{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:05:36Z","timestamp":1740146736615,"version":"3.37.3"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007421","name":"Li Ka Shing Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007421","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"crossref","award":["378073"],"award-info":[{"award-number":["378073"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The COVID-19 pandemic has alarming implications for individual and population level mental health. Although the future of COVID-19 is unknown at present, more countries or regions start to ease restrictions. The findings from this study have provided the empirical evidence of prevalence and patterns of mental disorders in Chinese general population before and after easing most COVID-19 restrictions, and information of the factors associated with these patterns.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional population-based online survey was carried out from February to March 2020 in the general population across all provinces in China. The 12-item General Health Questionnaire (GHQ-12) was incorporated in the survey. Latent class analyses were performed to investigate the patterns of mental disorders and multinomial logistic regressions were used to examine how individual and regional risk factors can predict mental disorder patterns.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Four distinctive patterns of mental health were revealed in the general population. After the ease of most COVID-19 restrictions, the prevalence of high risk of mental disorders decreased from 25.8% to 20.9% and prevalence of being high risk of unhappiness and loss of confidence decreased from 10.1% to 8.1%. However, the prevalence of stressed, social dysfunction and unhappy were consistently high before and after easing restrictions. Several regional factors, such as case mortality rate and healthcare resources, were associated with mental health status. Of note, healthcare workers were less likely to have mental disorders, compared to other professionals and students.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The dynamic management of mental health and psychosocial well-being is as important as that of physical health both before and after the ease of COVID-19 restrictions. Our findings may help in mental health interventions in other countries and regions while easing COVID-19 restrictions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255251","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T22:03:24Z","timestamp":1628028204000},"page":"e0255251","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Patterns of mental health problems before and after easing COVID-19 restrictions: Evidence from a 105248-subject survey in general population in China"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7060-4892","authenticated-orcid":true,"given":"Depeng","family":"Jiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixiu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haizhu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuejing","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binglin","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoping","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianchang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyi","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chendong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"pone.0255251.ref001","unstructured":"WHO. WHO coronavirus disease (COVID-19) dashboard. Geneva: World Health Organization, 2020. https:\/\/covid19.who.int"},{"key":"pone.0255251.ref002","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: rapid review of the evidence","volume":"395","author":"SK Brooks","year":"2020","journal-title":"Lancet"},{"issue":"6","key":"pone.0255251.ref003","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/jamainternmed.2020.1562","article-title":"The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention","volume":"180","author":"S Galea","year":"2020","journal-title":"JAMA Internal Medicine"},{"key":"pone.0255251.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.psychres.2020.112954","article-title":"Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey","volume":"288","author":"Y Huang","year":"2020","journal-title":"Psychiatry Research"},{"issue":"7","key":"pone.0255251.ref005","first-page":"1","article-title":"Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic","volume":"3","author":"L Shi","year":"2020","journal-title":"JAMA Network Open"},{"key":"pone.0255251.ref006","first-page":"1","article-title":"Social distancing in covid-19: What are the mental health implications?","volume":"369","author":"A Venkatesh","year":"2020","journal-title":"BMJ"},{"key":"pone.0255251.ref007","doi-asserted-by":"crossref","first-page":"e113045","DOI":"10.1016\/j.psychres.2020.113045","article-title":"How an Epidemic Outbreak Impacts Happiness: Factors that Worsen (vs. Protect) Emotional Well-being during the Coronavirus Pandemic","volume":"289","author":"H Yang","year":"2020","journal-title":"Psychiatry Research"},{"key":"pone.0255251.ref008","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S2215-0366(18)30511-X","article-title":"Prevalence of mental disorders in China: a cross-sectional epidemiological study","volume":"6","author":"Y Huang","year":"2019","journal-title":"The Lancet Psychiatry"},{"key":"pone.0255251.ref009","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/S0140-6736(09)60660-7","article-title":"Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001\u201305: an epidemiological survey","volume":"373","author":"MR Phillips","year":"2009","journal-title":"The Lancet"},{"issue":"2","key":"pone.0255251.ref010","first-page":"1","article-title":"The