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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Effect of COVID-19 on Youth Mental Health</title><author><name sortKey="Liang, Leilei" sort="Liang, Leilei" uniqKey="Liang L" first="Leilei" last="Liang">Leilei Liang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Ren, Hui" sort="Ren, Hui" uniqKey="Ren H" first="Hui" last="Ren">Hui Ren</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of the First Hospital,</institution><institution>Jilin University,</institution></institution-wrap>No.71 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Cao, Ruilin" sort="Cao, Ruilin" uniqKey="Cao R" first="Ruilin" last="Cao">Ruilin Cao</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Hu, Yueyang" sort="Hu, Yueyang" uniqKey="Hu Y" first="Yueyang" last="Hu">Yueyang Hu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Qin, Zeying" sort="Qin, Zeying" uniqKey="Qin Z" first="Zeying" last="Qin">Zeying Qin</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Li, Chuanen" sort="Li, Chuanen" uniqKey="Li C" first="Chuanen" last="Li">Chuanen Li</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Mei, Songli" sort="Mei, Songli" uniqKey="Mei S" first="Songli" last="Mei">Songli Mei</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31748955</idno><idno type="pmc">7173777</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173777</idno><idno type="RBID">PMC:7173777</idno><idno type="doi">10.1007/s11126-020-09744-3</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000128</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000128</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Effect of COVID-19 on Youth Mental Health</title><author><name sortKey="Liang, Leilei" sort="Liang, Leilei" uniqKey="Liang L" first="Leilei" last="Liang">Leilei Liang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Ren, Hui" sort="Ren, Hui" uniqKey="Ren H" first="Hui" last="Ren">Hui Ren</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of the First Hospital,</institution><institution>Jilin University,</institution></institution-wrap>No.71 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Cao, Ruilin" sort="Cao, Ruilin" uniqKey="Cao R" first="Ruilin" last="Cao">Ruilin Cao</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Hu, Yueyang" sort="Hu, Yueyang" uniqKey="Hu Y" first="Yueyang" last="Hu">Yueyang Hu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Qin, Zeying" sort="Qin, Zeying" uniqKey="Qin Z" first="Zeying" last="Qin">Zeying Qin</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Li, Chuanen" sort="Li, Chuanen" uniqKey="Li C" first="Chuanen" last="Li">Chuanen Li</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author><author><name sortKey="Mei, Songli" sort="Mei, Songli" uniqKey="Mei S" first="Songli" last="Mei">Songli Mei</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</nlm:aff></affiliation></author></analytic><series><title level="j">The Psychiatric Quarterly</title><idno type="ISSN">0033-2720</idno><idno type="eISSN">1573-6709</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par8">The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97–38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09–5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03–1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00–1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lu, R" uniqKey="Lu R">R Lu</name></author><author><name sortKey="Zhao, X" uniqKey="Zhao X">X Zhao</name></author><author><name sortKey="Li, J" uniqKey="Li J">J Li</name></author><author><name sortKey="Niu, P" uniqKey="Niu P">P Niu</name></author><author><name sortKey="Yang, B" uniqKey="Yang B">B Yang</name></author><author><name sortKey="Wu, H" uniqKey="Wu H">H Wu</name></author><author><name sortKey="Wang, W" uniqKey="Wang W">W Wang</name></author><author><name sortKey="Song, H" uniqKey="Song H">H Song</name></author><author><name sortKey="Huang, B" uniqKey="Huang B">B Huang</name></author><author><name sortKey="Zhu, N" uniqKey="Zhu N">N Zhu</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Psychiatr Q</journal-id><journal-id journal-id-type="iso-abbrev">Psychiatr Q</journal-id><journal-title-group><journal-title>The Psychiatric Quarterly</journal-title></journal-title-group><issn pub-type="ppub">0033-2720</issn><issn pub-type="epub">1573-6709</issn><publisher><publisher-name>Springer US</publisher-name><publisher-loc>New York</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31748955</article-id><article-id pub-id-type="pmc">7173777</article-id><article-id pub-id-type="publisher-id">9744</article-id><article-id pub-id-type="doi">10.1007/s11126-020-09744-3</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Paper</subject></subj-group></article-categories><title-group><article-title>The Effect of COVID-19 on Youth Mental Health</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Liang</surname><given-names>Leilei</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="FPar1"><title>Leilei Liang</title><p id="Par1">a MD of Jilin University and major in Social Medicine and Health Management.