Mental health problems and social media exposure during COVID-19 outbreak
Identifieur interne : 000789 ( Pmc/Corpus ); précédent : 000788; suivant : 000790Mental health problems and social media exposure during COVID-19 outbreak
Auteurs : Junling Gao ; Pinpin Zheng ; Yingnan Jia ; Hao Chen ; Yimeng Mao ; Suhong Chen ; Yi Wang ; Hua Fu ; Junming DaiSource :
- PLoS ONE [ 1932-6203 ] ; 2020.
Abstract
Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.
Url:
DOI: 10.1371/journal.pone.0231924
PubMed: 32298385
PubMed Central: 7162477
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PMC:7162477Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Mental health problems and social media exposure during COVID-19 outbreak</title><author><name sortKey="Gao, Junling" sort="Gao, Junling" uniqKey="Gao J" first="Junling" last="Gao">Junling Gao</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Zheng, Pinpin" sort="Zheng, Pinpin" uniqKey="Zheng P" first="Pinpin" last="Zheng">Pinpin Zheng</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Jia, Yingnan" sort="Jia, Yingnan" uniqKey="Jia Y" first="Yingnan" last="Jia">Yingnan Jia</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Hao" sort="Chen, Hao" uniqKey="Chen H" first="Hao" last="Chen">Hao Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Mao, Yimeng" sort="Mao, Yimeng" uniqKey="Mao Y" first="Yimeng" last="Mao">Yimeng Mao</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Suhong" sort="Chen, Suhong" uniqKey="Chen S" first="Suhong" last="Chen">Suhong Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Wang, Yi" sort="Wang, Yi" uniqKey="Wang Y" first="Yi" last="Wang">Yi Wang</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Fu, Hua" sort="Fu, Hua" uniqKey="Fu H" first="Hua" last="Fu">Hua Fu</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Dai, Junming" sort="Dai, Junming" uniqKey="Dai J" first="Junming" last="Dai">Junming Dai</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32298385</idno><idno type="pmc">7162477</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162477</idno><idno type="RBID">PMC:7162477</idno><idno type="doi">10.1371/journal.pone.0231924</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000789</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000789</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Mental health problems and social media exposure during COVID-19 outbreak</title><author><name sortKey="Gao, Junling" sort="Gao, Junling" uniqKey="Gao J" first="Junling" last="Gao">Junling Gao</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Zheng, Pinpin" sort="Zheng, Pinpin" uniqKey="Zheng P" first="Pinpin" last="Zheng">Pinpin Zheng</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Jia, Yingnan" sort="Jia, Yingnan" uniqKey="Jia Y" first="Yingnan" last="Jia">Yingnan Jia</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Hao" sort="Chen, Hao" uniqKey="Chen H" first="Hao" last="Chen">Hao Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Mao, Yimeng" sort="Mao, Yimeng" uniqKey="Mao Y" first="Yimeng" last="Mao">Yimeng Mao</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Suhong" sort="Chen, Suhong" uniqKey="Chen S" first="Suhong" last="Chen">Suhong Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Wang, Yi" sort="Wang, Yi" uniqKey="Wang Y" first="Yi" last="Wang">Yi Wang</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Fu, Hua" sort="Fu, Hua" uniqKey="Fu H" first="Hua" last="Fu">Hua Fu</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Dai, Junming" sort="Dai, Junming" uniqKey="Dai J" first="Junming" last="Dai">Junming Dai</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</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>Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bao, Y" uniqKey="Bao Y">Y Bao</name></author><author><name sortKey="Sun, Y" uniqKey="Sun Y">Y Sun</name></author><author><name sortKey="Meng, S" uniqKey="Meng S">S Meng</name></author><author><name sortKey="Shi, J" uniqKey="Shi J">J Shi</name></author><author><name sortKey="Lu, L" uniqKey="Lu L">L Lu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shigemura, J" uniqKey="Shigemura J">J Shigemura</name></author><author><name sortKey="Ursano, Rj" uniqKey="Ursano