Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China

• Published in: JAMA network open 2021-01, Vol.4 (1), p.e2035487
• Main Authors: Qin, Zuguo, Shi, Lei, Xue, Yaqing, Lin, Huang, Zhang, Jinchan, Liang, Pengyan, Lu, Zhiwei, Wu, Mengxiong, Chen, Yaguang, Zheng, Xiao, Qian, Yi, Ouyang, Ping, Zhang, Ruibin, Yi, Xuefeng, Zhang, Chichen
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety - epidemiology; Anxiety - etiology; Child; China - epidemiology; Coronaviruses; COVID-19; COVID-19 - psychology; Cross-Sectional Studies; Depression - epidemiology; Depression - etiology; Distance learning; Exercise; Female; Humans; Logistic Models; Male; Masks; Mental Health; Odds Ratio; Online Only; Original Investigation; Pandemics; Prevalence; Psychological Distress; Public Health; Risk Factors; SARS-CoV-2; Schools; Self Report; Stress, Psychological - epidemiology; Stress, Psychological - etiology; Students; Teenagers
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2020.35487

Schools have been suspended nationwide in 188 countries, and classes have shifted to home-based distance learning models to control the spread of the coronavirus disease 2019 (COVID-19) pandemic. Additional information is needed to determine mental health status among school-aged children and adolescents during this public health crisis and the risk factors associated with psychological distress during the pandemic. To assess self-reported psychological distress among school-aged children and adolescents associated with the COVID-19 pandemic. This cross-sectional study using data from a survey on the mental health of school-aged children and adolescents in Guangdong province, China, conducted by using a stratified cluster random sampling method between March 8 to 30, 2020. To estimate outcomes associated with location of districts, only data from students with internet protocol addresses and current addresses in Guangdong were included. Data were analyzed from April 5 to July 20, 2020. Home-based distance learning during the COVID-19 pandemic. The main outcome was self-reported psychological distress, measured using the total score on the 12-item General Health Questionnaire of 3 or greater. Multivariate logistic regression was used to analyze risk factors associated with mental health status. Odds ratios (ORs) were used to analyze the associations of factors with psychological distress. Among 1 310 600 students who completed the survey, 1 199 320 students (mean [SD] age, 12.04 [3.01] years; 619 144 [51.6%] boys) were included in the final analysis. A total of 126 355 students (10.5%) self-reported psychological distress. Compared with students in primary school, high school students had increased risk of psychological distress (OR, 1.19 [95% CI, 1.15-1.23]). Compared with students who wore a face mask frequently, students who never wore a face mask had increased risk of psychological distress (OR, 2.59 [95% CI, 2.41-2.79]). Additionally, students who spent less than 0.5 hours exercising had increased odds of self-reported psychological distress compared with students who spent more than 1 hour exercising (OR, 1.64 [95% CI, 1.61-1.67]). These findings suggest that the prevalence of self-reported psychological distress among students during the COVID-19 pandemic was relatively high. Frequency of wearing a face mask and time spent exercising were factors associated with mental health. Therefore, it may be necessary for governments, schools, and families to p