Risk factors associated with depression and anxiety among the Chinese general population after retracting the dynamic zero-COVID policy: A network analysis.

BACKGROUND: Recent studies have evidenced the negative psychological consequences of the COVID-19 pandemic and sociodemographic vulnerability among the general population, while limited information was available on which factors make the greatest contribution to psychological distress when these factors were considered concurrently. Herein, we aimed to investigate the pathways that underlie psychological distress in the context of retracting dynamic zero-COVID policy.

METHODS: We employed the mixed graphical model to construct the network of depression (PHQ-9), anxiety (GAD-7), and pandemic-related factors in a general population sample (N = 1610). Then, we re-examined the network by adding sociodemographic variables to further explore the influence of sociodemographic factors. Additionally, we repeated the analyses in the second sample (N = 620) collected in the same period to assess the replicability.

RESULTS: The relationships between the pandemic factors and anxiety and depressive symptoms exhibited a tendency to decrease after adding demographic variables, and income became the most important node and shared edge weights with all anxiety and depressive symptoms. These findings were replicable with the second sample. No significant difference in the network properties was detected between the two samples.

LIMITATIONS: The cross-sectional design limits the ability to observe longitudinal changes in these risk factors and their relationship with psychological distress.

CONCLUSIONS: Income level, rather than the pandemic-related factors, acted as a vital role in the psychological distress of the general population, implying that livelihood issues may be the critical intervention targets for mental health during the post-pandemic period.