{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:02:02Z","timestamp":1782846122883,"version":"3.54.5"},"reference-count":45,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To mitigate the rapid spread of COVID-19, numerous countries have adopted lockdowns and quarantine measures. Despite their public health benefits, the effects of these measures on suicidal ideation have not been well documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to examine the relationship among COVID-19 infection, perceived beliefs, uncertainty stress, and suicidal ideation during the transition from quarantine to post-quarantine periods amid China\u2019s COVID-19 surge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective longitudinal observational design was used. Changing trends across the 6 time points were assessed using the Mann-Kendall test and the Cochran-Armitage test. A generalized estimating equation was used to analyze the associations between independent variables and suicidal ideation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 221 (96.5%) participants completed all 6 observation waves. The prevalence of suicidal ideation during the quarantine period was 16.7% (n=37), 14.5% (n=32), and 14.5% (n=32), while during the post-quarantine period, it was 13.8% (n=30), 10.9% (n=24), and 10.0% (n=22), respectively. A significant downward trend in suicidal ideation was observed. In contrast, perceived risk, perceived severity, and the number of new infections exhibited significant upward trends (\n                      <jats:italic>z<\/jats:italic>\n                      scores of 9.56, 7.13, and 3.69, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001,\n                      <jats:italic\/>\n                      and\n                      <jats:italic>=<\/jats:italic>\n                      ). However, uncertainty stress remained stable over time (\n                      <jats:italic>z<\/jats:italic>\n                      =0.71;\n                      <jats:italic>P<\/jats:italic>\n                      =.48). The generalized estimating equation indicated that perceived risk (\u03b2=0.5482;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001), perceived severity (\u03b2=0.0817;\n                      <jats:italic>P<\/jats:italic>\n                      =.007), and uncertainty stress (\u03b2=0.1776;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001) were positively associated with suicidal ideation. The number of new infections (\u03b2=0.0041;\n                      <jats:italic>P<\/jats:italic>\n                      =.49) was not significantly associated with suicidal ideation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found that suicidal ideation gradually declined following the lifting of quarantine measures. Perceived risk, perceived severity, and uncertainty stress, rather than numbers of infected cases, were significantly associated with suicidal ideation. These findings highlight the importance of addressing individuals\u2019 perceptions with real-world context when developing effective strategies to manage COVID-19 and future infectious disease outbreaks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/74370","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:12:11Z","timestamp":1757110331000},"page":"e74370-e74370","source":"Crossref","is-referenced-by-count":0,"title":["Changing Trends in Suicidal Ideation and Its Influencing Factors During the Transition From Quarantine to Post-Quarantine Among Chinese University Students During the COVID-19 Surge: Six-Wave Panel Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5437-3996","authenticated-orcid":false,"given":"Lijing","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8234-0938","authenticated-orcid":false,"given":"Tingzhong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-537X","authenticated-orcid":false,"given":"Sihui","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8733-9127","authenticated-orcid":false,"given":"Randall R","family":"Cottrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2020.06.010","article-title":"Is the lockdown important to prevent the COVID-19 pandemic? Effects on psychology, environment and economy-perspective","volume":"56","author":"Atalan","journal-title":"Ann Med Surg (Lond)"},{"issue":"4","key":"R2","doi-asserted-by":"publisher","first-page":"354","DOI":"10.4103\/psychiatry.IndianJPsychiatry_427_20","article-title":"Psychological impact of COVID-19 lockdown: an online survey from India","volume":"62","author":"Grover","journal-title":"Indian J Psychiatry"},{"issue":"9","key":"R3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18094668","article-title":"Stress and mental health among children\/adolescents, their parents, and young adults during the first COVID-19 lockdown in Switzerland","volume":"18","author":"Mohler-Kuo","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1177\/0272684X211022121","article-title":"Trapped between two pandemics: domestic violence cases under COVID-19 pandemic lockdown: a scoping review","volume":"43","author":"Uzobo","journal-title":"Community Health Equity Res Policy"},{"issue":"7","key":"R5","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1017\/S0033291720003116","article-title":"Immediate and delayed psychological