R">RJ Ursano</name></author><author><name sortKey="Morganstein, Jc" uniqKey="Morganstein J">JC 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32298385</article-id><article-id pub-id-type="pmc">7162477</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0231924</article-id><article-id pub-id-type="publisher-id">PONE-D-20-06332</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Communications</subject><subj-group><subject>Social Communication</subject><subj-group><subject>Social Media</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Computer and Information Sciences</subject><subj-group><subject>Network Analysis</subject><subj-group><subject>Social Networks</subject><subj-group><subject>Social Media</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Social Networks</subject><subj-group><subject>Social Media</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Mental Health and Psychiatry</subject></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Mental Health and Psychiatry</subject><subj-group><subject>Mood Disorders</subject><subj-group><subject>Depression</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Education</subject><subj-group><subject>Schools</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Psychology</subject><subj-group><subject>Emotions</subject><subj-group><subject>Anxiety</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject><subj-group><subject>Psychology</subject><subj-group><subject>Emotions</subject><subj-group><subject>Anxiety</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject><subj-group><subject>Research Design</subject><subj-group><subject>Cross-Sectional Studies</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject><subj-group><subject>Research Design</subject><subj-group><subject>Survey Research</subject><subj-group><subject>Surveys</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Mental health problems and social media exposure during COVID-19 outbreak</article-title><alt-title alt-title-type="running-head">Mental health problems during COVID-19 outbreak</alt-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-0694-2010</contrib-id><name><surname>Gao</surname><given-names>Junling</given-names></name><role content-type="http://credit.casrai.org/">Conceptualization</role><role content-type="http://credit.casrai.org/">Formal analysis</role><role content-type="http://credit.casrai.org/">Funding acquisition</role><role content-type="http://credit.casrai.org/">Methodology</role><role content-type="http://credit.casrai.org/">Writing – original draft</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Zheng</surname><given-names>Pinpin</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><role content-type="http://credit.casrai.org/">Writing – review & editing</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Jia</surname><given-names>Yingnan</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><role content-type="http://credit.casrai.org/">Methodology</role><role content-type="http://credit.casrai.org/">Writing – review & editing</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Hao</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Mao</surname><given-names>Yimeng</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Suhong</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Yi</given-names></name><role content-type="http://credit.casrai.org/">Data curation</role><role content-type="http://credit.casrai.org/">Investigation</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Fu</surname><given-names>Hua</given-names></name><role content-type="http://credit.casrai.org/">Conceptualization</role><role content-type="http://credit.casrai.org/">Supervision</role><role content-type="http://credit.casrai.org/">Writing – review & editing</role><xref ref-type="aff" rid="aff001"></xref></contrib><contrib contrib-type="author"><name><surname>Dai</surname><given-names>Junming</given-names></name><role content-type="http://credit.casrai.org/">Conceptualization</role><role content-type="http://credit.casrai.org/">Methodology</role><role content-type="http://credit.casrai.org/">Writing – review & editing</role><xref ref-type="corresp" rid="cor001">*</xref><xref