prevalence of insomnia in the general population in China: A meta-analysis","volume":"12","author":"XL Cao","year":"2017","journal-title":"PLoS ONE"},{"key":"pone.0255251.ref011","first-page":"1","article-title":"Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China","volume":"17","author":"C Wang","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"pone.0255251.ref012","first-page":"277","article-title":"Utilization of specialty mental health care among persons with severe mental illness: the roles of demographics, need, insurance, and risk","volume":"35","author":"DD McAlpine","year":"2000","journal-title":"Health Services Research"},{"key":"pone.0255251.ref013","first-page":"69","article-title":"Epidemiological investigation on mental disorders in 7 areas of China","volume":"31","author":"WX Zhang","year":"1998","journal-title":"Chinese Journal of Neurology and Psychiatry"},{"key":"pone.0255251.ref014","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1056\/NEJMp2008017","article-title":"Mental Health and the Covid-19 Pandemic","volume":"383","author":"B Pfefferbaum","year":"2020","journal-title":"New England Journal of Medicine"},{"key":"pone.0255251.ref015","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/S2215-0366(20)30078-X","article-title":"Mental health care for medical staff in China during the COVID-19 outbreak","volume":"7","author":"Q Chen","year":"2020","journal-title":"The Lancet Psychiatry"},{"key":"pone.0255251.ref016","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1192\/bjp.185.2.127","article-title":"Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital","volume":"185","author":"MY Chong","year":"2004","journal-title":"British Journal of Psychiatry"},{"key":"pone.0255251.ref017","first-page":"1","article-title":"Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019","volume":"3","author":"J Lai","year":"2020","journal-title":"JAMA Network Open"},{"issue":"8","key":"pone.0255251.ref018","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1038\/s41380-020-0758-9","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the neuroendocrine stress axis","volume":"25","author":"C Steenblock","year":"2020","journal-title":"Molecular psychiatry"},{"key":"pone.0255251.ref019","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: A systematic review","volume":"277","author":"J Xiong","year":"2020","journal-title":"Journal of Affective Disorders"},{"key":"pone.0255251.ref020","first-page":"1","article-title":"Managing mental health challenges faced by healthcare workers during covid-19 pandemic","volume":"368","author":"N Greenberg","year":"2020","journal-title":"The BMJ"},{"key":"pone.0255251.ref021","first-page":"353","article-title":"The validity of General Health Questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people","volume":"15","author":"Z Makowska","year":"2002","journal-title":"International Journal of Occupational Medicine and Environmental Health"},{"key":"pone.0255251.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1477-7525-2-23","article-title":"Measuring mental health of the Dutch population: A comparison of the GHQ-12 and the MHI-5","volume":"2","author":"N Hoeymans","year":"2004","journal-title":"Health and Quality of Life Outcomes"},{"key":"pone.0255251.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-016-0539-y","article-title":"The factor structure of the 12-item general health questionnaire (GHQ-12) in young Chinese civil servants","volume":"14","author":"Y Liang","year":"2016","journal-title":"Health and Quality of Life Outcomes"},{"key":"pone.0255251.ref024","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/0010-440X(88)90021-1","article-title":"A comparison of methods of scoring the General Health Questionnaire","volume":"29","author":"SC Newman","year":"1988","journal-title":"Comprehensive Psychiatry"},{"key":"pone.0255251.ref025","first-page":"349","article-title":"The best thresholds and the screening features among the three scoring methods of the 12-item General Health Questionnaire","volume":"45","author":"W Wang","year":"2012","journal-title":"Chin J Psychiatry"},{"volume-title":"Latent class and latent transition analysis with applications in the social, behavioral, and health sciences","year":"2010","author":"LM Collins","key":"pone.0255251.ref026"},{"key":"pone.0255251.ref027","volume-title":"Mplus: statistical analysis with latent variables (user\u2019s guide)","author":"L Muth\u00e9n","year":"2007","edition":"6"},{"key":"pone.0255251.ref028","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1017\/S1049023X19004874","article-title":"A Systematic Review of the Impact of Disaster on the Mental Health of Medical Responders","volume":"34","author":"VA Naushad","year":"2019","journal-title":"Prehospital and Disaster Medicine"},{"key":"pone.0255251.ref029","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1017\/dmp.2013.22","article-title":"Posttraumatic stress disorder in parents and youth after health-related disasters","volume":"7","author":"G Sprang","year":"2013","journal-title":"Disaster Medicine and Public Health Preparedness"},{"key":"pone.0255251.ref030","article-title":"Covid-19 lockdown: a perfect storm for older people\u2019s mental health","author":"L Webb","year":"2020","journal-title":"Journal of Psychiatric and Mental Health Nursing"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T22:03:58Z","timestamp":1628028238000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255251"}},"subtitle":[],"editor":[{"given":"Wen-Jun","family":"Tu","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,3]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0255251","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2021,8,3]]}}}