effects of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China","volume":"52","author":"Gan","journal-title":"Psychol Med"},{"issue":"6491","key":"R6","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1126\/science.abb6105","article-title":"An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China","volume":"368","author":"Tian","journal-title":"Science"},{"issue":"7","key":"R7","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1017\/S0950268807009156","article-title":"Understanding, compliance and psychological impact of the SARS quarantine experience","volume":"136","author":"Reynolds","journal-title":"Epidemiol Infect"},{"issue":"10227","key":"R8","doi-asserted-by":"publisher","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":"Brooks","journal-title":"Lancet"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1177\/0956797612462222","article-title":"The wear and tear of daily stressors on mental health","volume":"24","author":"Charles","journal-title":"Psychol Sci"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1521\/jscp.2011.30.3.270","article-title":"Prospective relationship between negative affective reactivity to daily stress and depressive symptoms","volume":"30","author":"Parrish","journal-title":"J Soc Clin Psychol"},{"key":"R11","unstructured":"Cottrell R McKenzie JF . Health Promotion & Education Research Methods: Using the Five Chapter Thesis\/Dissertation Model. Jones & Bartlett Publishers; 2010."},{"key":"R12","unstructured":"Yang T . Health Research: Social and Behavioral Theory and Methods. People\u2019s Medical Publishing House; 2018."},{"issue":"2","key":"R13","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1093\/her\/cyab012","article-title":"Changing trends of mental and behavioral responses and associations during the COVID-19 epidemic in China: a panel study","volume":"36","author":"Yang","journal-title":"Health Educ Res"},{"issue":"4","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/24053","article-title":"Association of perceived threat, negative emotions, and self-efficacy with mental health and personal protective behavior among Chinese pregnant women during the COVID-19 pandemic: cross-sectional survey study","volume":"23","author":"Mo","journal-title":"J Med Internet Res"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1186\/s12889-020-09695-1","article-title":"Chinese public\u2019s knowledge, perceived severity, and perceived controllability of COVID-19 and their associations with emotional and behavioural reactions, social participation, and precautionary behaviour: a national survey","volume":"20","author":"Li","journal-title":"BMC Public Health"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.563741","article-title":"Epidemic risk perception, perceived stress, and mental health during COVID-19 pandemic: a moderated mediating model","volume":"11","author":"Li","journal-title":"Front Psychol"},{"key":"R17","unstructured":"Festinger L . A Theory of Cognitive Dissonance. Vol 2. Stanford University Press; 1962."},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"334","DOI":"10.5993\/AJHB.45.2.12","article-title":"Uncertainty stress, and its impact on disease fear and prevention behavior during the COVID-19 epidemic in China: a panel study","volume":"45","author":"Peng","journal-title":"Am J Health Behav"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13030481","article-title":"The association between COVID-19 related anxiety, stress, depression, temporomandibular disorders, and headaches from childhood to adulthood: a systematic review","volume":"13","author":"Minervini","journal-title":"Brain Sci"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.14349\/sumapsi.2020.v27.n1.8","article-title":"Intolerance of uncertainty and mental health in Brazil during the Covid-19 pandemic","volume":"27","author":"Seco Ferreira","journal-title":"Sumapsi"},{"issue":"7","key":"R21","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1177\/08901171211004249","article-title":"Perceived beliefs, uncertainty, and behavioral responses during the COVID-19 outbreak in China: findings from a convenience sample","volume":"35","author":"Wu","journal-title":"Am J Health Promot"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13788","article-title":"Comparative analysis of perceived stress in dermatologists and other physicians during national lock-down and COVID-19 pandemic with exploration of possible risk factors: a web-based cross-sectional study from Eastern India","volume":"33","author":"Podder","journal-title":"Dermatol Ther"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15701-z","article-title":"Impacting factors and sources of perceived stress by home-quarantined residents in Shanghai during COVID-19 epidemic","volume":"23","author":"Zhou","journal-title":"BMC Public Health"},{"issue":"6","key":"R24","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1007\/s10654-021-00770-4","article-title":"Economic uncertainty and suicide in the United States","volume":"36","author":"Vandoros","journal-title":"Eur J Epidemiol"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1177\/1359105318805820","article-title":"Uncertainty stress, social capital, and suicidal ideation among Chinese medical students: findings from a 22-university