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Associations between factors related to COVID-19 and depression: direct and indirect effects via mental distress due to COVID-19: an online cross-sectional survey conducted among students of 26 universities in 16 cities in China
Yanqiu Yu;
Rui She;
Sitong Luo;
Meiqi Xin;
Lijuan Li;
Suhua Wang;
Le Ma;
Fangbiao Tao;
Jianxin Zhang;
Junfeng Zhao;
Liping Li;
Dongsheng Hu;
Guohua Zhang;
Jing Gu;
Danhua Lin;
Hongmei Wang;
Yong Cai;
Zhaofen Wang;
Hua You;
Guoqing Hu;
Joseph Lau
ABSTRACT
Background:
The COVID-19 epidemic may elevate mental distress in various populations in China.
Objective:
The study investigated the levels of depression and negative psychological responses to COVID-19, and the associations between cognitive/behavioral/psychosocial factors and depression among university students in China.
Methods:
A large-scale online cross-sectional study (16 cities in 13 provinces) was conducted among university students from February 1st to 10th, 2020 in China; 23,863 valid questionnaires were returned. Patient Health Questionnaire-9 was used to assess depression. Structural equation modeling was performed to test mediation/suppression effects.
Results:
Of the participants, 47.1% reported high/very high levels of ≥ one type of negative psychological responses; 39.1% showed mild to severe depression. Negative psychological responses were positively associated with depression. All but one factor (perceived infection risks, perceived chance of controlling the epidemic, home-staying, contacted people from Wuhan, and perceived discrimination) was significantly associated with negative psychological responses and depression. Negative psychological responses partially mediated/suppressed the associations between the studied factors and depression (effect size of 6.0% to 79.5%).
Conclusions:
Both negative psychological responses to COVID-19 and depression were prevalent among university students in China; the former may increase the prevalence of the latter. The studied cognitive/behavioral/psychosocial factors related to COVID-19 may directly or indirectly (via negative psychological responses) affect depression. Interventions to modify such factors may reduce mental distress during the COVID-19 epidemic.
Citation
Please cite as:
Yu Y, She R, Luo S, Xin M, Li L, Wang S, Ma L, Tao F, Zhang J, Zhao J, Li L, Hu D, Zhang G, Gu J, Lin D, Wang H, Cai Y, Wang Z, You H, Hu G, Lau J
Factors Influencing Depression and Mental Distress Related to COVID-19 Among University Students in China: Online Cross-sectional Mediation Study