</p></sec></bio></contrib><contrib contrib-type="author"><name><surname>Ren</surname><given-names>Hui</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref><bio><sec id="FPar2"><title>Ren Hui</title><p id="Par3">a Ph.D. of Jilin University. She is major in Social Medicine and Health Management.</p></sec></bio></contrib><contrib contrib-type="author"><name><surname>Cao</surname><given-names>Ruilin</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="FPar3"><title>Ruilin Cao</title><p id="Par4">a MD of Jilin University and major in Social Medicine and Health Management.</p></sec></bio></contrib><contrib contrib-type="author"><name><surname>Hu</surname><given-names>Yueyang</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="FPar4"><title>Yueyang Hu</title><p id="Par5">a MD of Jilin University. She is major in Children and Adolescents Health.</p></sec></bio></contrib><contrib contrib-type="author"><name><surname>Qin</surname><given-names>Zeying</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="FPar5"><title>Zeying Qin</title><p id="Par6">a Ph.D. of Jilin University. She is major in Social Medicine and Health Management.</p></sec></bio></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Chuanen</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="FPar6"><title>Chuanen Li</title><p id="Par7">a MD of Jilin University and major in Social Medicine and Health Management.</p></sec></bio></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Mei</surname><given-names>Songli</given-names></name><address><email>meisongli@sina.com</email></address><xref ref-type="aff" rid="Aff1">1</xref><bio><sec id="d29e197"><title>Songli Mei</title><p>a professor. She is the director of Department of Children and Adolescents Health in school of Public Health, Jilin University.</p></sec></bio></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of Social Medicine and Health Management, School of Public Health,</institution><institution>Jilin University,</institution></institution-wrap>No.1163 Xinmin Street, Changchun, 130021 Jilin Province China</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.64924.3d</institution-id><institution-id institution-id-type="ISNI">0000 0004 1760 5735</institution-id><institution>Department of the First Hospital,</institution><institution>Jilin University,</institution></institution-wrap>No.71 Xinmin Street, Changchun, 130021 Jilin Province China</aff></contrib-group><pub-date pub-type="epub"><day>21</day><month>4</month><year>2020</year></pub-date><fpage>1</fpage><lpage>12</lpage><permissions><copyright-statement>© Springer Science+Business Media, LLC, part of Springer Nature 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><p id="Par8">The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97–38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09–5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03–1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00–1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.</p></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Post-traumatic stress disorder</kwd><kwd>Mental health</kwd><kwd>Negative coping styles</kwd><kwd>COVID-19</kwd></kwd-group><funding-group><award-group><funding-source><institution>International innovation team of Jilin University</institution></funding-source><award-id>2019GJTD06</award-id><principal-award-recipient><name><surname>Mei</surname><given-names>Songli</given-names></name></principal-award-recipient></award-group></funding-group></article-meta></front><body><sec id="Sec1"><title>Introduction</title><p id="Par9">In late December 2019, patients in Wuhan, China, reported having viral pneumonia due to an unknown microbial pathogen. A new coronavirus was subsequently identified as the pathogen and was temporarily named the 2019 new coronavirus (2019-nCoV) [<xref ref-type="bibr" rid="CR1">1</xref>]. On January 30, 2020, the World Health Organization (WHO) announced that the emergence of a new coronavirus (2019-nCoV) was a public health emergency of international concern (PHEIC). Infectious diseases have become one of the major threats to global public health in the twenty-first century [<xref ref-type="bibr" rid="CR2">2</xref>]; such diseases impact both physical health and mental health [<xref ref-type="bibr" rid="CR3">3</xref>, <xref ref-type="bibr" rid="CR4">4</xref>]. As of February 18, 2020, 57805 people have been confirmed to be infected with COVID-19, leading to 2004 deaths across 31 provinces in mainland China [<xref ref-type="bibr" rid="CR5">5</xref>]. The outbreak of COVID-19 in China caused public panic and mental health stress, with an increasing number of cases being diagnosed and some countries appearing to have confirmed cases and public concerns about infection [<xref ref-type="bibr" rid="CR6">6</xref>].