The proportion and associated factors of anxiety in Chinese adolescents with depression during the COVID-19 outbreak

Abstract

Background : Given the serious impact of the COVID-19 outbreak on the mental health of Chinese adolescents, this study aimed to examine the proportion of anxiety and its correlates among Chinese adolescents with depression during the pandemic. Methods : This cross-sectional online survey was conducted from February 20th to February 27, 2020 in China. Symptoms of depression and anxiety were assessed by the 20-item Center for Epidemiological Studies-Depression (CES-D) and 7-item Generalized Anxiety Disorder (GAD-7), respectively. Results : In this study, 3,498 adolescents with depression were identified. Of them, the proportion of anxiety was 45.1% (95% confidence interval [CI]=43.5%-46.8%). Multiple logistic regression analysis revealed that being concerned about graduation (OR=1.25, P=0.002, 95% CI=1.09-1.43), sleep duration <6hr/day (OR=1.80, P<0.001, 95% CI=1.38-2.34), study duration >8hr/day (OR=1.21, P=0.02, 95% CI=1.03-1.42), and quantity of homework higher than before (OR=1.68, P<0.001, 95% CI=1.40-2.02) were positively associated with anxiety; the number of confirmed COVID-19 cases at a provincial level of 100-999 (OR=0.70, P<0.001, 95% CI=0.59-0.83) and 1,000-9,999 (OR=0.69, P=0.001, 95% CI=0.55-0.87) were negatively related to anxiety in adolescents with depression. Limitations : Because this was a cross-sectional online study, the causality between variables and anxiety could not be examined among depressed adolescents. The use of self-reported scales may lead to an underestimation of the proportion of anxiety among adolescents with depression. Conclusions : The symptoms of anxiety were common in adolescents with depression during the COVID-19 outbreak. Timing screening and targeted interventions are necessary to mitigate the risks of mental illness of adolescents.

Prevalence and associated factors of depression, anxiety and suicidality among Chinese high school E-learning students during the COVID-19 lockdown

“…With regard to the daily routine behavioral factors, the study found that poor overall sleep quality had the highest association with the risk of depression, anxiety and suicidal ideation consistent with previous studies before and during the COVID-19 pandemic (Gong et al, 2020 ; Liu et al, 2021a ). Overall sleep quality was the most important factor associated with mental health problems during COVID-19 among high school students.…”

Screening for anxiety and its determinants among secondary school students during the COVID-19 era: a snapshot from Qatar in 2021

“…Anxiety was reported in 37.2% (n = 279) of the secondary school students in Qatar. Relatively, our data was lower than the results published in China, where the reported anxiety prevalence was 45.1% [ 22 ]. However, the results of our study show a higher prevalence than the expected anxiety level among adolescents in the GCC prior to the pandemic [ 4 ].…”

A narrative review into the impact of COVID‐19 pandemic on senior high school adolescent mental health

“…Meanwhile, the risk factors that are positively related to high anxiety in adolescents are lack of rest, having difficulty with online education, having too much schoolwork, focusing too much on graduation, where adolescents live, and low physical activity (AlAzzam et al, 2021 ; Andreas & Brunborg, 2021 ; Liu et al, 2021 ). Adolescents who participate in sports activities have a lower risk of anxiety and depression than adolescents who do not do sports (McGuine et al, 2021 ).…”