survey","volume":"26","author":"Wu","journal-title":"J Health Psychol"},{"issue":"2","key":"R26","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1192\/bjp.bp.107.040113","article-title":"Cross-national prevalence and risk factors for suicidal ideation, plans and attempts","volume":"192","author":"Nock","journal-title":"Br J Psychiatry"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112640","article-title":"A typology of social capital and its mixed blessing for suicidal ideation: a multilevel study of college students","volume":"243","author":"Peng","journal-title":"Soc Sci Med"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1136\/ip.5.4.311","article-title":"Injury and violence: a public health perspective","volume":"5","author":"Rockett","journal-title":"Inj Prev"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-021815-093204","article-title":"Suicide, suicide attempts, and suicidal ideation","volume":"12","author":"Klonsky","journal-title":"Annu Rev Clin Psychol"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2019.102199","article-title":"The effect of urban green space on uncertainty stress and life stress: a nationwide study of university students in China","volume":"59","author":"Yang","journal-title":"Health Place"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00243","article-title":"The impacts of uncertainty stress on mental disorders of Chinese college students: evidence from a nationwide study","volume":"11","author":"Wu","journal-title":"Front Psychol"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"55","DOI":"10.26599\/FIE.2023.9270005","article-title":"A goodness-of-fit test based on fuzzy random variables","volume":"15","author":"Hesamian","journal-title":"Fuzzy Inf Eng"},{"key":"R33","unstructured":"Kendall MG . Rank correlation methods. In: Public Program Analysis. Springer; 1948:146-163."},{"issue":"7","key":"R34","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1007\/s10389-023-01902-8","article-title":"Changes in incidence and mortality trend due to COVID-19 in southern Iran, from 2020 to 2021: based on Cochran\u2013Armitage trend test","volume":"32","author":"Rezaei","journal-title":"J Public Health (Berl)"},{"issue":"2","key":"R35","doi-asserted-by":"publisher","first-page":"470","DOI":"10.2307\/2669353","article-title":"Generalized estimating equation models for correlated data: a review with applications","volume":"45","author":"Zorn","journal-title":"Am J Pol Sci"},{"issue":"5","key":"R36","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1093\/qjmed\/hcaa110","article-title":"Mental health in the COVID-19 pandemic","volume":"113","author":"Cullen","journal-title":"QJM"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02847-5","article-title":"Social trust and stress symptoms among older adults during the COVID-19 pandemic: evidence from Asia","volume":"22","author":"Jiang","journal-title":"BMC Geriatr"},{"issue":"7","key":"R38","doi-asserted-by":"publisher","first-page":"e249","DOI":"10.1093\/geronb\/gbaa111","article-title":"Loneliness and mental health during the COVID-19 pandemic: a study among Dutch older adults","volume":"76","author":"van Tilburg","journal-title":"J Gerontol"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2017.04.017","article-title":"Intolerance of uncertainty, depression, and anxiety: examining the indirect and moderating effects of worry","volume":"29","author":"Dar","journal-title":"Asian J Psychiatr"},{"issue":"6","key":"R40","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1016\/S0191-8869(02)00091-0","article-title":"Uncertainty, stress, and health","volume":"34","author":"Greco","journal-title":"Pers Individ Dif"},{"issue":"3","key":"R41","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1080\/17437199.2015.1022901","article-title":"A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations","volume":"9","author":"Rebar","journal-title":"Health Psychol Rev"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.amepre.2017.01.010","article-title":"Social media use and perceived social isolation among young adults in the US","volume":"53","author":"Primack","journal-title":"Am J Prev Med"},{"issue":"2","key":"R43","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1089\/cyber.2011.0324","article-title":"\u201cThey are happier and having better lives than I am\u201d: the impact of using Facebook on perceptions of others\u2019 lives","volume":"15","author":"Chou","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"R44","doi-asserted-by":"crossref","unstructured":"Rabe-Hesketh S Everitt B . Handbook of Statistical Analyses Using Stata. CRC Press; 2003.","DOI":"10.1201\/NOE1584884040"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1139\/f90-001","article-title":"Statistical power analysis can improve fisheries research and management","volume":"47","author":"Peterman","journal-title":"Can J Fish Aquat Sci"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e74370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:05:32Z","timestamp":1782842732000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e74370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":45,"URL":"https:\/\/doi.org\/10.2196\/74370","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]},"article-number":"v9i4e74370"}}