Psychological resilience, depression, anxiety, and somatization symptoms in response to COVID-19: A study of the general population in China at the peak of its epidemic

Rationale: Psychological resilience is characterized as the ability to respond to extreme stress or trauma or adverse experience successfully. While the relation between public emergencies and psychological distress is well known, research on therelationship between psychological resilience and mental health is very limited during the outbreak of public health emergencies. Objective: This research investigated the relationship between psychological resilience and mental health (depression, anxiety, somatization symptoms) among the general population in China. Method: Psychological resilience, depression, anxiety, and somatization symptoms of 1770 Chinese citizens were investigated during the epidemic peak of coronavirus disease 2019 (COVID-19) (23rd February 2020 to 2nd March 2020). The analyses were done through the Connor-Davidson Resilience Scale (CD-RISC), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Patient Health Questionnaire-15 (PHQ-15) scale. Results: The prevalence of depression, anxiety, somatization symptoms was found to be 47.1%, 31.9%, 45.9%, respectively, among all participants. From them, 18.2% showed moderate to severe symptoms of depression, 8.8% showed moderate to severe symptoms of anxiety, and 16.6% showed moderate to severe symptoms of somatization. Psychological resilience was negatively correlated with depression (standardized beta = -0.490, P < 0.001), anxiety (standardized beta = -0.443, P < 0.001), and somatization symptom scores (standardized beta = -0.358, P < 0.001), while controlling for confounding factors. Analysis of the three-factor resilience structure showed that strength and tenacity were correlated with depression (standardized beta = -0.256, P < 0.001; standardized beta = -0.217, P < 0.001), anxiety (standardized beta = -0.268, P < 0.001; standardized beta = -0.147, P < 0.001), and somatization symptoms (standardized beta = -0.236, P < 0.001; standardized beta = -0.126, P < 0.01). Conclusions: Our results suggest that there is a high prevalence of psychological distresses among the general population at the peak of the COVID-19 epidemic in China, which is negatively correlated with resilience. Psychological resilience represents an essential target for psychological intervention in a public health emergency.