression and suicidal ideation during the COVID-19 outbreak in Hong Kong, but this should be viewed with caution due to the convenience sampling method employed. Future studies should recruit a representative probability sample in order to draw more reliable conclusions. The findings highlight that COVID-19 health information may be a protective factor of probable depression and suicidal ideation during the pandemic. Accurate and up-to-date health information should be disseminated to distressed and vulnerable subpopulations, perhaps using digital health technology, and social media platforms to prompt professional help-seeking behavior.
Highlights
The novel coronavirus (2019-nCoV) has been transmitting around the world since January 2020
Preliminary evidence highlights that levels of stress, fear, anxiety, Post-traumatic stress disorder (PTSD), sleep disorders and depressive symptoms may dramatically increase in response to the COVID-19 pandemic [4,5,6]
The use of a nonprobability sample in the current study introduces potential bias resulting from selectively recruiting participants who may be more distressed by the pandemic, which may explain the high prevalence of probable depression
Summary
The novel coronavirus (2019-nCoV) has been transmitting around the world since January 2020. The resulting COVID19 pandemic has undoubtedly resulted in great medical and psychosocial challenges that can damage mental health, including potentially increasing rates of depression. Depression is a common mental disorder that is highly prevalent in the general population and is a major contributor to the overall global burden of disease [1]. The importance of depression worldwide is illustrated by its inclusion as a priority condition within the World Health Organization’s Mental Health Gap Action Programme [2]. The average point prevalence of depression in the absence of a global pandemic has been recently reported to be 12.9% across 30 countries [3]. Preliminary evidence highlights that levels of stress, fear, anxiety, Post-traumatic stress disorder (PTSD), sleep disorders and depressive symptoms may dramatically increase in response to the COVID-19 pandemic [4,5,6]. It is possible that suicide rates may increase due to a variety of COVID-19 related issues, such as financial hardship, loneliness and lack of support [7]
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