Association Between Depression, Health Beliefs, and Face Mask Use During the COVID-19 Pandemic

Abstract

The 2019 novel coronavirus (COVID-19) pandemic is associated with increases in psychiatric morbidity, including depression. It is unclear if people with depressive symptoms understand or apply COVID-19 information differently to the general population. Therefore, this study aimed to examine associations between depression, health beliefs, and face mask use during the COVID-19 pandemic among the general population in Hong Kong. This study gathered data from 11,072 Hong Kong adults via an online survey. Respondents self-reported their demographic characteristics, depressive symptoms (PHQ-9), face mask use, and health beliefs about COVID-19. Hierarchical logistic regression was used to identify independent variables associated with depression. The point-prevalence of probable depression was 46.5% (n = 5,150). Respondents reporting higher mask reuse (OR = 1.24, 95%CI 1.17-1.34), wearing masks for self-protection (OR = 1.03 95%CI 1.01-1.06), perceived high susceptibility (OR = 1.15, 95%CI 1.09-1.23), and high severity (OR = 1.33, 95%CI 1.28-1.37) were more likely to report depression. Depression was less likely in those with higher scores for cues to action (OR = 0.82, 95%CI 0.80-0.84), knowledge of COVID-19 (OR = 0.95, 95%CI 0.91-0.99), and self-efficacy to wear mask properly (OR = 0.90 95%CI 0.83-0.98). We identified a high point-prevalence of probable major depression and suicidal ideation during the COVID-19 outbreak in Hong Kong, but this should be viewed with caution due to the convenience sampling method employed. Future studies should recruit a representative probability sample in order to draw more reliable conclusions. The findings highlight that COVID-19 health information may be a protective factor of probable depression and suicidal ideation during the pandemic. Accurate and up-to-date health information should be disseminated to distressed and vulnerable subpopulations, perhaps using digital health technology, and social media platforms to prompt professional help-seeking behavior.

Problematic Smartphone Use during the COVID-19 Pandemic: Its Association with Pandemic-Related and Generalized Beliefs

“…These findings may imply that pandemic-related government efficacy serves as a protective factor against the development of PSU among Chinese adults regardless of their gender, age, and educational level. The findings are also consistent with previous empirical evidence that pandemic-related self-efficacy bears a potential effect on promoting adherence to precautionary measures and lowering psychological distress during the pandemic [ 58 , 59 ]. However, pandemic-related self-efficacy did not significantly add to the explained variance in PSU beyond the demographic effects.…”

Factors Influencing Depression and Mental Distress Related to COVID-19 Among University Students in China: Online Cross-sectional Mediation Study

“…This study has interesting findings that involve interpretations in the context of the initial outbreak and in comparison with other studies. Spearman analysis and the SEM showed that some COVID-19–related cognitions (perceived chance of controlling COVID-19 and perceived risks of infection) were significantly associated with both mental distress due to COVID-19 and depressive symptoms; such findings corroborate with other studies [ 15 , 20 - 23 ]. However, it is unexpected that perceived bodily damages (a reflection of perceived severity) and perceived airborne transmission (possibly a misconception) were not significantly correlated with mental distress due to COVID-19 and depression, while such correlations were significant in similar H1N1 research [ 7 , 8 ].…”

“…For instance, the four Chinese university student studies conducted during the initial outbreak mainly mentioned lifestyle factors such as sleep and psychological attributes such as resilience but not COVID-19 cognitive factors [ 11 - 14 ]. Several studies of the population in China and overseas looked at cognitive factors such as perceived susceptibility and severity, which were positively associated with depression [ 15 , 20 - 23 ].…”

Adjustment to a “New Normal:” Coping Flexibility and Mental Health Issues During the COVID-19 Pandemic

“…Despite such resemblances, the COVID-19 pandemic is an unprecedented crisis in terms of the scope of its influence on both physical and mental health [e.g., ( 8 , 9 )]. To curb the transmission of this hitherto unknown virus, governments all over the world have enforced strict epidemic-control measures such as nationwide school closures, stay-at-home orders, and physical distancing regulations in public areas ( 10 ).…”