The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study
Open accessAbstract
An outbreak in Wuhan, China in late 2019 of a highly infectious new coronary pneumonia (COVID-19) led to the imposition of countrywide confinement measures from January to March 2020. This is a longitudinal study on changes in the mental health status of a college population before and after their COVID-19 confinement for the first two weeks, focusing on states of psychological distress, depression, anxiety and affectivity. The influence of possible stressors on their mental health were investigated, including inadequate supplies and fears of infection. Five hundred and fifty-five undergraduate students were recruited from Hebei Agricultural University in Baoding, China. The participants completed two online surveys—on anxiety and depression, and on positive and negative affect. One survey was conducted before the confinement and the other was conducted 15–17 days after the start of the confinement. Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement. Inadequate supplies of hand sanitizers, a higher year of study, and higher scores on anxiety and depression were common predictors of increased negative affect, anxiety, and depression across the confinement period. The results suggest that healthcare policymakers should carefully consider the appropriate confinement duration, and ensure adequate supplies of basic infection-control materials.
AI snapshot
Written from the paper’s full text.
TL;DR
In a two-wave longitudinal survey of 555 undergraduates at Hebei Agricultural University, the paper reports changes in affect, anxiety, and depression after 15–17 days of COVID-19 confinement and examines fear of infection and inadequate supplies as predictors. The abstract and Results section conflict on whether negative affect and anxiety/depression increased or decreased, but regression analyses link fear of infection and inadequate hand-hygiene supplies to worse mental-health scores.
Key findings
- The abstract states that “increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement,” while the Results section states that “significant decrements were observed for negative affect (PANAS-NA) and symptoms of anxiety and depression PHQ-4 (Ps < 0.001),” with a nonsignificant change on positive affect PANAS-PA (p = 0.107); this inconsistency is evident in the text.
- In regression models controlled for age, gender, year of study, and pre-confinement scores, fear of infection—own risk was associated with reduced positive affect (PANAS-PA) (coefficient = −0.047, 95%CI = −0.080, −0.014); inadequate supplies of hand sanitizers were associated with increased negative affect (PANAS-NA) (coefficient = 0.043, 95%CI = 0.008, 0.078).
- Fear of infection—general (coefficient = 0.806, 95%CI = 0.008, 0.043) and inadequate supplies of alcohol hand rubs (coefficient = 0.031, 95%CI = 0.002, 0.060) were associated with increased anxiety and depression (PHQ-4) after 2 weeks of confinement.
- The Discussion reports that each year of study significantly increased PANAS-NA by 0.123 and PHQ-4 by 0.136, and that inadequate supplies of hand sanitizers, higher year of study, and higher anxiety/depression scores were common predictors of increased negative affect, anxiety, and depression across confinement.
Methods
- Longitudinal two-wave online survey: 624 undergraduate students from Hebei Agricultural University in Baoding, China, were recontacted; 555 (88.9%) were included after 69 were excluded for missing required information. Mean age was 19.6 (SD = 3.4); 426 (76.8%) were female, and 99.1% were in year one or two.
- Measures included the 10-item Positive and Negative Affect Schedule (PANAS) and the 4-item Patient Health Questionnaire (PHQ-4), plus eight items on inadequate supplies and fear of infection added at the 2-week post-confinement survey. Exploratory factor analysis yielded three factors: fear of infection—general (three items), fear of infection—own risk (two items), and inadequate supplies of infection-control materials (three items), with Cronbach’s alphas 0.709, 0.928, and 0.564, respectively; the three supply items were treated as individual variables.
- Analysis used SPSS 25.0: paired t-tests for changes in PANAS-PA, PANAS-NA, and PHQ-4, and separate linear regressions for 2-week post-confinement scores, controlling for age, gender, year of study, and the pre-confinement score of the dependent variable.
Limitations
- The paper states the sample was undergraduate students, mostly female (about 77%), so results may not generalize to the general population, full-time workers, or healthcare workers; participants were also at home with family during an extended Chinese New Year holiday, so negative psychological impacts may have weighed less than for the general public or healthcare providers.
- Evident in the text: the abstract and Results section contradict each other on the direction of change in negative affect and anxiety/depression symptoms, and the reported coefficient and confidence interval for fear of infection—general appear mismatched (coefficient = 0.806, 95%CI = 0.008, 0.043).
- Evident in the text: the inadequate-supplies factor had low internal consistency (Cronbach’s alpha = 0.564) and its items were analyzed individually; all outcomes were self-reported, and the follow-up covered only 15–17 days after confinement began.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 10 cited sources checked · 0 supported · 0 flagged
- Findingreasoning
Each additional year of study was associated with increased negative affect (PANAS-NA) after 2 weeks of confinement (coefficient = 0.123).
