Prevalence of depression in China during the early stage of the COVID-19 pandemic: a cross-sectional study in an online survey sample

Weina Liu; Fengyun Yu; Pascal Geldsetzer; Juntao Yang; Zhuoran Wang; Todd Golden; Lirui Jiao; Qiushi Chen; Haitao Liu; Peixin Wu; Chen Wang; Till Bärnighausen; Simiao Chen

doi:10.1136/bmjopen-2021-056667

Prevalence of depression in China during the early stage of the COVID-19 pandemic: a cross-sectional study in an online survey sample

BMJ Open. 2022 Mar 9;12(3):e056667. doi: 10.1136/bmjopen-2021-056667.

Authors

Weina Liu^{1

2}, Fengyun Yu^{1

3}, Pascal Geldsetzer^{1

4}, Juntao Yang⁵, Zhuoran Wang⁵, Todd Golden⁶, Lirui Jiao⁷, Qiushi Chen⁸, Haitao Liu⁵, Peixin Wu⁵, Chen Wang^{5

9}, Till Bärnighausen^{10

11}, Simiao Chen^{12

5}

Affiliations

¹ Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
² Children and Adolescents Health Promotion, Jiangsu Provincial CDC, Nanjing, Jiangsu, China.
³ Department of Industrial Engineering, Tsinghua University, Beijing, China.
⁴ Division of Primary Care and Population Health,Department of Medicine, Stanford University, Stanford, California, USA.
⁵ Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
⁶ National Cancer Institute Division of Cancer Control and Population Sciences, Rockville, Maryland, USA.
⁷ Mailman School of Public Health, Columbia University, New York City, New York, USA.
⁸ Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania, USA.
⁹ Department of Pulmonary and Critical Care Medicine of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
¹⁰ Institute of Public Health, Universitatsklinikum Heidelberg Institut fur Global Health, Heidelberg, Germany.
¹¹ Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
¹² Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany simiao.chen@uni-heidelberg.de.

Abstract

Objectives: We aimed to determine (1) the prevalence of depression during the COVID-19 pandemic among Chinese adults and (2) how depression prevalence varied by province and sociodemographic characteristics.

Design: Cross-sectional study.

Setting: National online survey in China.

Participants: We conducted a cross-sectional online survey among adults registered with the survey company KuRunData from 8 May 2020 to 8 June 2020. We aimed to recruit 300-360 adults per province (n=14 493), with a similar distribution by sex and rural-urban residency as the general population within each of these provinces.

Primary outcome: Participants completed the Patient Health Questionaire-9 (PHQ-9). We calculated the prevalence of depression (defined as a PHQ-9 score ≥10) nationally and separately for each province.

Analysis: Covariate-unadjusted and covariate-adjusted logistic regression models were used to examine how the prevalence of depression varied by adults' sociodemographic characteristics. All analyses used survey sampling weights.

Results: The survey was initiated by 14 493 participants, with 10 000 completing all survey questions and included in the analysis. The prevalence of depression in the national sample was 6.3% (95% CI 5.7% to 6.8%). A higher odds of depression was associated with living in an urban area (OR 1.50; 95% CI 1.18 to 1.90) and working as a nurse (OR 3.06; 95% CI 1.41 to 6.66). A lower odds of depression was associated with participants who had accurate knowledge of COVID-19 transmission prevention actions (OR 0.71; 95% CI 0.51 to 0.98), the knowledge that saliva is a main transmission route (OR 0.80; 95% CI 0.64 to 0.99) and awareness of COVID-19 symptoms (OR, 0.82; 95% CI 0.68 to 1.00).

Conclusion: Around one in 20 adults in our online survey sample had a PHQ-9 score suggestive of depression. Interventions and policies to prevent and treat depression during the COVID-19 pandemic in China may be particularly needed for nurses and those living in urban areas.

Keywords: COVID-19; epidemiology; mental health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / epidemiology
COVID-19* / epidemiology
China / epidemiology
Cross-Sectional Studies
Depression / epidemiology
Humans
Pandemics
Prevalence
SARS-CoV-2
Surveys and Questionnaires