Potential joint effects of perceptions related to COVID-19 and future social development on depressive symptoms: a Chinese population-based study

Abstract

Background

The COVID-19 pandemic has caused significant negative socio-political, economic, and psychological consequences.

Aims

To investigate the impact of individual-level (illness representations of COVID-19) and structurally derived (anticipated social-political development in the economy, security, and social harmony in the next year) factors, and their potential moderation effects on depressive symptoms.

Methods

An anonymous population-based telephone survey was conducted among the general public of Hong Kong, China during 3–10 April 2020 (n = 300, response rate 56%). Depressive symptoms were assessed by the validated Chinese version of the Patient Health Questionnaire-9.

Results

Of the participants, 8.7% showed probable moderate-to-severe depression. Hierarchical linear regression models showed that illness representations of personal/treatment control and emotional responses and anticipated deterioration in social harmony were independently and significantly associated with depressive symptoms. Anticipated deterioration in security significantly moderated the associations between perceived consequence/treatment control of COVID-19 and depressive symptoms, such that the associations were stronger among people who anticipated a strong deterioration in security.

Conclusions

The findings suggested that perceptions of COVID-19 and future social-political development jointly and interactively contributed to depressive symptoms during the COVID-19 pandemic. Mental health professionals and promotions should take the multiple-level mental health determinants into account.

Keywords:

• COVID-19
• illness representation
• social-political perception
• depressive symptoms

Acknowledgement

We would like to thank all the participants for their contributions.

Ethical approval

The study was approved by the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (No. SBRE-19-660).

Availability of data: Data will be available on request from the authors.

Author contributions

Conceptualization and design: JTFL and RS; Acquisition of data: MMCL; Analysis and interpretation of data: RS; Drafting of the manuscript: RS; Critical revision of the manuscript for important intellectual content: JTFL; Statistical analysis: RS; Obtaining funding: JTFL; Administrative, technical, or material support: MMCL; Supervision: JTFL.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is supported by the internal funding of Center for Health Behaviour Research, The Chinese university of Hong Kong.