“each year of study also significantly increased the mean score of the PANAS-NA by 0.123 and the mean score of the PHQ-4 by 0.136.”
Quote in the paperSubstantial claim - Findingown data
After 2 weeks of confinement, symptoms of anxiety and depression (PHQ-4) increased among college students.
“Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement.”
Quote in the paperSubstantial claim- Rests on an assumption: The changes in mental health observed after 2 weeks of confinement are attributable to the confinement itself.
- Rests on an assumption: The first wave survey (before the outbreak) accurately represents the students' baseline mental health.
- Findingown data
After 2 weeks of confinement, positive affect (PANAS-PA) did not change significantly (p = 0.107).
“and a nonsignificant change on positive affect PANAS-PA (p = 0.107) after 2 weeks of confinement”
Quote in the paperNot a substantial claim- Rests on an assumption: The first wave survey (before the outbreak) accurately represents the students' baseline mental health.
- Findingown data
Inadequate supplies of hand sanitizers were associated with increased negative affect (PANAS-NA) after 2 weeks of confinement (coefficient = 0.043, 95%CI = 0.008, 0.078).
“inadequate supplies of hand sanitizers was associated with increased negative affect (PANAS-NA) (coefficient = 0.043, 95%CI = 0.008, 0.078)”
Quote in the paperSubstantial claim - Findingown data
Inadequate supplies of alcohol hand rubs were associated with increased anxiety and depression (PHQ-4) after 2 weeks of confinement (coefficient = 0.031, 95%CI = 0.002, 0.060).
“fear of infection—general (coefficient = 0.806, 95%CI = 0.008, 0.043) and inadequate supplies of alcohol hand rubs (coefficient = 0.031, 95%CI = 0.002, 0.060) were associated with an increase in anxiety and depression (PHQ-4) after 2 weeks of confinement”
Quote in the paperSubstantial claim
- Findingown data
Fear of infection-general was associated with increased anxiety and depression (PHQ-4) after 2 weeks of confinement (coefficient = 0.806, 95%CI = 0.008, 0.043).
“fear of infection—general (coefficient = 0.806, 95%CI = 0.008, 0.043) and inadequate supplies of alcohol hand rubs (coefficient = 0.031, 95%CI = 0.002, 0.060) were associated with an increase in anxiety and depression (PHQ-4) after 2 weeks of confinement”
Quote in the paperSubstantial claim - Findingown data
After 2 weeks of confinement, negative affect (PANAS-NA) increased among college students.
“Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement.”
Quote in the paperSubstantial claim- Rests on an assumption: The changes in mental health observed after 2 weeks of confinement are attributable to the confinement itself.
- Rests on an assumption: The first wave survey (before the outbreak) accurately represents the students' baseline mental health.
- Findingown data
Fear of infection-own risk was associated with reduced positive affect (PANAS-PA) after 2 weeks of confinement (coefficient = −0.047, 95%CI = −0.080, −0.014).
“fear of infection—own risk had a significant association with reduced positive affect (PANAS-PA) in a negative sense (coefficient = −0.047, 95%CI = −0.080, −0.014)”
Quote in the paperSubstantial claim - Findingreasoning
Each additional year of study was associated with increased anxiety and depression (PHQ-4) after 2 weeks of confinement (coefficient = 0.136).
“each year of study also significantly increased the mean score of the PANAS-NA by 0.123 and the mean score of the PHQ-4 by 0.136.”
Quote in the paperSubstantial claim - Study design and conductcitation
The study used reliable and valid self-reported questionnaires (PANAS and PHQ-4).
“The immediate psychological consequences of the confinement were examined with reliable and valid self-reported questionnaires, which included the 10-item Positive and Negative Affect Schedule (PANAS) [15] and the 4-item Patient Health Questionnaire (PHQ-4) [16].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [15] Thompson, 2007, Development and validation of an internationally reliable short-form of the positive and negative affect schedule (PANAS), J. Cross-Cult. Psychol. source
Not checked in the free run.
- cites [16] Kroenke, 2009, An ultra-brief screening scale for anxiety and depression: The PHQ–4, Psychosomatics
Not checked in the free run.
- Interpretationcitation
The results might not be generalizable to the general population, including full-time workers or healthcare workers, because the study group was undergraduate students, mostly female.
