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BackgroundA novel coronavirus (SARA-CoV-2) emerged in Wuhan, China, in December 2019. Within a few weeks, the disease caused by SARA-CoV-2, which is named COVID-19, has escalated into an unprecedented ongoing outbreak with frightening speed, becoming a global health emergency. This study aimed to exam the prevalence and risk factors of acute posttraumatic stress symptoms (PTSS) in Chinese people shortly after the massive outbreak of COVID-19.

Corona virus disease 2019 (COVID-19) outbreak has attracted worldwide attention.The COVID-19 outbreak is unique in its rapid transmission and results in heavy stress for the front-line health care workers (HCWs). The current study aimed to exam posttraumatic stress symptoms (PTSSs) of HCWs fighting for the COVID-19 and to evaluate their sleep quality after 1-month stressful suffering. Three hundred seventyseven HCWs working in different provinces of China participated in the survey between February 1 and 5. The demographic information was collected first. Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Pittsburgh Sleep Quality Index (PSQI) were selected to measure PTSSs and sleep quality. Results showed that 1 month after the outbreak, the prevalence of PTSSs was 3.8% in HCWs. Female HCWs were more vulnerable to PTSSs with hazard ratio of 2.136 (95% CI = 1.388-3.286). HCWs with higher exposure level also significantly rated more hyperarousal symptoms (hazard ratio = 4.026, 95% CI = 1.233-13.140). There was a significant difference of sleep quality between participants with and without PTSSs (z value = 6.014, p < .001) and among different groups with various contact frequencies (chi-square = 7.307, p = .026). Path analysis showed that there was a significant indirect effect from exposure level to PTSSs through sleep quality (coefficient = 1.750, 95% CI of Boostroop test = 0.543-2.998). In summary, targeted interventions on sleep contribute to the mental recovery during the outbreak of COVID-19. Understanding the mental health response after a public health emergency might help HCWs and communities prepare for a population's response to disaster. K E Y W O R D S

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The study investigated the quarantine of COVID-19 and its impact on mental health. The results showed that there was a significant difference in PTSD Checklist for DSM-5 scores between the quarantine group and the non-quarantine group. As a result, the mental health of residents in mandatory quarantine zones urgently requires intervention.

Background: China has the largest population of '"loss-of-only-child' parents, that are also known as Shidu parents in Chinese society; however, little is known about their unresolved grief. Objective: This is the first study to examine the grief symptoms, prevalence, comorbidity and potential predictors of prolonged grief disorder (PGD) in such parents, taking into consideration that the new PGD diagnostic criteria ICD-11 will soon be implemented in China. Methods: 149 Shidu parents completed assessments of PGD (PG-13), PTSD (PCL-C), depression (CES-D) and general psychiatric morbidity (GHQ-12) via in-person interviews. Results: Of the 149 Shidu parents, 22.2% met the PGD criteria, with a mean of 7.59 years post-loss, and 62.4% experienced daily longing or yearning. Regression analysis indicated that fewer years since loss, subjective perception of poor economic situation, female gender and more hospital visits were prominent risk factors for the development of PGD. Older age of the parents at the time of child loss was also associated with PGD. Parents with PGD had higher comorbidity of PTSD or depression compared with those without PGD. Conclusions: There is a high prevalence of PGD and a high rate of comorbidity between PGD and PTSD or depression in Shidu parents in China, which highlights the need of timely developing effective assessments and interventions to prevent PGD in this population, particularly in female, recently bereaved, low-income and aged parents who lost their only child.

The impact of 2019 coronavirus disease (COVID-19) outbreak on mental health was of widespread concern recently. The present study aimed to exam sleep quality and posttraumatic stress symptoms (PTSS) and potential influence factors in the first phases of COVID-19 massive outbreak in China. A snowball sampling technique was used and a total of 2027 Chinese participated in the present study. Demographic information, epidemic area contact history, sleep quality and PTSS data were collected with an internet-based cross-sectional survey. Results suggested that 59.7% participants were not fully satisfied with their sleep quality, and 50.9% participants had various degrees of short sleep duration problems. 44.1% and 33.0% participants had sleep disturbance and sleep onset latency problems. Also, the prevalence of PTSS reached 4.7% in the self-rating survey. Epidemic area contact history affected PTSS and latency onset of sleep under the influence of COVID-19. Epidemic area contact history and sleep quality had interaction effects on PTSS. The present study was one of the first to evaluate acute psychological responses and possible risk factors during the peak of COVID-19 in China and results indicate that keeping good sleep quality in individuals with pandemic exposure experiences is a way to prevent PTSS.

Background Since the beginning of 21st century, several major public health emergencies (PHEs) have threatened the health of people globally. Posttraumatic stress symptoms (PTSS) was one of the most concerned mental health problems. The objective of this study is to systematically estimate the prevalence of PTSS under the influence of PHEs. Method We searched both English and Chinese databases. This meta-analysis used a random-effects model to estimate the prevalence of PTSS. Subgroup analysis were conducted to analyze the source of heterogeneity. Meta-regression model was used to calculate the proportion of the variance explained by subgroup moderators. Results Forty eligible studies ( n = 15,538) were identified. The results revealed a pooled prevalence of PTSS of 17.0% (95%CI: 13.5%–21.2%), higher than that of previous epidemiological survey, with high between-studies heterogeneity (Q = 1199, I 2 = 96.75%, p < .001). There was variance of prevalence in different countries (4%–36.5%) and epidemics (12.1%–36.5%). The prevalence of PTSS showed the feature of fluctuation in the change of time (Q = 6.173, p = .290). Patients had higher prevalence (26.2%) compared to healthcare workers (HCWs) (18.5%) and community samples (12.4%) and frontline HCWs had marginally significantly higher estimated rate than general HCWs (22.2%, 95%CI:16.0%–30.1% vs. 10.4%, 95%CI: 6.4%–16.6%). The variance of prevalence screened by interview and self-reported was significant (Q = 3.393, p = .05) and studies with higher quality possessed lower prevalence (high:12.4%; moderate: 17.3%; low: 18.0%). The total variance explained by subgroup moderators was estimated 64% by meta regression model. Limitations Limitations include high level of heterogeneity between studies and within subgroups as well as the lack of studies with high quality and using probability sampling. Conclusions This study suggested that the PTSS was common under the influence of PHEs. It was crucial to further explore the psychological mechanism and effective strategies for prevention and intervention in future research with more high-quality studies.