</p><p id="Par10">Many studies have demonstrated the impact of infectious disease outbreaks on public mental health, such as severe acute respiratory syndrome (SARS) in 2003 [<xref ref-type="bibr" rid="CR7">7</xref>, <xref ref-type="bibr" rid="CR8">8</xref>], and the 2009 novel influenza A (HIN1) epidemic [<xref ref-type="bibr" rid="CR9">9</xref>, <xref ref-type="bibr" rid="CR10">10</xref>]. These types of epidemics lead the public to experience psychological problems such as post-traumatic stress disorder, psychological distress, depression and anxiety [<xref ref-type="bibr" rid="CR11">11</xref>]. Some studies have shown that post-traumatic stress disorder is closely related to depression and other psychological problems [<xref ref-type="bibr" rid="CR12">12</xref>]. According to a theoretical model developed by Ehlers and Clark [<xref ref-type="bibr" rid="CR13">13</xref>], after experiencing a traumatic event, individuals may make a negative assessment of the trauma and its sequelae. In this way, they may easily to adopt maladaptive strategies to maintain PTSD symptoms such as invasion, arousal symptoms and strong negative emotions [<xref ref-type="bibr" rid="CR14">14</xref>]. Therefore, this study assumes that youth groups may have a tendency to develop psychological problems after experiencing traumatic stress disorder.</p><p id="Par11">Studies have shown that effective coping strategies can protect individuals from mental health problems when facing emergencies [<xref ref-type="bibr" rid="CR15">15</xref>], but the coping styles can be divided into positive and negative subsacles [<xref ref-type="bibr" rid="CR16">16</xref>]. Multiple studies have shown that the relationship between negative coping styles and depression, such that the use of avoiding or negative coping styles is related to psychological problems such as depression [<xref ref-type="bibr" rid="CR17">17</xref>, <xref ref-type="bibr" rid="CR18">18</xref>]. For example, the 5-8 weeks after September 11, 2001, 28.8% of respondents reported consuming more tobacco, alcohol and marijuana [<xref ref-type="bibr" rid="CR19">19</xref>]. These negative responses were the main predictors of psychological distress, such as depression, anxiety and stress [<xref ref-type="bibr" rid="CR20">20</xref>]. However, few studies have considered the psychological impact of a negative coping strategy on youth during public health emergencies (e.g., COVID-19).</p><p id="Par12">In this study, we aimed to examine the extent to which youth groups were prone to psychological problems due to COVID-19 and to explore the correlation between the GHQ-12, PTSD, negative coping styles and sociodemographic variables. In addition, we explored the factors affecting the mental health of youth groups and provided suggestions for intervention in the mental health of youth groups.</p></sec><sec id="Sec2"><title>Methods</title><sec id="Sec3"><title>Participants</title><p id="Par13">On January 30, 2020, approximately two weeks after the World Health Organization announced the emergence of a new coronavirus (2019-nCoV) as a public health emergency of international concern (PHEIC), we conducted this cross-sectional study. We used a snowball sampling approach to distribute questionnaires online. The questionnaires were distributed to WeChat circles of friends, when a participant completed the questionnaire, they forwarded it to their own WeChat circle of friends to expand the sample size. The participants of this survey were mainly young people aged 14–35 who could complete the questionnaires without assistance. Approximately 610 questionnaires were completed. After deleting incomplete and random responses, a total of 584 valid questionnaires were analyzed in this study, thus, the valid response rate was 95.7%.</p></sec><sec id="Sec4"><title>Measures</title><sec id="Sec5"><title>Knowledge about COVID-19</title><p id="Par14">Five items were used to measure knowledge about COVID-19, such as “Do you know that 56° for 30 minutes, diethyl ether, 75% ethanol, peracetic acid and other lipid solvents can effectively kill the virus?”. Participants could select from 1 (did not have full knowledge) to 5 (full knowledge) to judge the participants’ knowledge about COVID-19.</p></sec><sec id="Sec6"><title>The General Health Questionnaire Scale (GHQ-12)</title><p id="Par15">Mental health was measured using the General Health Questionnaire(GHQ-12) [<xref ref-type="bibr" rid="CR21">21</xref>], which is a self-assessment screening tool. This questionnaire has been successfully used in Chinese samples and has good psychometric properties [<xref ref-type="bibr" rid="CR22">22</xref>]. The questionnaire consists of 12 items, and response options range from 0 (never) to 3 (usually). Total scores ranges from 0 to 36 with higher scores indicating higher degrees of disturbance of the general health status. A total score higher than 15 points indicates a tendency toward psychological problems [<xref ref-type="bibr" rid="CR23">23</xref>]. In our study, the Cronbach’s alpha coefficient of the GHQ-12 was 0.793.</p></sec><sec id="Sec7"><title>The PTSD Checklist-Civilian Version (PCL-C)</title><p id="Par16">The PTSD Checklist-Civilian Version (PCL-C) [<xref ref-type="bibr" rid="CR24">24</xref>] was used to measure post-traumatic stress symptoms with respect to COVID-19. Response options ranged from 1(not at all) to 5(seriously). The reliability and validity of this questionnaire have been previously assessed [<xref ref-type="bibr" rid="CR25">25</xref>]. It consists of 17 items, and the total scores range from 17 to 85. Participants with a cut-off score of 38 or higher were classified as having PTSD symptoms [<xref ref-type="bibr" rid="CR24">24</xref>, <xref ref-type="bibr" rid="CR26">26</xref>]. In this study, this scale presented good internal consistency, and the Cronbach’s alpha coefficient of the PCL-C was 0.943.