Prevalence of depression and its associated factors among adolescents in China during the early stage of the COVID-19 outbreak

Han Qi; Rui Liu; Yuan Feng; Jia Luo; Si Man Lei; Teris Cheung; Gabor S Ungvari; Xu Chen; Yu-Tao Xiang

doi:10.7717/peerj.12223

Prevalence of depression and its associated factors among adolescents in China during the early stage of the COVID-19 outbreak

PeerJ. 2021 Nov 11:9:e12223. doi: 10.7717/peerj.12223. eCollection 2021.

Authors

Han Qi^#¹, Rui Liu^#¹, Yuan Feng¹, Jia Luo¹, Si Man Lei², Teris Cheung³, Gabor S Ungvari^{4

5}, Xu Chen¹, Yu-Tao Xiang^{6

7}

Affiliations

¹ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
² Faculty of Education, University of Macau, Macao SAR, China.
³ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
⁴ Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.
⁵ The University of Notre Dame Australia, Fremantle, Australia.
⁶ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
⁷ Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.

^# Contributed equally.

Abstract

Background: The outbreak of the 2019 coronavirus disease outbreak (COVID-19) had a detrimental impact on adolescents' daily life and studying, which could increase the risk of depression. This study examined the prevalence of depressive symptoms (depression hereafter) among Chinese adolescents and its associated factors.

Methods: An online survey was conducted during the COVID-19 outbreak in China. Adolescents aged 11-20 years who currently lived in China were invited to participate in the study. Data were collected with the "SurveyStar" platform using the Snowball Sampling method. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D).

Results: A total of 9,554 adolescents participated in the study. The prevalence of depression was 36.6% (95% CI [35.6%-37.6%]); the prevalence of mild and moderate-severe depression was 9.2% (95% CI [8.9%-9.5%]) and 27.4% (95% CI [26.9%-27.9%]), respectively. Female gender (OR = 1.235, P < 0.001), senior secondary school grade (OR = 1.513, P < 0.001), sleep duration of <6 h/day (OR = 2.455, P < 0.001), and living in Hubei province (total number of infected cases > 10,000) (OR = 1.245, P = 0.038) were significantly associated with higher risk of depression. Concern about COVID-19 (OR = 0.632, P < 0.001), participating in distance learning (OR = 0.728, P = 0.001), sleep duration of >8 h/day (OR = 0.726, P < 0.001), exercise of >30 min/day, and study duration of ≥4 h/day (OR = 0.835, P < 0.001) were associated with lower risk of depression.

Conclusion: Depression was common among adolescents in China during the COVID-19 outbreak. Considering the negative impact of depression on daily life and health outcomes, timely screening and appropriate interventions are urgently needed for depressed adolescents during the COVID-19 outbreak.

Keywords: Adolescents; COVID-19; China; Depression; Prevalence.

Grants and funding

The study was supported by the National Science and Technology Major Project for investigational new drug (2018ZX09201-014), the Beijing Municipal Science & Technology Commission (Z181100001518005; Z181100001718124), the National Key R&D Program of China (2017YFC1311100), the Beijing Municipal Science & Tech Commission (D171100007017001), and the University of Macau (MYRG2019-00066-FHS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.