General characteristics of the participants
The cohort comprised 34418 (57.2%) females and 25781 (42.8%) males among the 60199 questionnaires, aged18–65 (average: 34.66 ± 12.02)-years-old. The demographic characteristics of participants are shown in Table 1.
Confirmed growth rate and death rate
According to the cumulative numbers of confirmed cases and deaths of COVID-19 in China provided by the National Health Commission of the People’s Republic of China, we found that the confirmed growth rate fluctuated between 0.28% and 0.85%, and the death rate fluctuated between 1.60% and 6.14% from February 23–29 (Figure 1).
Prevalence of anxiety and depression
The SDS standard score of all the participants was 58.31 ± 8.46 points; among them, 11971 were non-depressed (19.89%), 37713 were mildly depressed (62.65%), 6819 were moderately depressed (11.33%), and 3696 were severely depressed (6.14%). The SAI score of all the participants was 51.52 ± 7.52 points; among them, 1522 were non-anxious (2.53%), 19994 were mildly anxious (33.21%), 24843 were moderately anxious (41.27%), and 13840 were severely anxious (22.99%) (Figure 2). The correlation analysis showed a significant positive correlation between depression and anxiety level (r = 0.33, P < 0.001).
Analysis of related factors of anxiety and depression
According to the SDS scoring criteria, 11971 individuals constituted the non-depressed group, 37713 were in the mild depression group, 6819 were in the moderate depression group, and 3696 formed the severe depression group. According to the SAI scoring criteria, 1522 individuals comprised the non-anxiety group, 19994 were in the mild anxiety group, 24843 were in the moderate anxiety group, and 13840 were in the severe anxiety group. Single-factor chi-square test results showed significant differences in the ratio of different depression degrees and the ratio of different anxiety degrees with respect to gender, age, education level, occupation, family structure in childhood, whether the only child in the family, parenting style in childhood, whether living with parents before 10-years-old, number of close friends, collective atmosphere in work/school, management style of work/school, marital status, and social activities of last 2 weeks (P < 0.001). The one-way analysis of variance results showed significant differences in the scores of negative attention bias, negative memory bias, and rumination, confirmed growth rate, and death rate associated with different depression and anxiety degrees (P < 0.001).
In the ordered multiple logistic regression model of depression, all the factors were correlated with the severity of depression except the factor of the only child in the family. The male was 0.727 times more likely to have severe depression than females. Compared to the 18–25-year-old group, the risk of more severe depression in people > 25-years-old was higher, that in 26–35-years-old was 1.824-fold, that in 36–45-years-old was 2.250 times, that in 46–55-years-old age group was 6.177 times, and in 56–65-years-old age group was 52.726 times. Compared to those with primary school education level, those with middle school, high school, and Bachelor’s degree had a more severe depression risk of 1.826, 2.386, and 1.864 times, respectively. Compared to the workers, farmer, soldier, medical staff, teacher, cadre, and other staff had a more severe depression risk of 1.121, 1.297, 1.353, 1.741, 0.677, and 1.281 times, respectively. Compared to the two parents’ family structure in childhood, one parent and other family structures had a more severe depression risk of 1.378 times and 1.551 times, respectively. Compared to the coercive type parenting style in childhood, the democratic type had a severe depression risk of 0.817 times. Compared to those living with parents before the age of 10 years, the risk of severe depression in people living without parents was 1.36 times. Compared to those without a close friend, people with 1-2 friends and 3 friends and above had a more severe depression risk of 1.697 times and 1.286 times. Compared to the peace and tranquility atmosphere at work/school, occasional and frequent quarrels had a more severe depression risk of 0.871 times and 0.649 times, respectively. Compared to the coercive type management style of work/school, laissez-faire type and democratic type had a more severe depression risk of 1.62 times and 0.91 times, respectively. Furthermore, divorced people were 1.317 times more likely to have severe depression than unmarried people, and married, remarried, and widowed people were faced a 0.802, 0.853, and 0.702 times of risk. Compared to those who had 0–2 social activities in the last 2 weeks, those who had 3–5, 6-8 activities, 9 activities, and above had a more severe depression risk of 1.475 times, 1.165 times, and 0.827 times, respectively. Negative attention bias, rumination, confirmed growth rate, and death rate had positive effects on the severity of depression (odds ratio (OR) = 1.048, 1.022, 6.993, 1.024). Negative memory bias had a negative effect on the severity of depression (OR = 0.988) (Table 2).
In the ordered multiple logistic regression model of anxiety, all the factors were correlated with the severity of anxiety except the confirmed growth rate. The males were 0.585 times more likely to have severe anxiety than females. Compared to the 18–25-year-old, the risk of severe anxiety in age groups 26–35, 36–45, 46–55, and 56–65-years-old was 0.831 times, 3.176 times, 3.261 times, and 23.473 times, respectively. Compared to the individuals with primary school level of education, those with middle school, high school, Bachelor’s degree, and Master’s degree or above had a more severe anxiety risk of 4.464 times, 7.214 times, 4.704 times, and 1.914 times, respectively. Compared to workers, farmers, soldiers, medical staff, cadre, and white collar had a more severe anxiety risk of 1.495 times, 1.139 times, 2.786 times, 0.653 times, and 1.301 times, respectively. Compared to the two-parent family structure in childhood, one-parent and other family structure had a more severe anxiety risk of 0.865 times and 1.774 times, respectively. The only-child family was 1.078-times more likely to have severe anxiety than others. Compared to the coercive type parenting style in childhood, laissez-faire type, doting type, and democratic type had a more severe anxiety risk of 0.766 times, 1.452 times, and 0.772 times. Compared to those living with parents before the age of 10 years, the risk of severe anxiety in people living without parents was 1.068 times. Compared to those without close friends, people with 3 or more close friends and had a more severe anxiety risk of 0.585 times. Compared to the peace and tranquility collective atmosphere in work/school, occasional quarrels and frequent quarrels had a more severe anxiety risk of 0.794 times and 1.181 times. Compared to the coercive type management style of work/school, the democratic type had a more severe anxiety risk of 0.923 times. Compared to the unmarried people, married, divorced, remarried, and widowed people had a more severe anxiety risk of 1.294 times, 2.696 times, 1.502 times, and 2.186 times, respectively. Compared to those with 0–2 social activities in the last 2 weeks, those with 3–5 activities, 6–8 activities, 9 activities, and above had a severe anxiety risk of 2.284 times, 1.394 times, and 0.405 times. Negative attention bias, negative memory bias, rumination, and death rate had positive effects on the severity of anxiety (OR = 1.110, 1.069, 1.134, and 1.144, respectively) (Table 3).