ref-type="aff" rid="aff001"></xref></contrib></contrib-group><aff id="aff001"><addr-line>School of Public Health, Fudan University, Fudan Institute of Health communication, Shanghai, China</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Hashimoto</surname><given-names>Kenji</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Chiba Daigaku, JAPAN</addr-line></aff><author-notes><fn fn-type="COI-statement" id="coi001"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><corresp id="cor001">* E-mail: <email>jmdai@fudan.edu.cn</email></corresp></author-notes><pub-date pub-type="epub"><day>16</day><month>4</month><year>2020</year></pub-date><pub-date pub-type="collection"><year>2020</year></pub-date><volume>15</volume><issue>4</issue><elocation-id>e0231924</elocation-id><history><date date-type="received"><day>4</day><month>3</month><year>2020</year></date><date date-type="accepted"><day>4</day><month>4</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Gao et al</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Gao et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="pone.0231924.pdf"></self-uri><abstract><p>Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.</p></abstract><funding-group><award-group id="award001"><funding-source><institution>National key R&D Program of China</institution></funding-source><award-id>2018YFC2002000 & 2018YFC2002001</award-id><principal-award-recipient><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-0694-2010</contrib-id><name><surname>Gao</surname><given-names>Junling</given-names></name></principal-award-recipient></award-group><award-group id="award002"><funding-source><institution-wrap><institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100001809</institution-id><institution>National Natural Science Foundation of China</institution></institution-wrap></funding-source><award-id>71573048</award-id><principal-award-recipient><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-0694-2010</contrib-id><name><surname>Gao</surname><given-names>Junling</given-names></name></principal-award-recipient></award-group><funding-statement>Junling Gao was funded by National key R&D Program of China (grant no. 2018YFC2002000 & 2018YFC2002001) and National Natural Science Foundation of China (grant no. 71573048). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><fig-count count="3"></fig-count><table-count count="1"></table-count><page-count count="10"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>All relevant data are within the manuscript and its Supporting Information files.</meta-value></custom-meta><custom-meta id="outbreaks"><meta-name>Outbreaks</meta-name><meta-value>COVID-19</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>All relevant data are within the manuscript and its Supporting Information files.</p></notes></front><body><sec sec-type="intro" id="sec001"><title>Introduction</title><p>A public health emergency of international concern-novel coronavirus disease (COVID-19) outbroke[<xref rid="pone.0231924.ref001" ref-type="bibr">1</xref>] in Wuhan, China on 31 December 2019, which has been spread to 24 countries outside of China and infected 37,558 patients globally (37,251 in China) by 9 February 2020[<xref rid="pone.0231924.ref002" ref-type="bibr">2</xref>]. The outbreak of COVID-19 in China has caused mental health problems among the public in China[<xref rid="pone.0231924.ref003" ref-type="bibr">3</xref>] and Japan[<xref rid="pone.0231924.ref004" ref-type="bibr">4</xref>] and medical workers in Wuhan[<xref rid="pone.0231924.ref005" ref-type="bibr">5</xref>]. The National Health Commission has released guideline for local authorities to promote psychological crisis intervention for patients, medical personnel, people under medical observation and civilians during the COVID-19 outbreak[<xref rid="pone.0231924.ref006" ref-type="bibr">6</xref>]. However, what type of mental disorders are prevalent and how they distribute among population are not know. So, a rapid assessment of outbreak-associated mental disorders for both civilians and health care workers, is needed[<xref rid="pone.0231924.ref007" ref-type="bibr">7</xref>].