Loneliness, depression, anxiety, and post-traumatic stress disorder among Chinese adults during COVID-19: A cross-sectional online survey

Zijun Xu, Dexing Zhang, Dong Xu, Xue Li, Yaojie Xie, Wen Sun, Eric Kam-Pui Lee, Benjamin Hon Kei Yip, Shuiyuan Xiao, Samuel Yeung Shan Wong

Research output: Journal article publicationJournal articleAcademic researchpeer-review


This study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic.

This is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed.

This study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (p<0.05).

Mental health problems during the COVID-19 epidemic were associated with various biopsychosocial and COVID-19 related factors. Psychological interventions should be aware of these influencing factors and prioritize support for those people at higher risk.
Original languageEnglish
Pages (from-to)e0259012
JournalPLoS ONE
Issue number10
Publication statusPublished - 21 Oct 2021

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