The Impact of Omicron-related Stress on Mental Health in the General Population of China

Abstract

Background: Outbreaks of infectious disease represent unique stressors for the general population. In this study, we investigated the prevalence of mental health symptoms and associated risk factors in the general population of China during the Omicron wave. 

Methods: We conducted a cross-sectional and large sample online survey during the surge of Omicron cases between 17 December 2022 and 8 January 2023 among Chinese citizens. Then we assessed the prevalence of symptoms of anxiety, depression, insomnia, acute stress disorder, and resilience levels, in the general population of China during the Omicron pandemic by utilizing the coronavirus disease 2019 (COVID-19) anxiety scale (CAS), the Center for Epidemiologic Studies Depression Scale (CES-D), the Insomnia Severity Index scale (ISI), the Stanford Acute Stress Reaction Questionnaire (SASRQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multivariate logistic regression analyses were used to identify demographic and Omicron-related risk factors. 

Results: In total, 2800 respondents across 32 provinces and autonomous regions on the Chinese mainland participated in this survey; 1133 (40.5%) were male, and 1860 (66.4%) were 40 years-of-age or younger. The prevalence of anxiety, depression, insomnia, and acute stress disorder was 52%, 58.3%, 45.2%, and 34.8%, respectively. After adjustment for covariates, female gender, a younger age, being unmarried, low income, and a non-medical post were all associated with mental health problems. During the course of infection, participants had a higher risk of developing symptoms of anxiety (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.03–1.57; p = 0.028), depression (OR: 1.76; 95% CI: 1.44–2.16; p < 0.001), insomnia (OR: 1.95; 95% CI: 1.57–2.42, p < 0.001) and acute stress disorder (OR: 1.56; 95% CI: 1.25–1.93, p = 0.001). In addition, we found that a lower resilience among participants was associated with a higher risk of anxiety, depression, insomnia, and acute stress disorder (p < 0.001). 

Conclusion: Omicron-related stress had a profound effect on the mental health of the general population of China, especially among those infected during the course of coronavirus disease 2019 (COVID-19) and with lower resilience. Our findings suggest that mental health can be improved during a pandemic by increasing resilience.