Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19
Open accessAbstract
Psychological health problems, especially emotional disorders, are common among adolescents. The epidemiology of emotional disorders is greatly influenced by stressful events. This study sought to assess the prevalence rate and socio-demographic correlates of depressive and anxiety symptoms among Chinese adolescents affected by the outbreak of COVID-19. We conducted a cross-sectional study among Chinese students aged 12-18 years during the COVID-19 epidemic period. An online survey was used to conduct rapid assessment. A total of 8079 participants were involved in the study. An online survey was used to collect demographic data, assess students' awareness of COVID-19, and assess depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) questionnaire, respectively. The prevalence of depressive symptoms, anxiety symptoms, and a combination of depressive and anxiety symptoms was 43.7%, 37.4%, and 31.3%, respectively, among Chinese high school students during the COVID-19 outbreak. Multivariable logistic regression analysis revealed that female gender was the higher risk factor for depressive and anxiety symptoms. In terms of grades, senior high school was a risk factor for depressive and anxiety symptoms; the higher the grade, the greater the prevalence of depressive and anxiety symptoms. Our findings show there is a high prevalence of psychological health problems among adolescents, which are negatively associated with the level of awareness of COVID-19. These findings suggest that the government needs to pay more attention to psychological health among adolescents while combating COVID-19.
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Anxiety levels among the adolescent population were significantly higher than those in children.
“Studies (n = 4) also reported that the anxiety levels among the adolescent population were significantly higher than those in children [23,27,28,33].”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [33]
The Results report a significant association between school grade and anxiety symptoms (Table 1, grade P < 0.001), with generally higher rates in later grades. But the study surveyed students aged 12–18 and did not compare adolescents with a separate group of children, so it does not establish the claimed population-level comparison. (LLM, conf=0.83)
Experimental — accuracy not yet measuredFemale adolescents have a higher risk of depression and anxiety during the COVID-19 pandemic.
“Because female adolescents have a higher risk of depression and anxiety during the COVID‑19 pandemic [23,24,25,32,33], generating mental health-promoting strategies specific to these gender and age categories is critical.”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [33]
The Results report that female students had higher odds of depressive and anxiety symptoms during the COVID-19 outbreak (OR 1.15 and 1.10, respectively). The study surveyed Chinese students aged 12–18, so it supports the claim for that population but does not establish the same risk for female adolescents generally throughout the pandemic. (LLM, conf=0.84)
Experimental — accuracy not yet measuredFemale adolescents showed higher depression and anxiety levels during COVID-19 than male adolescents.
“Studies also reported that female adolescents showed higher depression and anxiety levels during COVID‑19 than male adolescents did [23,24,25,32,33].”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [33]
Adolescents in senior high school had the greatest depressive and anxiety symptoms.
“In addition, adolescents in senior high school had the greatest depressive and anxiety symptoms [20,23,27,33]”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [33]
Decline in mental health in young populations leads to engagement in unhealthy behaviors such as substance abuse, absenteeism from work, and school interruptions.
“The consequences of the decline in mental health in young populations lead to engagement in unhealthy behaviors such as substance abuse, absenteeism from work, and school interruptions [22,24,27,28,33].”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [33]
The Discussion describes COVID-19 school closures and disrupted education as possible contributors to students’ anxiety and depression, not as consequences of declining mental health. The passages searched for substance abuse, work absenteeism, and school interruptions do not address the claimed consequences. (LLM, conf=0.75)
Experimental — accuracy not yet measured
The prevalence of depression in young people across the three studies that reported such information ranged from 22.6% to 43.7%.
“The prevalence of depression in young people across the three studies that reported such information ranged from 22.6% to 43.7% [36,37,39].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
One study recruited students aged 12-18 years old across the country (China).
“one study recruited students aged 12–18 years old across the country (China) [36]”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
Older cohorts of young people are likely to report higher levels of symptoms of mental distress.
“Two studies suggested that older cohorts of young people are likely to report higher levels of symptoms of mental distress.”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
In an adolescent sample (12-18 years), older adolescents (senior high school) were more likely to report higher depression and anxiety symptoms than their younger counterparts (junior high school).
“Similarly, in an adolescent sample (12–18 years), older adolescents (senior high school) were more likely to report higher depression and anxiety symptoms than their younger counterparts (junior high school) [36].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
The presence of anxiety symptoms was identified in 18.9% and 37.4% of young people measured by SCARED and GAD-7, respectively, in two studies.
“The presence of anxiety symptoms was identified in 18.9% and 37.4% of young people measured by SCARED and GAD-7, respectively, in two studies [36,39].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
Only one study reported explicitly that females were more likely to report higher levels of depression and anxiety.
“but only one study reported explicitly that females were more likely to report higher levels of depression and anxiety [36].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
Of the four studies that examined gender differences in young people under 18 years of age, differences were evident in two studies.
“Of the four studies that examined gender differences in young people under 18 years of age, differences were evident in two studies [36,42]”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
Two studies indicated that as age increases, reported levels of anxiety and depression are likely to increase as well.
“Two studies indicated that as age increases, reported levels of anxiety and depression are likely to increase as well [35,36].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [36]
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- Authors
- Zhou, S.-J., Zhang, L.-G., Wang, L.-L., Guo, Z.-C., Wang, J.-Q., Chen, J.-C., Liu, M., Chen, X., & Chen, J.-X.
- Affiliations
- Peking University (CN)
- Nankai University (CN)
- Corresponding author
- Chen, Jin-Cheng
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2020-05-03
- Volume
- 29
- Issue
- 6
- Pages
- 749-758
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC7196181
- OpenAlex
- W3021560368
- Cited by
- 1,464
- References
- 46
- Citations by year
- 2026: 40 · 2025: 97 · 2024: 146 · 2023: 272 · 2022: 408 · 2021: 405 · 2020: 94
- FWCI
- 118.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Capital Foundation of Medicine Research and Development (2018-3-2132)
- the Special Foundation of Beijing Municipal Science & Technology Commission (Z171100001017001)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, adolescent mental health, depressive symptoms, anxiety symptoms, prevalence, sociodemographic risk factors, gender differences, grade level, COVID-19 awareness, Chinese adolescents, high school students
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Anxiety, Child, China, Cross-Sectional Studies, Depression, Disease Outbreaks, Female, Humans, Male, Mental Health, Pneumonia, Viral, Surveys and Questionnaires, Risk Factors, Students, Prevalence, Coronavirus Infections, Pandemics
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