Abstract
BackgroundGeneralized Anxiety Disorder (GAD) is a common but urgent mental health problem during disease outbreaks. Resilience buffers against the negative impacts of life stressors on common internalizing psychopathology such as GAD. This study assesses the prevalence of GAD and examines the protective or compensatory effect of resilience against worry factors during the COVID-19 outbreak.MethodsA cross-sectional online survey was conducted among Chinese citizens aged ≥18 years from January 31 to February 2, 2020. A total of 4827 participants across 31 provinces and autonomous regions of the mainland of China participated in this study. The Generalized Anxiety Disorder scale (GAD-7), the Connor-Davidson Resilience Scale (CD-RISC), and a self-designed worry questionnaire were used to asses anxiety disorder prevalence, resilience level, and anxiety risk factors. Multivariable logistic regression was used to identify the associations of resilience and worry factors with GAD prevalence after controlling for other covariates.ResultsThe prevalence of anxiety disorder was 22.6% across the 31 areas, and the highest prevalence was 35.4% in Hubei province. After controlling for covariates, the results suggested a higher GAD prevalence among participants who were worried about themselves or family members being infected with COVID-19 (adjusted odds ratio, AOR 3.40, 95%CI 2.43–4.75), worried about difficulty obtaining masks (AOR 1.92, 95%CI 1.47–2.50), worried about difficulty of distinguishing true information (AOR 1.65, 95%CI 1.36–2.02), worried about the prognosis of COVID-19 (AOR 2.41, 95%CI 1.75–3.33), worried about delays in working (AOR 1.71, 95%CI 1.27–.31), or worried about decreased income (AOR 1.45, 95%CI 1.14–1.85) compared with those without such worries. Additionally, those with a higher resilience level had a lower prevalence of GAD (AOR 0.59, 95%CI 0.51–0.70). Resilience also showed a mediating effect, with a negative influence on worry factors and thereby a negative association with GAD prevalence.ConclusionIt may be beneficial to promote public mental health during the COVID-19 outbreak through enhancing resilience, which may buffer against adverse psychological effects from worry factors.
Highlights
Generalized Anxiety Disorder (GAD) is a common but urgent mental health problem during disease outbreaks
GAD prevalence and distribution of worry factors to COVID-19 According to cut-off points, 32.7% of respondents had mild GAD, 13.0% had moderate GAD, and 9.6% had severe GAD
Our findings showed a higher GAD prevalence among participants who worried about themselves or family members being infected with COVID-19, difficulty obtaining masks, difficulty distinguishing information, the prognosis of COVID-19, delays in working, or decrease income compared to those without such worries
Summary
Generalized Anxiety Disorder (GAD) is a common but urgent mental health problem during disease outbreaks. The 2019 coronavirus outbreak (COVID-19) was reported in late December 2019 in Wuhan, China, spread to the majority of the world in just 2 months and was reclassified as a pandemic on March 11 by World Health Organization (WHO) [1,2,3]. Several countries continue to observe a similar outbreak to that which was observed in China in February; at that time, the number of COVID-19 infected persons rapidly increased from 24,324 to 40,235 in just 7 days, and cases were recorded in every province of mainland China as well as across 24 countries [5]. Strong policy and pressure are beneficial to controlling the spread of the virus, travel and work restrictions, as well as worry about the outbreak, could induce anxiety, depressive disorders, and post-traumatic stress disorder, which could pose a greater hazard to some individuals than COVID-19 itself [8]
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