</p><p>The official departments strive to improve the public’s awareness of prevention and intervention strategies by providing daily updates about surveillance and active cases on websites and social media[<xref rid="pone.0231924.ref003" ref-type="bibr">3</xref>]. Besides, many self-media and netizens also release and transfer related information on social media, such as WeChat and Weibo. Social media may lead to (mis)information overload[<xref rid="pone.0231924.ref008" ref-type="bibr">8</xref>,<xref rid="pone.0231924.ref009" ref-type="bibr">9</xref>], which in turn may cause mental health problems. WHO pointed out that identifying the underlying drivers of fear, anxiety and stigma that fuel misinformation and rumour, particularly through social media[<xref rid="pone.0231924.ref010" ref-type="bibr">10</xref>]. Previous studies indicated that indirect exposure to mass trauma through the media can increase the initial rates of post-traumatic stress disorder (PTSD) symptoms[<xref rid="pone.0231924.ref011" ref-type="bibr">11</xref>]. A previous study also shown social media exposure may positively related to forming risk perceptions during the MERS outbreak in South Korea[<xref rid="pone.0231924.ref012" ref-type="bibr">12</xref>]. But there was no study to examine the association between social media exposure and mental health problems. So, the current study aims to describes the prevalence and distribution of two major mental disorders-anxiety and depression among Chinese population [<xref rid="pone.0231924.ref013" ref-type="bibr">13</xref>], and examine their associations with social media exposure by rapid assessment during COVID-19 outbreak.</p></sec><sec sec-type="materials|methods" id="sec002"><title>Materials and methods</title><sec id="sec003"><title>Design and participants</title><p>This cross-sectional study was online conducted during Jan 31 to Feb 2, 2020. Chinese citizens aged≥18 years old were invited to participate online survey though Wenjuanxing platform(<ext-link ext-link-type="uri" xlink:href="https://www.wjx.cn/app/survey.aspx">https://www.wjx.cn/app/survey.aspx</ext-link>). In total, 5,851 participants took part in the survey. After removing the participants without completed questionnaires, 4872 participants from 31 provinces and autonomous regions were involved in the current study. A written consent in the first section of online survey was given to all participants before filling the questionnaire. This study has been approved by the Institutional Review Board of Fudan University, School of Public Health(IRB#2020-01-0800).</p></sec><sec id="sec004"><title>Measurements</title><sec id="sec005"><title>Mental health problems</title><p>According to a previous study two major mental disorders-depression and anxiety [<xref rid="pone.0231924.ref013" ref-type="bibr">13</xref>] were assessed in the current study. Depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5)[<xref rid="pone.0231924.ref014" ref-type="bibr">14</xref>], which consists of five positively worded items that reflect the presence or absence of well-being rather than depressive symptomatology. Participants are asked to report the presence of these positive feelings in the last 2 weeks on a 6-point scale ranging from all of the time (5 points) to at no time (0 points). A summed score below 13 indicates depression[<xref rid="pone.0231924.ref014" ref-type="bibr">14</xref>]. Anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7)[<xref rid="pone.0231924.ref015" ref-type="bibr">15</xref>,<xref rid="pone.0231924.ref016" ref-type="bibr">16</xref>], which consists 7 symptoms. Participants were asked how often they were bothered by each symptom during the last 2 weeks. Response options were “not at all,” “several days,” “more than half the days,” and “nearly every day,” scored as 0, 1, 2, and 3, respectively. A score of 10 or greater represents a reasonable cut point for identifying cases of anxiety[<xref rid="pone.0231924.ref015" ref-type="bibr">15</xref>,<xref rid="pone.0231924.ref016" ref-type="bibr">16</xref>](<xref ref-type="supplementary-material" rid="pone.0231924.s001">S1 Table</xref>).