“Our study group was comprised of undergraduate students, most of them female (about 77%); thus, the results might not be generalizable to the general population, including people working full-time who might be the main breadwinners of their families, or healthcare workers taking care of affected patients [26].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [26] British Broadcasting Corporation (BBC) (2020, May 12). Pneumonia in Wuhan: Wuhan Nurses Cry Increasing Death Cases. 23 January 2020. Available online: https://www.bbc.com/zhongwen/simp/chinese-news-51222564.
Not checked in the free run.
- Premisecitation
Previous studies found that people in quarantine reported higher rates of psychological symptoms (stress, depression, anxiety, insomnia) compared to people not in quarantine or the general population.
“Previous studies have found that people in quarantine reported higher rates of psychological symptoms, such as stress symptoms, depression, anxiety, and insomnia, compared to people not in quarantine or in the general population.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Brooks, 2020, The psychological impact of quarantine and how to reduce it: Rapid review of the evidence, Lancet source
Not checked in the free run.
- Interpretationreasoning
The negative psychological impacts of quarantine might have weighed less heavily on the confined college students than on the general public or healthcare providers because they were staying at home with families and in holiday mood.
“The quarantined participants of this survey were staying at home with their families in an extension of the Chinese New Year holiday. Therefore, they were not deprived of the company of their families and were still in a holiday mood; thus, the negative psychological impacts of being in quarantine might have weighed less heavily on them than on the general public or on healthcare providers.”
Quote in the paperNot a substantial claim- Rests on an assumption: The changes in mental health observed after 2 weeks of confinement are attributable to the confinement itself.
- Premisecitation
Only one previous study focused on the impact of COVID-19 on adolescents.
“Furthermore, only one previous study focused on the impact of COVID-19 on adolescents [13].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., and Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res., 112934. source
Not checked in the free run.
- May combine two claims. 6
- Classified as probably not a substantial claim. 10
May combine two claims.
Study design and conductreasoningThe mental health survey data of the same cluster of college students were compared before the outbreak and after 2 weeks of confinement, ensuring temporal precedence and excluding background differences between comparison groups.
“One strength of this survey is that the mental health survey data of the same cluster of college students were compared before the outbreak of COVID-19 and after 2 weeks of confinement to ensure temporal precedence of the findings of the study, meaning that background differences between the two comparison groups could be excluded.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationStudents were one of the groups experiencing a higher degree of psychological difficulty.
“The study also found that students were one of the groups experiencing a higher degree of psychological difficulty.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThere was no indication of multicollinearity, with all VIFs ranging from 1.037 to 1.345.
“There was no indication of multicollinearity, with all the VIFs ranging from 1.037 to 1.345 for the predictors in all three regression analyses.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationEmotional disorders such as anxiety, depression, and affectivity can profoundly affect the health and school performance of adolescents.
“Emotional disorders such as anxiety, depression, and affectivity, can profoundly affect the health and school performance of adolescents [14].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] Suldo, 2011, Longitudinal academic outcomes predicted by early adolescents’ subjective well-being, psychopathology, and mental health status yielded from a dual factor model, J. Posit. Psychol. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe negative psychological effects of quarantine were due to relatively long periods of quarantine, fears of infection, frustration, boredom, inadequate supplies, inadequate information, and stigma.
“The negative psychological effects were due to relatively long periods of quarantine, fears of infection, frustration, boredom, inadequate supplies, inadequate information, and stigma [11].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] Brooks, 2020, The psychological impact of quarantine and how to reduce it: Rapid review of the evidence, Lancet source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe study was approved by the Ethics Committee of Hebei Agricultural University (Ref: 20190309).
“The study was approved by the Ethics Committee of Hebei Agricultural University (Ref: 20190309).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationA cross-sectional survey in 194 cities in China found that more than 50% of 1210 respondents from the general population reported moderate to severe psychological difficulties due to COVID-19, with about 16% depression, 29% anxiety, and 8% stress.
“The study was conducted in 194 cities in China and found that more than 50% of the 1210 respondents from the general population reported moderate to severe levels of psychological difficulties due to the COVID-19 outbreak, with about 16% suffering from symptoms of depression, 29% from anxiety, and 8% from stress [12].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17. source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe regression models controlled for age, gender, year of study, and the score of the dependent variable before confinement.
“controlled for age, gender, year of study, and the score of the dependent variable before confinement.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningYear-two college students would have higher negative affect and higher levels of anxiety and depression than year-one students.
“This means that year-two college students would have a higher negative affect and higher levels of anxiety and depression than year-one students”
Quote in the paperSubstantial claim- Rests on an assumption: The changes in mental health observed after 2 weeks of confinement are attributable to the confinement itself.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenConsent from each student was obtained at the beginning of each of the online surveys.
“Consent from each student was obtained at the beginning of each of the online surveys.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataA total of 555 (88.9%) students were included in the analysis; 69 were excluded because they did not provide required information.
