Mental Health Status Among Children in Home Confinement During the Coronavirus Disease 2019 Outbreak in Hubei Province, China

Xinyan Xie, Qi Xue, Yu Zhou, et al

Published online April 24, 2020.


The COVID-19 infection has become a global pandemic. As of April 9, 2020, the infection has caused 188 countrywide closures around the world and has affected 1 576 021 818 learners ( The caution about protecting the mental health of children in home confinement is warranted. This study investigated depressive and anxiety symptoms among students in Hubei province, China, which can help optimize interventions on the mental health of children for stakeholders in all countries affected by COVID-19.

Among 2330 students, 1784 participants (1012 boys [56.7%]; 1109 children [62.2%] residing in Huangshi) completed the survey, yielding a response rate of 76.6%. Students had been restricted to home for a mean (SD) of 33.7 (2.1) days when they completed this survey. A total of 403 students (22.6%) and 337 students (18.9%) reported depressive and anxiety symptoms, respectively. Students in Wuhan had significantly higher CDI-S scores than those in Huangshi (β, 0.092 [95% CI, 0.014-0.170]), with a greater risk of depressive symptoms (odds ratio, 1.426 [95% CI, 1.138-1.786]). Students who were slightly or not worried about being affected by COVID-19 had significantly lower CDI-S scores than those who were quite worried (β, −0.184 [95% CI, −0.273 to −0.095]), with a decreased risk of depressive symptoms (odds ratio, 0.521 [95% CI, 0.400-0.679]). Those who were not optimistic about the epidemic, compared with those who were quite optimistic, had significantly higher CDI-S scores (β, 0.367 [95% CI, 0.250-0.485]), with an increased risk of depressive symptoms (odds ratio 2.262 [95% CI, 1.642-3.117]). There was no significant association between demographic characteristics and anxiety symptoms.

In this study, 22.6% of students reported having depressive symptoms, which is higher than other investigations in primary schools of China (17.2%). During the outbreak of COVID-19, the reduction of outdoor activities and social interaction may have been associated with an increase in children’s depressive symptoms. Our study found that 18.9% of students reported anxiety symptoms, which is higher than the prevalence in other surveys. These findings suggest that serious infectious diseases may influence the mental health of children as other traumatic experiences do.