</p></sec><sec id="sec006"><title>Social media exposure (SME)</title><p>Social media exposure was measured by asking how often respondents during the past week were exposed to news and information about COVID-19 on social media, such as Sina weibo, Zhihu, Douban, WeChat and etc (<xref ref-type="supplementary-material" rid="pone.0231924.s001">S1 Table</xref>). Response options were “never”, “once in a while”, “sometimes”, “often” and “very often”. Because of less proportion of “never”, so we recoded social media exposure into “less” (“never” and “once in a while”), “sometimes” and “frequently” (“often” and “very often”).</p></sec><sec id="sec007"><title>Covariates</title><p>The following covariates were included in this study: gender, age (10-year categories), educational level (junior high school, senior high school, college and master and higher), marital status (recoded into married and other [including unmarried, divorced, and widowed]), self-rated health (categorized as excellent, very good and good or low), occupation(students/retired, health care worker and others), cities(Wuhan and others), area(urban and rural).</p></sec></sec><sec id="sec008"><title>Statistical analyses</title><p>The χ<sup>2</sup> /trend tests were used to determine the prevalence of depression, anxiety and combination of depression and anxiety by categorical variables including social media exposure and covariates. Logistic regression analyses were used to explain the association between the prevalence of depression, anxiety and combination of depression and anxiety and SME after controlling for covariates. We estimated the adjusted ORs and their 95% confidence intervals (CIs) of independent variables for frailty. The STATA version 13.0 program (StataCorp LP., College Station, TX, USA) was used to carry out all analyses.</p></sec></sec><sec sec-type="results" id="sec009"><title>Results</title><sec id="sec010"><title>Social media exposure</title><p>Of all 4827 participants, the mean age of was 32.3±10.0 years (ranged 18–85), the proportion of “less”, “sometimes”, and “frequently” of SME was 8.8%(95%CI:8.0%-9.6%), 9.2%(95%CI:8.4%-10.0%) and 82.0%(95%CI:80.9%-83.1%). As shown in <bold><xref rid="pone.0231924.t001" ref-type="table">Table 1</xref></bold>, more than 60% of them (67.7%) were women, and most (47.9%) were aged 21–30 years. Many participants (62.2%) had achieved a college education, more than half of them were married. Only 5.2% of them were health care workers and 2.7% were from Hubei province, and 81.2% were from urban area. Most of them reported “excellent” (43.9%) or “very good” (45.6%) health.</p><p>Univariate analyses found that the proportion of frequently SME among men (78.4%, 95%CI: 76.3%-80.3%) was lower than among women (83.8%, 95%CI: 82.4%-85.0%), the proportion of frequently SME among youngers (aged -30 years) was higher than among elders (aged 41- years). Participants with low education (middle school and high school) had lower proportion of frequently SME than who with high education (college and master). Participants who are students or retired had higher proportion of frequently SME. The proportion of SME was not different between participants from Hubei province and others, however, participants from rural area reported higher proportion of frequently SME than who from urban area. Participants who were excellent health had higher proportion of frequently SME than others.</p><table-wrap id="pone.0231924.t001" orientation="portrait" position="float"><object-id pub-id-type="doi">10.1371/journal.pone.0231924.t001</object-id><label>Table 1</label><caption><title>Participants characteristic and social media exposure.</title></caption><alternatives><graphic id="pone.0231924.t001g" xlink:href="pone.0231924.t001"></graphic><table frame="hsides" rules="groups"><colgroup span="1"><col align="left" valign="middle" span="1"></col><col align="left" valign="middle" span="1"></col><col align="left" valign="middle" span="1"></col><col align="left" valign="middle" span="1"></col><col align="left" valign="middle" span="1"></col><col align="left" valign="middle" span="1"></col></colgroup><thead><tr><th align="justify" rowspan="2" colspan="1"></th><th align="justify" rowspan="2" colspan="1">N(%)</th><th align="center" colspan="3" rowspan="1">Social media exposure</th><th align="justify" rowspan="2" colspan="1">P value</th></tr><tr><th