</p></sec><sec id="Sec8"><title>Simplified Copying Style Questionnaire (SCSQ)</title><p id="Par17">Negative coping styles were measured by the Simplified Copying Style Questionnaire (SCSQ), which was originally developed for Chinese respondents and has been proven to be reliable and effective [<xref ref-type="bibr" rid="CR16">16</xref>]. This questionnaire includes two subscales: active coping (12 items) and negative coping (8 items). Response options ranged from 0 (never) to 3 (very frequently). In the negative coping subscales, higher scores indicate more frequent use of negative coping strategies. The Cronbach’s alpha coefficient of the negative coping subscale was 0.834.</p></sec></sec><sec id="Sec9"><title>Data Analyses</title><p id="Par18">All statistical analyses were performed using SPSS 24.0 (IBM Corp), with <italic>P</italic><0.05 as the level of statistical significance. Means (M) and standard deviation (SD) were used to describe the demographic data. One-way ANOVA and LSD post hoc comparisons were used to assess the associations between sociodemographic characteristics, GHQ-12, PTSD and negative coping style. In addition, we used univariate logistic regression analysis to explore the factors that influence mental health among the participants.</p></sec></sec><sec id="Sec10"><title>Results</title><sec id="Sec11"><title>Participant Characteristics</title><p id="Par19">The demographic information for 584 participants (361 females and 223 males) is shown in Table <xref rid="Tab1" ref-type="table">1</xref>. Their ages ranged from 14 to 35, and most of them were between 21 and 30 years old(74.6%). In addition, 77.9% of the participants had a bachelor’s degree, and 13.5% had a master’s degree or above. In addition, most of the participants were single, and 77.7% were students. More than half of the participants’ (69.2%) had a monthly average disposable income less than 2000 RMB.<table-wrap id="Tab1"><label>Table 1</label><caption><p>Demographic characteristics of the participants (<italic>n</italic> = 584)</p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="2">Variable</th><th>Sample (<italic>n</italic> = 584)</th><th>Percentage (%)</th></tr></thead><tbody><tr><td rowspan="2">Gender</td><td>Female</td><td>361</td><td>61.8</td></tr><tr><td>Male</td><td>223</td><td>38.2</td></tr><tr><td rowspan="3">Age</td><td>14–20</td><td>130</td><td>22.3</td></tr><tr><td>21–30</td><td>436</td><td>74.6</td></tr><tr><td>31–35</td><td>18</td><td>3.1</td></tr><tr><td rowspan="4">Educational level</td><td>Junior high school or below</td><td>18</td><td>3.1</td></tr><tr><td>High school or secondary school</td><td>32</td><td>5.5</td></tr><tr><td>Undergraduate or college</td><td>455</td><td>77.9</td></tr><tr><td>Master’s degree or above</td><td>79</td><td>13.5</td></tr><tr><td rowspan="3">Marital status</td><td>Single</td><td>548</td><td>93.8</td></tr><tr><td>Married/Cohabitating</td><td>32</td><td>5.5</td></tr><tr><td>Divorced/widowed</td><td>4</td><td>0.7</td></tr><tr><td rowspan="5">Occupation</td><td>Student</td><td>454</td><td>77.7</td></tr><tr><td>Medical staff</td><td>17</td><td>2.9</td></tr><tr><td>Business</td><td>22</td><td>3.8</td></tr><tr><td>Enterprise employee</td><td>72</td><td>12.3</td></tr><tr><td>Other</td><td>19</td><td>3.3</td></tr><tr><td rowspan="5">Monthly average disposable income</td><td><2000 RMB</td><td>404</td><td>69.2</td></tr><tr><td>2001–3000 RMB</td><td>77</td><td>13.2</td></tr><tr><td>3001–4000 RMB</td><td>45</td><td>7.7</td></tr><tr><td>4001–5000 RMB</td><td>16</td><td>2.7</td></tr><tr><td>>5001RMB</td><td>42</td><td>7.2</td></tr></tbody></table></table-wrap></p><p id="Par20">Regarding knowledge about COVID-19, 30.1% of the participants had full knowledge of the information presented in item 1, but 6.5% of the participants did not have full knowledge of the information. In addition, most of the participants had full knowledge of the information presented in items 2, 3 and 4. Approximately 5.0% of the participants did not fully understand that psychological balance can improve immunity. More information is provided in Table <xref rid="Tab2" ref-type="table">2</xref>.<table-wrap id="Tab2"><label>Table 2</label><caption><p>Knowledge about COVID-19 (<italic>n</italic> = 584)</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th>Fully known (%)</th><th>Not known (%)</th></tr></thead><tbody><tr><td>Item 1. Do you know that 56°for 30 min, diethyl ether, 75% ethanol, peracetic acid and other lipid solvents can effectively kill the virus?</td><td>176(30.1)</td><td>38(6.5)</td></tr><tr><td>Item 2. COVID-19’s incubation period is generally 3–7 days, with a maximum of 14 days.</td><td>379(64.9)</td><td>23(3.9)</td></tr><tr><td>Item 3. COVID-19 is mainly transmitted through respiratory droplets and can also be transmitted through contact.