Social anxiety and depression symptoms in Chinese left-behind children after the lifting of COVID-19 lockdown: A network analysis

Abstract

Background:

Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them.

Aims:

To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown.

Methods:

A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis.

Results:

After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that “Social tension” and “Social avoidance” had the greatest expected influence; “Humiliation” and “Motor” were bridge symptom nodes in the network. The directed acyclic graph indicated that “Social fright” was at the upstream of all symptoms.

Conclusion:

Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown.

Keywords

Depression social anxiety left-behind children adolescents network analysis lockdown removal

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