“A total of 555 (88.9%) students were ultimately included in the analysis because 69 did not provide the required information on some of the items, and were therefore excluded.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningThe two waves of measures include the total period of confinement, so the data set forth in the report should be reliable.
“Nevertheless, the two waves of measures that have been taken include the total period of confinement, so the data set forth in this report should be reliable.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationConcerns have arisen about the potential psychological impact of confinement measures.
“concerns have arisen about their potential psychological impact [11].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Brooks, 2020, The psychological impact of quarantine and how to reduce it: Rapid review of the evidence, Lancet source
Not checked in the free run.
The paper relies on this without support.
There has been no previous longitudinal study on the impact of COVID-19 during the confinement period on college students.
“To the best of our knowledge, there has been no previous longitudinal study on the impact of COVID-19 during the confinement period on this population.”
The paper relies on this without support.
The changes in mental health observed after 2 weeks of confinement are attributable to the confinement itself.
“our results suggest that it also leads to fear, anxiety, and depression, and has negative psychological impacts on the affected persons.”
The paper relies on this without support.
The first wave survey (before the outbreak) accurately represents the students' baseline mental health.
“The first wave of the survey was conducted on 20 December 2019, which was before the outbreak of COVID-19.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
After two weeks of isolation, participants showed an increase in symptoms of anxiety and depression.
“After two weeks of isolation, participants showed an increase in symptoms of anxiety and depression.”
From Social isolation and its impact on child and adolescent development: a systematic review (2022) · cites this paper as [18]
Psychological problems, including anxiety, sadness, depression, and guilt, are direct consequences of the confinement process in children and adolescents.
“Psychological problems, including anxiety, sadness, depression, and guilt, were raised as direct consequences of the confinement process. 3 , 18”
From Social isolation and its impact on child and adolescent development: a systematic review (2022) · cites this paper as [18]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Changes in negative affect, anxiety, and depression are described in opposite directions
MajorThe abstract reports increases in negative affect and symptoms of anxiety and depression after two weeks, while the Results section reports significant decrements in those same measures.
“Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement.”
“Significant decrements were observed for negative affect (PANAS-NA) and symptoms of anxiety and depression PHQ-4 (Ps < 0.001)”
PHQ-4 coefficient falls outside its reported confidence interval
MajorThe reported coefficient for fear of infection-general is 0.806, but its stated 95% confidence interval runs from 0.008 to 0.043 and therefore cannot contain that estimate.
“fear of infection—general (coefficient = 0.806”
“95%CI = 0.008, 0.043)”
Cites
Clinical characteristics of coronavirus disease 2019 in China
Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., Liu, L., Shan, H., Lei, C.-L., Hui, D. S. C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2002032 · Cited by 30,246 · see citing works
A novel coronavirus from patients with pneumonia in China, 2019
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001017 · Cited by 28,244 · see citing works
Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001316 · Cited by 16,575 · see citing works
Self-citationThe psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378 · see citing works
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17051729 · Cited by 9,923 · see citing works
The psychological impact of the COVID-19 epidemic on college students in China
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112934 · Cited by 5,843 · see citing works
An Ultra-Brief Screening Scale for Anxiety and Depression: The PHQ–4
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2009) · Psychosomatics · doi:10.1016/s0033-3182(09)70864-3 · Cited by 4,261 · see citing works
Thompson, E. R. (2007) · Journal of Cross-Cultural Psychology · doi:10.1177/0022022106297301 · Cited by 2,399 · see citing works
SARS control and psychological effects of quarantine, Toronto, Canada
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004) · Emerging Infectious Diseases · doi:10.3201/eid1007.030703 · Cited by 1,929 · see citing works
Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., Liu, X., Fuller, C. J., Susser, E., Lü, J., et al. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905400504 · Cited by 1,651 · see citing works
Maunder, R., Hunter, J., Vincent, L. H., Bennett, J. P., Peladeau, N., Leszcz, M., Sadavoy, J., Verhaeghe, L. M., Steinberg, R. J., & Mazzulli, T. (2003) · Europe PMC (PubMed Central) · Cited by 1,495 · see citing works
Lee, S. M., Kang, W. S., Cho, A.-R., Kim, T., & Park, J. K. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2018.10.003 · Cited by 1,112 · see citing works
The psychological effects of quarantining a city
Rubin, G. J., & Wessely, S. (2020) · BMJ · doi:10.1136/bmj.m313 · Cited by 999 · see citing works
Understanding, compliance and psychological impact of the SARS quarantine experience
REYNOLDS, D. L., GARAY, J. R., DEAMOND, S. L., MORAN, M. K., GOLD, W., & STYRA, R. (2008) · Epidemiology and Infection · doi:10.1017/s0950268807009156 · Cited by 895 · see citing works
Suldo, S., Thalji, A., & Ferron, J. (2011) · The Journal of Positive Psychology · doi:10.1080/17439760.2010.536774 · Cited by 369 · cited 1× · see citing works
“Emotional disorders such as anxiety, depression, and affectivity, can profoundly affect the health and school performance of adolescents [14].”