align="center" rowspan="1" colspan="1">Less</th><th align="center" rowspan="1" colspan="1">Sometimes</th><th align="center" rowspan="1" colspan="1">Frequently</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1"><bold>Overall</bold></td><td align="left" rowspan="1" colspan="1">4827(100)</td><td align="left" rowspan="1" colspan="1">424(8.8:8.0–9.6)</td><td align="left" rowspan="1" colspan="1">444(9.2:8.4–10.0)</td><td align="left" rowspan="1" colspan="1">3959(82.0:80.9–83.1)</td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Gender</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Male</td><td align="left" rowspan="1" colspan="1">1560(32.3)</td><td align="left" rowspan="1" colspan="1">161(10.3:8.9–11.9)</td><td align="left" rowspan="1" colspan="1">176(11.3:9.8–13.0)</td><td align="left" rowspan="1" colspan="1">1223(78.4:76.3–80.3)</td><td align="left" rowspan="2" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">Female</td><td align="left" rowspan="1" colspan="1">3267(67.7)</td><td align="left" rowspan="1" colspan="1">263(8.1:7.2–9.0)</td><td align="left" rowspan="1" colspan="1">268(8.2:7.3–9.2)</td><td align="left" rowspan="1" colspan="1">2736(83.8:82.4–85.0)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Age(years)</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">-20</td><td align="left" rowspan="1" colspan="1">256(5.3)</td><td align="left" rowspan="1" colspan="1">11(4.3:2.2–7.6)</td><td align="left" rowspan="1" colspan="1">14(5.5:3.0–9.0)</td><td align="left" rowspan="1" colspan="1">231(90.2:85.9–93.6)</td><td align="left" rowspan="5" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">21–30</td><td align="left" rowspan="1" colspan="1">2312(47.9)</td><td align="left" rowspan="1" colspan="1">120(5.2:4.3–6.2)</td><td align="left" rowspan="1" colspan="1">150(6.5:5.5–7.6)</td><td align="left" rowspan="1" colspan="1">2042(88.3:86.9–89.6)</td></tr><tr><td align="left" rowspan="1" colspan="1">31–40</td><td align="left" rowspan="1" colspan="1">1288(26.9)</td><td align="left" rowspan="1" colspan="1">124(9.6:8.1–11.4)</td><td align="left" rowspan="1" colspan="1">144(11.2:9.5–13.0)</td><td align="left" rowspan="1" colspan="1">1020(79.2:76.9–81.4)</td></tr><tr><td align="left" rowspan="1" colspan="1">41–50</td><td align="left" rowspan="1" colspan="1">749(15.5)</td><td align="left" rowspan="1" colspan="1">120(16.0:13.5–18.8)</td><td align="left" rowspan="1" colspan="1">109(14.6:12.1–17.3)</td><td align="left" rowspan="1" colspan="1">520(69.4:66.0–72.7)</td></tr><tr><td align="left" rowspan="1" colspan="1">51-</td><td align="left" rowspan="1" colspan="1">222(4.6)</td><td align="left" rowspan="1" colspan="1">49(22.1:16.8–28.1)</td><td align="left" rowspan="1" colspan="1">27(12.2:8.2–17.2)</td><td align="left" rowspan="1" colspan="1">146(65.8:59.1–72.0)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Education</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Middle school</td><td align="left" rowspan="1" colspan="1">257(5.3)</td><td align="left" rowspan="1" colspan="1">45(17.5:13.1–22.7)</td><td align="left" rowspan="1" colspan="1">30(11.7:8.0–16.2)</td><td align="left" rowspan="1" colspan="1">182(70.8:64.8–76.3)</td><td align="left" rowspan="4" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">High School</td><td align="left" rowspan="1" colspan="1">782(16.2)</td><td align="left" rowspan="1" colspan="1">85(10.9:8.8–13.3)</td><td align="left" rowspan="1" colspan="1">96(12.3:10.1–14.8)</td><td align="left" rowspan="1" colspan="1">601(76.9:73.7–79.8)</td></tr><tr><td align="left" rowspan="1" colspan="1">College</td><td align="left" rowspan="1" colspan="1">3002(62.2)</td><td align="left" rowspan="1" colspan="1">224(7.5:6.5–8.5)</td><td align="left" rowspan="1" colspan="1">256(8.5:7.6–9.6)</td><td align="left" rowspan="1" colspan="1">2522(84.0:82.6–85.3)</td></tr><tr><td align="left" rowspan="1" colspan="1">Master</td><td align="left" rowspan="1" colspan="1">786(16.3)</td><td align="left" rowspan="1" colspan="1">70(8.9:7.0–11.1)</td><td align="left" rowspan="1" colspan="1">62(7.9:6.1–10.0)</td><td align="left" rowspan="1" colspan="1">654(83.2:80.4–85.8)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Marriage</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Married</td><td