Mental health and its relationship with resilience among adolescents in Chengdu, China, during the COVID-19 pandemic

Yuqiong Yang¹Shujuan Liao²Biru Luo^2*Li Zhao^3*Jingjing He²Yan Wang²Chuanya Huang²Xiang Li³Wenlin Ma³

• ¹Department of Day Surgery Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
• ²Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
• ³Department of Health Policy and Management, West China School of Public Health/West China Forth Hospital, Sichuan University, Chengdu, China

Background Mental health consequences that are associated with COVID-19 are monumental. As an integral part of positive youth development, resilience is an important contributor to mental health. Aim To assess the mental health and its relationship with resilience among adolescents in Chengdu, China, during the COVID-19 pandemic. Methods In December 2020, 2,452 students were recruited from 3 middle schools in Chengdu, Sichuan, China, by convenience. Resilience, depressive symptoms, and anxiety were measured by the Resilience Subscale of the Chinese Positive Youth Development Scale (RE-CPYDS), the Center for Epidemiological Studies Depression Scale for Children (CES-DC), and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. Independent sample t-test was used to analyze the associations between anxiety, depressive symptoms, and resilience. Univariate and multivariable logistic regression were performed to explore the influential factors of anxiety and depressive symptoms. Results The prevalence of anxiety and depressive symptoms among adolescents was 30.30% and 43.30%, respectively. According to the results of t-test, adolescents with lower level of resilience were more likely to experience anxiety (t=11.117, p＜0.001) and depressive symptoms (t=12.271, p＜0.001). Logistic regression showed higher level of resilience (OR 0.609, 95% CI [0.550, 0.674]; OR 0.592, 95% CI [0.534, 0.655]) and male (OR 0.493, 95% CI [0.411, 0.593]; OR 0.704, 95% CI [0.595, 0.833]) were protective factors for both anxiety and depressive symptoms, and longer daily internet duration was a risk factor for both of them (OR 1.002, 95%CI [1.001,1.002]; OR 1.002, 95%CI [1.002,1.003]). Moreover, compared with students in grade 7, students in grade 9 were more likely to experience anxiety symptoms (OR 1.961, 95% CI [1.199, 3.061]). Students with longer daily sleep duration were less likely to develop depressive symptoms (OR 0.998, 95% CI [0.996, 0.999]).This study shows a high prevalence of anxiety and depressive symptoms among adolescents during the COVID-19 pandemic. This study also finds resilience is a protective factor for both anxiety and depressive symptoms among adolescent, indicating school-based resilience programs should be highlighted. Restricted daily online duration and healthy sleep duration are also good for easing the burden of anxiety and depressive symptoms.