BackgroundMaunder, R. G., Lancee, W. J., Rourke, S., Hunter, J. J., Goldbloom, D., Balderson, K., Petryshen, P., Steinberg, R., Wasylenki, D., Koh, D., et al. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000145673.84698.18 · Cited by 368 · see citing works
Robertson, E., Hershenfield, K., Grace, S. L., & Stewart, D. E. (2004) · The Canadian Journal of Psychiatry · doi:10.1177/070674370404900612 · Cited by 298 · see citing works
Wang, Y., Xu, B., Zhao, G., Cao, R., He, X., & Fu, S. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.11.001 · Cited by 206 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Browning, M. H. E. M., Larson, L. R., Sharaievska, I., Rigolon, A., McAnirlin, O., Mullenbach, L., Cloutier, S., Vu, T. M., Thomsen, J., Reigner, N., et al. (2021) · PLOS ONE · doi:10.1371/journal.pone.0245327 · Cited by 888 · see citing works
Saraswathi, I., Saikarthik, J., Senthil Kumar, K., Madhan Srinivasan, K., Ardhanaari, M., & Gunapriya, R. (2020) · PeerJ · doi:10.7717/peerj.10164 · Cited by 608 · see citing works
Kauhanen, L., Wan Mohd Yunus, W. M. A., Lempinen, L., Peltonen, K., Gyllenberg, D., Mishina, K., Gilbert, S., Bastola, K., Brown, J. S. L., & Sourander, A. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02060-0 · Cited by 544 · see citing works
Social isolation and its impact on child and adolescent development: a systematic review
Almeida, I. L. D. L., Rego, J. F., Teixeira, A. C. G., & Moreira, M. R. (2022) · Revista Paulista de Pediatria · doi:10.1590/1984-0462/2022/40/2020385 · Cited by 223 · see citing works
Buizza, C., Bazzoli, L., & Ghilardi, A. (2022) · Adolescent Research Review · doi:10.1007/s40894-022-00192-7 · Cited by 149 · see citing works
Qi, X., Yu, H., & Ploeger, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17197106 · Cited by 141 · see citing works
El-Monshed, A. H., El-Adl, A. A., Ali, A. S., & Loutfy, A. (2022) · Journal of American College Health · doi:10.1080/07448481.2021.1891086 · Cited by 84 · see citing works
Shek, D. T. L., Zhao, L., Dou, D., Zhu, X., & Xiao, C. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.01.011 · Cited by 80 · see citing works
Mental health of nursing students amid coronavirus disease 2019 pandemic.
Gao, J., Wang, F., Guo, S., & Hu, F. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.699558 · Cited by 76 · see citing works
Tan, Y., Huang, C., Geng, Y., Cheung, S. P., & Zhang, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.671553 · Cited by 73 · see citing works
Huang, X., Wang, Y., & Zhang, H. (2023) · Asian Journal of Sport and Exercise Psychology · doi:10.1016/j.ajsep.2023.01.001 · Cited by 51 · see citing works
- Authors
- Li, H. Y., Cao, H., Leung, D. Y. P., & Mak, Y. W.
- Affiliations
- Hebei Agricultural University (CN)
- Beijing Institute of Education (CN)
- Hong Kong Polytechnic University (HK)
- Corresponding author
- Mak, Yim Wah
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2020-06-02
- Volume
- 17
- Issue
- 11
- Pages
- 3933
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC7312488
- OpenAlex
- W3032508718
- Semantic Scholar
- c86bab13648eace0855c2b346344618e72e437e8
- Cited by
- 372
- References
- 18
- Citations by year
- 2026: 2 · 2025: 15 · 2024: 26 · 2023: 68 · 2022: 96 · 2021: 128 · 2020: 35
- FWCI
- 32.63
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, lockdown, university students, mental health, psychological distress, depression, anxiety, negative affect, positive affect, fear of infection, predictors of mental health
- MeSH terms
- COVID-19, Adolescent, China, Humans, Longitudinal Studies, Mental Health, Pneumonia, Viral, Policy Making, Quarantine, Students, Time Factors, Universities, Coronavirus Infections, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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