</td><td>402(68.8)</td><td>20(3.4)</td></tr><tr><td>Item 4. The early general symptoms of COVID-19 are fever, fatigue, dry cough, and gradually dyspnea. Some patients have mild onset symptoms without fever. In severe cases, symptoms such as respiratory distress syndrome and septic shock occur, but most patients are mild to moderate with a good prognosis, but a few patients are in critical condition and even die.</td><td>332(56.8)</td><td>18(3.1)</td></tr><tr><td>Item 5. Do you know that psychological balance can improve the body’s immunity?</td><td>216(37.0)</td><td>29(5.0)</td></tr></tbody></table></table-wrap></p></sec><sec id="Sec12"><title>Univariate Analysis</title><p id="Par21">One-way ANOVA revealed significant differences in the GHQ-12, PTSD and negative coping between genders. However, age did not have a significant effect on any variable. In addition, this study found significant differences in the GHQ-12 and PTSD across education status and across marital status. However, occupation only had a significant effect on PTSD. The GHQ-12, PTSD, and negative coping also did not differ significantly between monthly average disposable income brackets (see Table <xref rid="Tab3" ref-type="table">3</xref>).<table-wrap id="Tab3"><label>Table 3</label><caption><p>Demographic characteristics by the GHQ-12, PTSD and negative coping (<italic>n</italic> = 584)</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="2">Variable</th><th colspan="2">GHQ-12</th><th colspan="2">PTSD</th><th colspan="2">Negative Coping</th></tr><tr><th>M ± SD</th><th><italic>P</italic></th><th>M ± SD</th><th><italic>P</italic></th><th>M ± SD</th><th><italic>P</italic></th></tr></thead><tbody><tr><td colspan="8">Gender</td></tr><tr><td></td><td>Female</td><td>11.55 ± 6.14</td><td><bold><0.01</bold></td><td>26.74 ± 8.89</td><td><bold><0.01</bold></td><td>19.15 ± 5.00</td><td><bold><0.01</bold></td></tr><tr><td></td><td>Male</td><td>12.85 ± 6.66</td><td></td><td>29.27 ± 13.58</td><td></td><td>20.44 ± 6.05</td><td></td></tr><tr><td colspan="8">Age</td></tr><tr><td></td><td>14–20</td><td>12.45 ± 6.48</td><td>0.48</td><td>26.35 ± 9.96</td><td>0.28</td><td>19.73 ± 6.03</td><td>0.87</td></tr><tr><td></td><td>21–30</td><td>11.99 ± 6.33</td><td></td><td>28.10 ± 11.37</td><td></td><td>19.59 ± 5.28</td><td></td></tr><tr><td></td><td>31–35</td><td>10.61 ± 6.75</td><td></td><td>28.06 ± 7.36</td><td></td><td>20.22 ± 5.54</td><td></td></tr><tr><td>Educational Level</td><td></td><td></td><td><bold><0.001</bold></td><td></td><td><bold><0.05</bold></td><td></td><td>0.05</td></tr><tr><td></td><td>Junior high school or below</td><td>18.39 ± 4.77</td><td></td><td>32.50 ± 15.08</td><td></td><td>17.06 ± 5.92</td><td></td></tr><tr><td></td><td>High school or secondary school</td><td>12.72 ± 5.37</td><td></td><td>32.75 ± 17.44</td><td></td><td>20.81 ± 6.29</td><td></td></tr><tr><td></td><td>Undergraduate or college</td><td>11.94 ± 6.32</td><td></td><td>27.16 ± 10.10</td><td></td><td>19.79 ± 5.29</td><td></td></tr><tr><td></td><td>Master’s degree or above</td><td>10.92 ± 6.58</td><td></td><td>27.76 ± 10.90</td><td></td><td>18.87 ± 5.77</td><td></td></tr><tr><td>Marital Status</td><td></td><td></td><td><bold><0.05</bold></td><td></td><td><bold><0.01</bold></td><td></td><td>0.42</td></tr><tr><td></td><td>Single</td><td>12.00 ± 6.32</td><td></td><td>27.44 ± 10.63</td><td></td><td>19.57 ± 5.48</td><td></td></tr><tr><td></td><td>Married/Cohabitating</td><td>11.65 ± 6.51</td><td></td><td>30.28 ± 12.95</td><td></td><td>20.47 ± 4.90</td><td></td></tr><tr><td></td><td>Divorced/widowed</td><td>21.00 ± 8.29</td><td></td><td>44.75 ± 24.90</td><td></td><td>22.25 ± 5.91</td><td></td></tr><tr><td>Occupation</td><td></td><td></td><td>0.40</td><td></td><td><bold><0.01</bold></td><td></td><td>0.13</td></tr><tr><td></td><td>Student</td><td>11.83 ± 6.27</td><td></td><td>27.18 ± 10.12</td><td></td><td>19.53 ± 5.36</td><td></td></tr><tr><td></td><td>Medical staff</td><td>9.70 ± 7.39</td><td></td><td>29.35 ± 7.59</td><td></td><td>18.64 ± 3.29</td><td></td></tr><tr><td></td><td>Business</td><td>13.77 ± 8.33</td><td></td><td>37.41 ± 20.51</td><td></td><td>21.68 ± 7.15</td><td></td></tr><tr><td></td><td>Enterprise employee</td><td>13.22 ± 6.08</td><td></td><td>27.70 ± 12.16</td><td></td><td>19.95 ± 5.73</td><td></td></tr><tr><td></td><td>Other</td><td>12.78 ± 5.50</td><td></td><td>27.79 ± 8.77</td><td></td><td>19.68 ± 5.84</td><td></td></tr><tr><td>Monthly average disposable income</td><td></td><td></td><td>0.40</td><td></td><td>0.05</td><td></td><td>0.66</td></tr><tr><td></td><td><2000 RMB</td><td>11.85 ± 6.32</td><td></td><td>26.89 ± 9.69</td><td></td><td>19.57 ± 5.31</td><td></td></tr><tr><td></td><td>2001–3000 RMB</td><td>11.57 ± 6.09</td><td></td><td>29.75 ± 12.86</td><td></td><td>19.98 ± 5.63</td><td></td></tr><tr><td></td><td>3001–4000 RMB</td><td>12.98 ± 5.75</td><td></td><td>31.16 ± 14.64</td><td></td><td>19.91 ± 5.29</td><td></td></tr><tr><td></td><td>4001–5000 RMB</td><td>13.37 ± 7.33</td><td></td><td>28.19 ± 6.56</td><td></td><td>17.87 ± 6.46</td><td></td></tr><tr><td></td><td>>5001 RMB</td><td>13.28 ± 7.25</td><td></td><td>28.00 ± 14.53</td><td></td><td>20.07 ± 6.33</td><td></td></tr></tbody></table></table-wrap></p><p id="Par22">To show which