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Background School closures during the COVID-19 pandemic may have exacerbated students’ loneliness, addictive gaming behaviors, and poor mental health. These mental health issues confronting young people are of public concern. Objective This study aimed to examine the associations between loneliness and gaming addiction behaviors among young people in Hong Kong and to investigate how familial factors, psychological distress, and gender differences moderate these relationships. Methods This cross-sectional study was conducted in June 2020 when schools reopened after 6 months of school closures. Participants included 2863 children and adolescents in primary (Grades 4 to 6) and secondary (Grades 7 and 8) schools (female participants: 1502/2863, 52.5%). Chi-square tests, one-way analyses of variance, and independent-samples t tests were performed to compare the differences of distribution in gaming addiction behaviors across gender, age, and other sociodemographic characteristics. Multinomial logistic regression analyses were conducted to identify factors that relate to excessive or pathological gaming behaviors separately, in comparison with leisure gaming. Results A total of 83.0% (2377/2863) of the participants played video games during the COVID-19 pandemic. The prevalence of excessive and pathological game addiction behaviors was 20.9% (597/2863) and 5.3% (153/2863), respectively. More male students had gaming addiction symptoms than female students. The multinomial logistic regressions showed that feeling lonely was associated with more problematic gaming behaviors, and the association was stronger for older female students. Low socioeconomic status, less parental support and less supervision, and poor mental health were risk factors for gaming addiction behaviors, especially among primary school students. Conclusions Loneliness was associated with gaming addiction behaviors; the findings from this study suggested that this association was similar across gender and age groups among young people. Familial support and supervision during school closures can protect young people from developing problematic gaming behaviors. Results of this study have implications for prevention and early intervention on behalf of policy makers and game developers.

The impacts of the COVID-19 pandemic on physical and mental health-related behaviors among children and adolescents are likely to be profound and long-lasting. This study aimed to investigate the changes in lifestyle and social support and their associations with negative impacts due to the pandemic. A classroom survey using stratified random sampling and structured questionnaire was conducted among Hong Kong primary and secondary school students. The paper-and-pen survey, administered by well-trained research assistants, was completed by 2863 participants aged 9–17 years old (M = 12.6, SD = 1.3) at a brief school reopening six months after the outbreak of the COVID-19 pandemic. About 48% and 37% of the participants stated that they paid increased attention to physical and mental health, respectively. About 20% to 40% stated that they found more support from their friends and family members; only a small percentage reported decreased social support. Around 25% to 50% spent more time to rest, relax, and exercise. The aforementioned changes varied among genders, education groups, and socio-economic status. In general, higher perceived vulnerability, feeling more stressed, apprehensive, and helpless were associated with more reported positive lifestyle changes, including more social/family support, increased mental health awareness, and a positive lifestyle. These positive changes serve as important cushions against the negative impacts of COVID-19.

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For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.