Mental health consequences during alerting situations and recovering to a new normal of coronavirus epidemic in 2019: a cross-sectional study based on the affected population

Qian Zhang,Qianqian Mu,Junying Li,Rujun Zheng,Yan Fu

doi:10.1186/s12889-021-11550-w

Abstract

BackgroundAs a major virus outbreak in the twenty-first century, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented hazards to mental health globally.MethodsWe performed a cross-sectional study based on the results of an online survey. The survey was conducted 1 month after the outbreak (February 18–29, 2020) and repeated at the time of resuming activity (April 8–14, 2020). The 15-item Death Anxiety Scale (T-DAS) was used to assess the degree of death anxiety, and the Chinese version of PTSD checklist-civilian version (PCL-C), for PTSD symptom clusters. Through convenient sampling, a total of 7678 cases were collected.ResultsOur findings showed that even after the lockdown was lifted, the prevalence of the symptoms of post-traumatic stress disorder (PTSD) and death anxiety remained significantly high in the general population affected by the outbreak. Regression model analysis showed that PTSD was significantly associated with age > 50 years, contact history/living community, poor health status of participants, past traumatic experience (PTE), and medical occupation. Moreover, death anxiety mediated the relationship between life-threatening PTE and PTSD, indicating that reducing death anxiety could buffer the negative effects of PTE on PTSD.ConclusionsDespite the lifting of the lockdown, long-term adverse psychological effects remain in the affected general population. The management of mental health after major public health events is important, and high-risk groups such as the elderly and healthcare workers should receive targeted interventions. In addition, the study suggests that methods for alleviating death anxiety must be included in plans to manage the psychological impact of public health emergencies.

Highlights

As a major virus outbreak in the twenty-first century, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented hazards to mental health globally
The COVID-19 pandemic has had an unprecedented impact on all societies worldwide, and the World Health Organization (WHO) declared the COVID-19 outbreak an international public health emergency on January 30, 2020 [1]
84 participants refused to participate in the study, and 9 participants were excluded because their questionnaires were inconsistent

Summary

Introduction

As a major virus outbreak in the twenty-first century, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented hazards to mental health globally. The 2019 coronavirus influenza pandemic caused prolonged exposure to stress, and the incidence of PTSD was associated with stress levels in different populations. Liang et al assessed the mental health of adolescents in the early stages of the outbreak and found that 14.4% of young people had PTSD-related symptoms [10]. As the severity of the outbreak lessened, several countries began to lift the mandatory lockdowns. In this regard, Eldhuis et al found through follow-up observation that PTSD symptoms decreased with the remission of the epidemic. Gonzalez-Sanguino et al looked at 3480 ordinary Spaniards and found that the psychological effects of the epidemic, such as anxiety, were not relieved during the stable phase [15]

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