Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: gender differences matter
Open accessAbstract
Highlights • The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%.• Hierarchical regression analysis and non-parametric test suggested that women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal.• Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.
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Risk of PTSS was positively associated with lower education.
“lower education (Liu et al., 2020)”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Liu et al., 2020
In Results > Related factors of the occurrence of PTSS (page unavailable), the initial regression shows lower PTSS scores for respondents with high-school education or below than for those with university or college education. That difference is not significant in the final model. Results > The prevalence and demographic characteristics likewise reports a lower mean PTSS score for the lower-education group, not the higher risk claimed. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe high PTSS level in COVID-19 patients is far higher than in the general public (7%).
“which is far higher than found in the general public (7%) (Liu et al., 2020)”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Liu et al., 2020
The Results report that 20 of 285 participants (7%) met the criteria for PTSS, and the Discussion identifies the population as people in China's hardest-hit areas. This supports the 7% public comparator, but not a prevalence estimate for the general public more broadly. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRisk of PTSS was positively associated with living in Hubei province.
“living in Hubei province (Sun et al., 2020, Liu et al., 2020)”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Liu et al., 2020
The Results (page not provided) report significantly higher PCL-5 scores among respondents currently or previously in Wuhan than among those outside Wuhan. The Methods identify the study area as Wuhan and surrounding cities in Hubei, but the paper does not establish an association for living anywhere in Hubei province versus living outside the province. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDuring the COVID-19 pandemic, women had worse mental health consequences and a greater psychological impact than men.
“Recent studies underlined that women had worse mental health consequences and a greater psychological impact due to COVID-19 [17,18,19].”
From Beneficial effects of mindfulness-based stress reduction training on the well-being of a female sample during the first total lockdown due to covid-19 pandemic in italy (2021) · cites this paper as [17]
The Conclusion and Discussion report more posttraumatic stress symptoms in women than men after the COVID-19 outbreak in China’s hardest-hit areas. This supports a gender difference in psychological impact, but the study measured PTSS in that setting, not mental health consequences generally or across the pandemic. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe COVID-19 pandemic crisis has caused an unprecedented impact on most areas of people's lives.
“This crisis has caused an unprecedented impact on most areas of people’s lives, along with the uncertainness regarding its duration and the ongoing personal and social adjustments to this new “way of life” (e.g., Liu et al., 2020; Rodríguez-Rey et al., 2020; Wang et al., 2020; Zacher and Rudolph, 2020).”
From Dealing With the Pandemic of COVID-19 in Portugal: On the Important Role of Positivity, Experiential Avoidance, and Coping Strategies (2021) · cites this paper as Liu et al., 2020
The Introduction (page unavailable) describes anxiety, quarantine and psychosocial effects in Wuhan and surrounding cities, and the Discussion (page unavailable) reports post-traumatic stress symptoms among residents of the hardest-hit areas. This supports a significant impact on mental health, but the paper does not establish that the pandemic had an unprecedented impact on most areas of people’s lives. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Risk of PTSS was positively associated with female gender.
“The risk of PTSS were positively associated with female gender (Sun et al., 2020, Liu et al., 2020)”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Liu et al., 2020
Risk of PTSS was positively associated with subjective sleep quality.
“subjective sleep quality (Sun et al., 2020, Liu et al., 2020)”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Liu et al., 2020
Women are at higher risk than men of developing symptoms of stress, anxiety, or depression during the Covid-19 pandemic.
“In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression”
From Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy (2020) · cites this paper as [42]
In a Hubei Province, China study, women reported significantly more post-traumatic stress symptoms than men following the Covid-19 outbreak.
“A study of the Hubei Province in China showed that women endorsed significantly more post-traumatic stress symptoms than men in the aftermath of the Covid-19 outbreak (Liu et al., 2020).”
From Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review (2020) · cites this paper as Liu et al., 2020
Younger age and female sex have already emerged as risk factors for psychological distress during the Covid-19 outbreak in China.
“Younger age and female sex have been already emerged as risk factors for psychological distress during the Covid-19 outbreak in China.”
From Cancer Care During COVID-19 Era: The Quality of Life of Patients With Thyroid Malignancies (2020) · cites this paper as [29]
Women in particular were likely to experience anxiety, fears, depression, anger, guilt, grief and loss, post-traumatic stress, stigmatization, negative alterations in cognition or mood, and hyper-arousal during the Covid-19 outbreak.
“Women in particular were likely to experience anxiety, fears, depression, anger, guilt, grief and loss, post-traumatic stress, stigmatization, negative alterations in cognition or mood, and hyper-arousal (23, 29, 30).”
From Cancer Care During COVID-19 Era: The Quality of Life of Patients With Thyroid Malignancies (2020) · cites this paper as [29]
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- Authors
- Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., Wu, L., Sun, Z., Zhou, Y., Wang, Y., & Liu, W.
- Affiliations
- Second Military Medical University (CN)
- Corresponding author
- Liu, Nianqi
- Liu, Weizhi
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 287
- Pages
- 112921
- ISSN
- 0165-1781 (ISSN-L)
- PMC
- PMC7102622
- OpenAlex
- W3011481653
- Semantic Scholar
- 78a858182ce5b361c4776652629359a348396761
- Cited by
- 1,548
- References
- 27
- Citations by year
- 2026: 12 · 2025: 50 · 2024: 90 · 2023: 215 · 2022: 301 · 2021: 532 · 2020: 343 · 2019: 2 · 2013: 1
- FWCI
- 139.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatry Research (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- posttraumatic stress symptoms, COVID-19 pandemic, gender differences, sleep quality, early morning awakening, re-experiencing, hyperarousal, negative alterations in cognition and mood, mental health services, Wuhan
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, China, Disease Outbreaks, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Pneumonia, Viral, Surveys and Questionnaires, Sex Factors, Stress Disorders, Post-Traumatic, Prevalence, Coronavirus Infections, Young Adult, Pandemics
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