key: cord-0825834-oxhi0cqj
authors: Zhang, Jie; Lu, Huipeng; Zeng, Haiping; Zhang, Shining; Du, Qifeng; Jiang, Tingyun; Du, Baoguo
title: The differential psychological distress of populations affected by the COVID-19 pandemic
date: 2020-04-15
journal: Brain Behav Immun
DOI: 10.1016/j.bbi.2020.04.031
sha: c42102c6d4959052fb8e1f19028691c45913fa13
doc_id: 825834
cord_uid: oxhi0cqj

nan

The differential psychological distress of populations affected by the COVID-19 pandemic Jie Zhang a1* , Huipeng Lu a1 , Haiping Zeng b1 , Shining Zhang b1 , Qifeng Du a , Tingyun Jiang a , Baoguo Du a a. Department of Psychiatry, b. Mental Health Centre, The Third People's Hospital of Zhongshan, Guangdong 528451, China 1 These authors contributed equally to this work. *Corresponding author: dr.zhangjie@gmail.com (J. Zhang)

Coronavirus disease 2019 initially outbroke in Wuhan, China in December 2019 and promptly became a pandemic worldwide within the following two months. The public health emergencies resulting from COVID-19 are negatively impacting the mental health of the population and increasing the incidence of psychological crises . Early identification of populations in the first stages of psychological crisis will allow for the efficient implementation of interventional strategies (National Health Commission of China 2020). The clinical characteristics of psychological distress have not been well established across the populations affected by the COVID-19 pandemic, although a general increased level of mental distress has been reported from both the general public and frontline medical personnel (Kang et al., 2020; Qiu et al., 2020) .

Therefore, we designed a pilot and cross-sectional study to identify the characteristics of psychological distress across populations affected by the COVID-19 pandemic. The app-based, anonymous questionnaire was designed to survey the level of psychological distress, and the study was conducted in the Zhongshan, one of prefecture-level cities in Guangdong province, P. R. China, from February 15 to February 29, 2020. A total of 205 participants responded and completed the questionnaires. The Chinese version 9-item General Health Questionnaire (GHQ-9) and 7-item Generalized Anxiety Disorder (GAD-7) scale were employed to evaluate the prevalence and severity of psychological distress within patients newly recovery from COVID-19 infection, individuals under quarantine, and the general public. A total score of ≥ 10 for both the PHQ-9 and GAD-7 was defined as depression and anxiety respectively. The severity of psychological distress was classified with the standard thresholds: Minimal or none (0-4), Mild (5-9), Moderate (10-14), Severe (>15) for both the PHQ-9 and GAD-7.

An increased prevalence of depression (29.2%) was found predominately in patients who experienced COVID-19 infection (p = 0.016), while the prevalence of anxiety was not statistically different across the three groups (p = 0.154) as shown in Table 1 . Trends for an increased prevalence of depression comorbid with anxiety (p = 0.086) were identified in both patients who experienced COVID-19 infection (21.1%) and the general public (22.4%) compared to those in quarantine. Both patients who experienced COVID-19 infection (19.3%) and the general public (14.3%) also had a greater proportion of severe depressive symptom (p = 0.002) as shown in Table 1 . Moreover, patients who experienced COVID-19 infection and the general public more likely to demonstrate depressed mood (p = 0.038) and somatic symptoms (all p < 0.01) in the sub-items of the PHQ-9, compared to individuals under quarantine . Anxiety-like behavior, including becoming easily annoyed or irritable, manifested primarily in the general public and patients who experienced COVID-19 infection (p < 0.01).

To the best of our knowledge, this is the first study aimed at exploring the psychological health across populations with different levels of exposure to the COVID-19 epidemic. Our study revealed differential levels of psychological distress in patients who experienced COVID-19 infection, individuals under quarantine, and the general public. The vulnerability to psychological distress across populations in the COVID-19 pandemic could be attributable to various factors, including gender, social support, specific experiences with COVID-19 infection, length of isolation, and amount of exposure to the media (Brooks et al., 2020; Li et al., 2020) . The preliminary findings from our study suggest that timely identification of psychological distress and precise classifying of the mental health needs across populations will facilitate development of targeted psychological interventions for individuals in epidemics of emerging infectious diseases.

The authors declare that they have no known competing financial interests or personal relationships that could have influence the work reported in this correspondence 

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Impact on Mental Health and Perceptions of Psychological Care among Medical and Nursing Staff in Wuhan during the 2019 Novel Coronavirus Disease Outbreak: a Cross-sectional Study

Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control

National Health Commission of China. Principles for emergency psychological crisis intervention for the new coronavirus pneumonia

A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed

The study was supported by grants from the Social Welfare Scientific Research Project (Key Program) of Zhongshan City (grant numbers: 2018B1006 to B. D). The authors thank Hanna. E. Stevens from University of Iowa for language editing.