subcategories of the demographic variables were associated with GHQ-12, PTSD and negative coping, LSD post hoc comparisons were conducted, and the results are shown in Table <xref rid="Tab4" ref-type="table">4</xref>. The LSD post hoc comparisons showed that participants with a junior high school education or below had significantly (<italic>P</italic> < 0.05) higher scores than the other three groups (high school or secondary school, undergraduate or college and master’s degree or above) on the GHQ-12. For PTSD, participants with a junior high school education or below had significantly (<italic>P</italic> < 0.05) higher scores than the undergraduate or college group, and participants with a high school or secondary school education had significantly (<italic>P</italic> < 0.05) higher scores than the undergraduate or college and master’s degree or above groups. Additionally, this study found that the divorced/widowed participants had significantly (<italic>P</italic> < 0.05) higher scores on the GHQ-12 and PTSD scales than the married/cohabitating and single participants, but there were no significant differences for the other groups. Note that the results of other subcategories of occupation were omitted here. We only list the business compared with other groups; we found that the business had significantly higher scores than the other group (<italic>P</italic> < 0.05).<table-wrap id="Tab4"><label>Table 4</label><caption><p>The results of post-hoc analyses (<italic>n</italic> = 584)</p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="2">Variable</th><th colspan="2">GHQ-12</th><th colspan="2">PTSD</th></tr><tr><th>I</th><th>J</th><th>Mean Difference (I-J)</th><th><italic>P</italic></th><th>Mean Difference (I-J)</th><th><italic>P</italic></th></tr></thead><tbody><tr><td colspan="6">Education level</td></tr><tr><td>Junior high school or below</td><td>High school or secondary school</td><td>5.67</td><td><0.01</td><td>−0.25</td><td>0.93</td></tr><tr><td></td><td>Undergraduate or college</td><td>6.45</td><td><0.001</td><td>5.33</td><td><0.05</td></tr><tr><td></td><td>Master’s degree or above</td><td>7.46</td><td><0.001</td><td>4.74</td><td>0.09</td></tr><tr><td>High school or secondary school</td><td>Junior high school or below</td><td>−5.67</td><td><0.01</td><td>0.25</td><td>0.93</td></tr><tr><td></td><td>Undergraduate or college</td><td>0.77</td><td>0.49</td><td>5.58</td><td><0.01</td></tr><tr><td></td><td>Master’s degree or above</td><td>1.79</td><td>0.17</td><td>4.99</td><td><0.05</td></tr><tr><td>Undergraduate or college</td><td>Junior high school or below</td><td>−6.45</td><td><0.001</td><td>−5.33</td><td><0.05</td></tr><tr><td></td><td>High school or secondary school</td><td>−0.77</td><td>0.49</td><td>−5.58</td><td><0.01</td></tr><tr><td></td><td>Master’s degree or above</td><td>1.01</td><td>0.18</td><td>−0.59</td><td>0.65</td></tr><tr><td>Master’s degree or above</td><td>Junior high school or below</td><td>−7.46</td><td><0.001</td><td>−4.74</td><td>0.09</td></tr><tr><td></td><td>High school or secondary school</td><td>−1.79</td><td>0.17</td><td>−4.99</td><td><0.05</td></tr><tr><td></td><td>Undergraduate or college</td><td>−1.01</td><td>0.18</td><td>0.59</td><td>0.65</td></tr><tr><td colspan="6">Marital status</td></tr><tr><td>Single</td><td>Married/Cohabitating</td><td>0.34</td><td>0.76</td><td>−2.84</td><td>0.15</td></tr><tr><td></td><td>Divorced/widowed</td><td>−8.99</td><td><0.01</td><td>−17.31</td><td><0.01</td></tr><tr><td>Married/Cohabitating</td><td>Single</td><td>−0.34</td><td>0.76</td><td>2.84</td><td>0.15</td></tr><tr><td></td><td>Divorced/widowed</td><td>−9.34</td><td><0.01</td><td>−14.46</td><td><0.05</td></tr><tr><td>Divorced/widowed</td><td>Single</td><td>8.99</td><td><0.01</td><td>17.31</td><td><0.01</td></tr><tr><td></td><td>Married/Cohabitating</td><td>9.34</td><td><0.01</td><td>14.46</td><td><0.05</td></tr><tr><td colspan="6">Occupation</td></tr><tr><td>Business</td><td>Student</td><td>–</td><td>–</td><td>10.23</td><td><0.01</td></tr><tr><td></td><td>Medical staff</td><td>–</td><td>–</td><td>8.05</td><td><0.05</td></tr><tr><td></td><td>Enterprise employee</td><td>–</td><td>–</td><td>9.70</td><td><0.01</td></tr><tr><td></td><td>Other</td><td>–</td><td>–</td><td>9.62</td><td><0.01</td></tr></tbody></table><table-wrap-foot><p>“-”: There was no significant difference in one-way ANOVA.</p></table-wrap-foot></table-wrap></p></sec><sec id="Sec13"><title>Univariate Logistic</title><p id="Par23">To determine the factors that predict psychiatric symptoms, univariate logistic regression was conducted. Since there were nominal (i.e., categorical) variables, it was necessary to recode them into dummy variables. The results showed that participants with a junior high school education or below (OR = 8.71, 95% CI: 1.97–38.43), enterprise employee (OR = 2.36, 95% CI: 1.09-5.09), those who had PTSD symptoms (OR = 1.05, 95% CI: 1.03–1.07) and those who used adopted negative coping strategies (OR = 1.03, 95% CI: 1.00–1.07) were more likely to have psychological disorders (see Table <xref rid="Tab5" ref-type="table">5</xref>).