Anxiety symptoms and associated factors among school students after 2 years of the COVID-19 pandemic: a cross-sectional study in Zhejiang Province, China

Author:

Wang HaoORCID,Zhou Yi,Dai Pinyuan,Guan Yunqi,Zhong JieMing,Li Na,Yu Min

Abstract

ObjectivesTo ascertain the prevalence and associated factors of anxiety symptoms among middle and high school students in Zhejiang after 2 years of the COVID-19 pandemic.DesignA school-based cross-sectional study.Setting30 counties/districts in Zhejiang Province, China.Participants27 019 students attending middle and high schools.Outcome measuresAnxiety symptoms were assessed using the Generalised Anxiety Disorder 7-item scale (GAD-7). A total score of 10 or more is considered indicative of anxiety symptoms.ResultsThe overall prevalence (95% CI) of anxiety symptoms was 14.2% (13.4 to 15.0), higher among girls (18.6%, 95% CI: 17.5 to 19.7) than boys (10.2%, 95% CI: 9.5 to 10.9) (p<0.001), higher among rural students (15.1%, 95% CI: 14.1 to 16.2) than urban students (12.5%, 95% CI: 11.6 to 13.4) (p<0.001). Older age (14–15 years, OR=1.25, 95% CI: 1.09 to 1.44; ≥16 years, OR=1.32, 95% CI: 1.07 to 1.63), being girls (OR=1.76, 95% CI: 1.58 to 1.96), living in rural areas (OR=1.14, 95%CI: 1.01 to 1.29), poor academic performance (OR=1.20, 95% CI: 1.03 to 1.41), alcohol drinking (OR=1.15, 95% CI: 1.01 to 1.30), inadequate fruits (OR=1.31, 95% CI: 1.19 to 1.45) and vegetables intake (OR=1.32, 95% CI: 1.10 to 1.57), insomnia (sometimes, OR=2.14, 95% CI: 1.93 to 2.38; often/always, OR=4.73, 95% CI: 4.03 to 5.56), loneliness (sometimes, OR=2.97, 95%CI: 2.59 to 3.41; often/always, OR=8.35, 95% CI: 7.20 to 9.69), sadness (OR=2.51, 95% CI: 2.25 to 2.79) and physical fight (OR=1.29, 95% CI: 1.13 to 1.48) were positively associated with anxiety symptoms, while studying at vocational high school (OR=0.61, 95% CI: 0.49 to 0.75), coming from family with middle income (OR=0.76, 95% CI: 0.64 to 0.89), being physically active 3–7 days weekly (OR=0.85, 95% CI: 0.75 to 0.95) were negatively associated with anxiety symptoms.ConclusionAnxiety symptoms prevailed among middle and high school students in China. A variety of factors, containing sociodemographic factors, lifestyle behaviours, mental health, academic performance and physical fight should be taken in consideration in addressing prevention and intervention of anxiety symptoms.

Funder

Project on Youth and Youth Work

Program of Zhejiang Federation of Humanities and Social Sciences

Publisher

BMJ

Subject

General Medicine

Reference55 articles.

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