Depression and Anxiety Symptoms and Their Associated Factors Among Chinese Residents After the Lifting of the Dynamic Zero-COVID Policy: A Cross-Sectional Study

Abstract

Purpose China lifted its strict zero-Covid approach on December 7, 2022. This study aimed to investigate depression and anxiety symptoms and their associations among Chinese residents after the change in public policy. Methods A cross-sectional sample of 925 Chinese residents (726 females and 199 males) was recruited using convenience and snowball sampling approach between 16 and 25 December 2022. Participants completed online questionnaires on basic information, depression, anxiety, COVID-19 related perceptions, and protective behaviors change. Results Mild and moderate-to-severe depression symptoms were reported by 35.6% and 19.1% of participants, respectively. Nearly 40% of participants reported mild anxiety and 18.7% reported moderate-to-severe anxiety. Results from multinomial logistic regression analysis indicated that male gender, younger age, the presence of chronic disease, poorer self-rated mental health status, perceived impact, and worry were risk factors for both depression and anxiety, while higher education and protective behaviors change were protective factors. Besides, living with or caring for children (4–6 years), family members or other housemates currently with influenza-like symptoms, and perceived severity were also risk factors for depression. Conclusion Our findings provided initial evidence that Chinese residents may face heightened depression and anxiety during the early stage after the policy was released. Furthermore, we identified some vulnerable populations in need of prioritizing mental health assistance and some potentially modifiable factors associated with depression and anxiety, which provides an important guide for developing timely and effective psychological interventions and preparing for future pandemics.

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“…During the initial phase of the pandemic, China implemented a dynamic zero-COVID strategy, focusing on controlling sources of infection, interrupting transmission pathways, and safeguarding vulnerable populations ( Bai et al, 2022 ). On December 7, 2022, in response to the evolving characteristics of COVID-19 variants and changing epidemic conditions, China released the “Notice on Further Optimizing the Implementation of COVID-19 Prevention and Control Measures,” signaling a strategic shift away from the stringent zero-COVID policy ( Song et al, 2023 ). This abrupt policy change led to significant impacts, including overwhelmed healthcare facilities and funeral homes, as well as a historically high youth unemployment rate ( Li et al, 2023 ; Mallapaty, 2023 ).…”