<table-wrap id="Tab5"><label>Table 5</label><caption><p>Factors associated with psychological disorder (GHQ-12 score>15)</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th>Variable</th><th>OR(95%CI)</th><th><italic>P</italic></th></tr></thead><tbody><tr><td colspan="4">Education status</td></tr><tr><td></td><td>Master’s degree or above</td><td>1.00 (reference)</td><td></td></tr><tr><td></td><td>Undergraduate or college</td><td>1.10(0.58-1.77)</td><td>0.95</td></tr><tr><td></td><td>High school or secondary school</td><td>0.79(0.28-2.26)</td><td>0.67</td></tr><tr><td></td><td>Junior high school or below</td><td>8.71(1.97-38.43)</td><td> <0.01</td></tr><tr><td colspan="4">Occupation</td></tr><tr><td></td><td>Student</td><td>1.00 (reference)</td><td></td></tr><tr><td></td><td>Medical staff</td><td>1.14(0.34–3.85)</td><td>0.83</td></tr><tr><td></td><td>Business</td><td>1.18(0.50–6.63)</td><td>0.36</td></tr><tr><td></td><td>Enterprise employee</td><td>2.36(1.09–5.09)</td><td><0.05</td></tr><tr><td></td><td>Other</td><td>1.67(0.57–4.93)</td><td>0.35</td></tr><tr><td>PTSD</td><td></td><td>1.05(1.03–1.07)</td><td><0.001</td></tr><tr><td>Negative Coping</td><td></td><td>1.03(1.00–1.07)</td><td><0.05</td></tr></tbody></table></table-wrap></p></sec></sec><sec id="Sec14"><title>Discussion</title><p id="Par24">In this study, we investigated the factors that influence mental health problems among the youth approximately two weeks after the occurrence of COVID-19. Approximately 40.4% of the participants reported having psychological problems and 14.4% youth groups with PTSD symptoms. Having a junior high school education or below, being the enterprise employee, having PTSD symptoms and using negative coping measures were the factors associated with psychological disorders.</p><p id="Par25">In this survey, it was found that there were more young people with a tendency toward psychological problems, which was higher than the ratio of psychological problems in other studies [<xref ref-type="bibr" rid="CR3">3</xref>, <xref ref-type="bibr" rid="CR27">27</xref>, <xref ref-type="bibr" rid="CR28">28</xref>]. For example, some studies during the SARS period found that 26.2% of participants had a tendency to have psychological problems [<xref ref-type="bibr" rid="CR29">29</xref>] and 14.1% youth groups with PTSD symptoms at three years after the 2013 earthquake in Lushan, China [<xref ref-type="bibr" rid="CR30">30</xref>]. This finding was most likely because this study was a survey conducted two weeks after the COVID-19, while other surveys started one month or even a year after the emergencies occurred and previous studies showed a decrease in PTSD cases with time [<xref ref-type="bibr" rid="CR31">31</xref>]. In addition, COVID-19 seems to spread via human-to-human transmission, and a first-level response to public health emergencies has been initiated in some provinces in China, which raising concerns about the infection.</p><p id="Par26">It was found that most of the participants had some knowledge about COVID-19, but a few participants had no knowledge. Studies have shown that the ability of the public to understand and respond to the information obtained played a key role in stopping the spread of SARS [<xref ref-type="bibr" rid="CR32">32</xref>]. Therefore, during this epidemic, public media education should be carried out, including using the media for the prevention and control of the epidemic [<xref ref-type="bibr" rid="CR33">33</xref>], so that young people can learn about the COVID-19 and take action to protect themselves and others.</p><p id="Par27">This study found that compared to women, men scored significantly higher on the GHQ-12, PTSD and negative coping scales, which is inconsistent with other research results [<xref ref-type="bibr" rid="CR34">34</xref>, <xref ref-type="bibr" rid="CR35">35</xref>], The difference may be due to different coping styles and social roles. Women were more likely to show symptoms of PTSD during the COVID-19 outbreak, which may reduce the incidence of PTSD [<xref ref-type="bibr" rid="CR36">36</xref>], but men may take more responsibility leading to stress, PTSD symptoms and psychological distress symptoms [<xref ref-type="bibr" rid="CR37">37</xref>]. Regarding factors of educational level, participants with a lower education were more likely to show PTSD symptoms and psychological distress, which is consistent with other research results [<xref ref-type="bibr" rid="CR38">38</xref>]. In this study, LSD post-hoc comparisons were used to discover differences between different educational levels. The participants with junior high school or below educational level had higher PTSD and GHQ-12 scores than other groups, which may be because a higher level of education can improve one’s understanding of issues related to post-traumatic stress disorder and psychological distress, leading one to take positive measures to prevent related symptoms from appearing and increasing confidence in mental health recovery [<xref ref-type="bibr" rid="CR39">39</xref>]. In terms of marital status, the LSD post-hoc comparisons revealed that the divorced/widowed participants had significantly higher PTSD and GHQ-12 scores than single and married/cohabitating