align="left" rowspan="1" colspan="1">2607(54.0)</td><td align="left" rowspan="1" colspan="1">314(12.0:10.8–13.5)</td><td align="left" rowspan="1" colspan="1">306(11.7:10.5–13.0)</td><td align="left" rowspan="1" colspan="1">1987(76.2:74.5–77.8)</td><td align="left" rowspan="2" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">No married</td><td align="left" rowspan="1" colspan="1">2220(46.0)</td><td align="left" rowspan="1" colspan="1">110(5.0:4.1–5.9)</td><td align="left" rowspan="1" colspan="1">138(6.2:5.2–7.3)</td><td align="left" rowspan="1" colspan="1">1972(88.8:87.4–90.1)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Occupation</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Students/retired</td><td align="left" rowspan="1" colspan="1">1189(24.6)</td><td align="left" rowspan="1" colspan="1">84(7.1:5.7–8.7)</td><td align="left" rowspan="1" colspan="1">70(5.9:4.7–7.4)</td><td align="left" rowspan="1" colspan="1">1035(87.1:85.0–88.9)</td><td align="left" rowspan="3" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">Health care workers</td><td align="left" rowspan="1" colspan="1">251(5.2)</td><td align="left" rowspan="1" colspan="1">25(10.0:6.5–14.4)</td><td align="left" rowspan="1" colspan="1">23(9.2:5.9–13.4)</td><td align="left" rowspan="1" colspan="1">203(80.9:75.5–85.6)</td></tr><tr><td align="left" rowspan="1" colspan="1">others</td><td align="left" rowspan="1" colspan="1">3387(70.2)</td><td align="left" rowspan="1" colspan="1">315(9.3:8.3–10.3)</td><td align="left" rowspan="1" colspan="1">351(10.4:9.4–11.4)</td><td align="left" rowspan="1" colspan="1">2721(80.3:79.0–81.7)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Cities</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Hubei</td><td align="left" rowspan="1" colspan="1">130(2.7)</td><td align="left" rowspan="1" colspan="1">7(5.4:2.2–10.8)</td><td align="left" rowspan="1" colspan="1">13(10.0:5.4–16.5)</td><td align="left" rowspan="1" colspan="1">110(84.6:77.2–90.3)</td><td align="left" rowspan="2" colspan="1">0.375</td></tr><tr><td align="left" rowspan="1" colspan="1">Others</td><td align="left" rowspan="1" colspan="1">4697(97.3)</td><td align="left" rowspan="1" colspan="1">417(8.9:8.1–9.7)</td><td align="left" rowspan="1" colspan="1">431(9.2:8.4–10.0)</td><td align="left" rowspan="1" colspan="1">3849(82.0:80.8–83.0)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Area</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Urban</td><td align="left" rowspan="1" colspan="1">3920(81.2)</td><td align="left" rowspan="1" colspan="1">363(9.3:8.4–10.2)</td><td align="left" rowspan="1" colspan="1">371(9.5:8.6–10.4)</td><td align="left" rowspan="1" colspan="1">3186(81.3:80.0–82.5)</td><td align="left" rowspan="2" colspan="1">0.015</td></tr><tr><td align="left" rowspan="1" colspan="1">Rural</td><td align="left" rowspan="1" colspan="1">907(18.8)</td><td align="left" rowspan="1" colspan="1">61(6.7:5.2–8.6)</td><td align="left" rowspan="1" colspan="1">73(8.1:6.4–10.0)</td><td align="left" rowspan="1" colspan="1">773(85.2:82.7–87.5)</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Self-rate health</bold></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td><td align="left" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Excellent</td><td align="left" rowspan="1" colspan="1">2118(43.9)</td><td align="left" rowspan="1" colspan="1">173(8.2:7.0–9.4)</td><td align="left" rowspan="1" colspan="1">179(8.5:7.3–9.7)</td><td align="left" rowspan="1" colspan="1">1766(83.4:81.7–84.9)</td><td align="left" rowspan="3" colspan="1">0.020</td></tr><tr><td align="left" rowspan="1" colspan="1">Very good</td><td align="left" rowspan="1" colspan="1">2202(45.6)</td><td align="left" rowspan="1" colspan="1">191(8.7:7.5–9.9)</td><td align="left" rowspan="1" colspan="1">209(9.5:8.3–10.8)</td><td align="left" rowspan="1" colspan="1">1802(81.8:80.2–83.4)</td></tr><tr><td align="left" rowspan="1" colspan="1">Good/general/poor</td><td align="left" rowspan="1" colspan="1">507(10.5)</td><td align="left" rowspan="1" colspan="1">60(11.8:9.1–15.0)</td><td align="left" rowspan="1" colspan="1">56(11.1:8.5–14.1)</td><td