participants; this difference may be due to family financial loss, a lack of support against negative emotions or depression symptoms [<xref ref-type="bibr" rid="CR40">40</xref>, <xref ref-type="bibr" rid="CR41">41</xref>] and a lack of opportunities to communicate with family members leading to psychological problems such as depression and anxiety, which highlight the importance of family support during this emergency [<xref ref-type="bibr" rid="CR12">12</xref>]. In the professional dimension, this study found that business groups have significantly higher PTSD scores than the other four groups, which may be because during the occurrence of COVID-19, compared to other professions, the businessman who needed to trade with others were worried about being infected and had some PTSD symptoms.</p><p id="Par28">This study suggested that participants with junior high school or below education had significantly higher scores on the GHQ-12. These groups may experience long-term mental health problems because they lack the ability to recover from emergencies [<xref ref-type="bibr" rid="CR8">8</xref>]. The government and relevant psychological institutions should take relevant psychological counseling measures to help this group recover from the impact of COVID-19. In addition, it also found that the enterprise employees may occurrence to the tendency of psychological distress, because during the occurrence of COVID-19, the working style of employees has changed. Faced with the sudden change of working style, they may not be able to adapt to this changes in a short time and cause certain psychological pressure. However, the specific reasons need to be further confirmed in the future. Using negative coping was also a predictive factor for the tendency of psychological distress, and studies showed that negative coping styles were linked to mental health issues [<xref ref-type="bibr" rid="CR42">42</xref>]. These group used negative, avoidance-focused coping as a risk factor for post-traumatic symptoms [<xref ref-type="bibr" rid="CR43">43</xref>]. Furthermore, post-traumatic symptoms were a strong predictor of psychological distress [<xref ref-type="bibr" rid="CR12">12</xref>]. Thus, PTSD symptoms and negative coping styles were strong predictors of youth mental health with respect to COVID-19.</p></sec><sec id="Sec15"><title>Conclusion</title><p id="Par29">In summary, this study found that mental health problems remain serious among the most of youth group during public health emergency. This study also indicated that low education level, enterprise employee, PTSD symptom and negative coping styles were the influence factors of youth mental health. These results highlight the need for local governments to take appropriate mental health interventions based on the characteristics of youth groups. The future research should moved beyond the cross-sectional design of the present study to explore the other factors affecting the youth mental health in public health emergency.</p><sec id="Sec16"><title>Limitations and Future Research Directions</title><p id="Par30">Certain limitations of this study should be recognized. The main limitation was that our study used a cross-sectional design, which cannot provide strong evidence for causality. Thus, further research should use a longitudinal design. Second, this study used self-reported questionnaires, which have issues with subjectivity and reliability. In addition, because of the limited sample size and snowball sampling approach, these findings may not represent the entire youth population. Therefore, a larger sample size might be needed. Finally, other variables affecting youth mental health with respect to COVID-19 should be examined.</p></sec></sec></body><back><fn-group><fn><p><bold>Publisher’s Note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn></fn-group><ack><p>We would like to thank all participants for their participation in this study. This research received support from International innovation team of Jilin University (2019GJTD06), and also received support form the research on the problems related to the prevention and treatment of COVID-19 of Jilin University (2020XGZX11).</p></ack><notes notes-type="author-contribution"><title>Authors’ Contributions</title><p>Conceptualization and Methodology:[Songli Mei]; Writing - review and editing: [Leilei Liang], [Hui Ren]; Formal analysis and investigation: [Ruilin Cao],[Yueyang Hu],[Zeying Qin],[Chuanen Li].</p></notes><notes><title>Compliance with Ethical Standards</title><notes><title>Ethical Approval</title><p id="Par31">This study has received approval from the Research Ethical Committee of Jilin University and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. In addition, we obtained verbal consent from participants before data collection.</p></notes><notes notes-type="COI-statement"><title>Conflict of Interest</title><p id="Par32">The authors declare that they have no conflict of interest.</p></notes><notes><title>Informed Consent</title><p id="Par33">During the research process, informed consent was obtained from all individual participants all. 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