align="left" rowspan="1" colspan="1">391(77.2:73.2–80.7)</td></tr></tbody></table></alternatives></table-wrap></sec><sec id="sec011"><title>Depression and SME</title><p>The prevalence of depression was 48.3% (95%CI: 46.9%-49.7%). As shown <bold><xref ref-type="fig" rid="pone.0231924.g001">Fig 1</xref></bold>, Multivariate analyses found that the adjusted odds of depression were greater among who age 21–30 years (OR = 1.49, 95%CI: 1.12–1.99) and 31–40 years (OR = 1.54, 95%CI: 1.11–2.14) compared with who aged ≤20 years, and lower among those with college (OR = 0.69, 95%CI: 0.53–0.91) and master (OR = 0.46, 95%CI: 0.63–0.85) education than those with middle school. Participants from Hubei province had no higher adjusted odds than those from other province (OR = 1.06, 95%CI: 0.75–1.52), but those from rural area had lower adjusted odds (OR = 0.74, 95%CI: 0.64–0.87) than those from urban area. The decrease of self-rated health significantly accompanied the increased odds of depression. About the focus of this study, higher frequency of SME was insignificantly positively associated with the adjusted odds of depression after controlling for all covariates.</p><fig id="pone.0231924.g001" orientation="portrait" position="float"><object-id pub-id-type="doi">10.1371/journal.pone.0231924.g001</object-id><label>Fig 1</label><caption><title>Prevalence of depression and relevant factors.</title></caption><graphic xlink:href="pone.0231924.g001"></graphic></fig></sec><sec id="sec012"><title>Anxiety and SME</title><p>The prevalence of anxiety was 22.6% (95%CI: 21.4%-23.8%). As shown <bold><xref ref-type="fig" rid="pone.0231924.g002">Fig 2</xref></bold>, Multivariate analyses found that that the adjusted odds of depression were greater among those aged 31–40 years (OR = 1.63, 95%CI: 1.06–2.51) compared with those aged -20 years, and lower among those with college (OR = 0.40, 95%CI: 0.30–0.53) and master (OR = 0.31, 95%CI: 0.22–0.44) education than those with middle school. The adjusted odds of depression among unmarried participants (OR = 0.80, 95%CI: 0.66–0.96) was lower than among married ones. Participants from other provinces had no higher adjusted odds (OR = 0.49, 95%CI: 0.33–0.71) than those from Hubei province. The adjusted odds of depression were greater among those with good/general/poor SRH (OR = 1.77, 95%CI: 1.41–2.21) compared with those with excellent SRH. About the focus of this study, frequently SME can increase the adjusted odds (OR = 1.72, 95%CI: 1.31–2.26) of anxiety compared with less SME after controlling for all covariates.</p><fig id="pone.0231924.g002" orientation="portrait" position="float"><object-id pub-id-type="doi">10.1371/journal.pone.0231924.g002</object-id><label>Fig 2</label><caption><title>Prevalence of anxiety and relevant factors.</title></caption><graphic xlink:href="pone.0231924.g002"></graphic></fig></sec><sec id="sec013"><title>Combination of depression and anxiety and SME</title><p>The prevalence of combination of depression and anxiety (CDA) was 19.4% (95%CI: 18.3%-20.6%). As shown <bold><xref ref-type="fig" rid="pone.0231924.g003">Fig 3</xref></bold>, Multivariate analyses found that that the adjusted odds of depression were greater among those aged 31–40 years (OR = 1.69, 95%CI: 1.07–2.68) compared with those aged -20 years, and lower among those with college (OR = 0.50, 95%CI: 0.37–0.68) and master (OR = 0.40, 95%CI: 0.28–0.57) education than those with middle school. The adjusted odds of depression among unmarried participants (OR = 0.79, 95%CI: 0.64–0.97) was lower than among married ones. The adjusted odds of depression were greater among those with good/general/poor SRH (OR = 1.77, 95%CI: 1.41–2.21) compared with those with excellent SRH. About the focus of this study, frequently SME can increase the adjusted odds (OR = 1.91, 95%CI: 1.52–2.41) of CDA compared with less SEM after controlling for all covariates.</p><fig id="pone.0231924.g003" orientation="portrait" position="float"><object-id pub-id-type="doi">10.1371/journal.pone.0231924.g003</object-id><label>Fig 3</label><caption><title>Prevalence of combination of depression and anxiety and relevant factors.</title></caption><graphic xlink:href="pone.0231924.g003"></graphic></fig></sec></sec><sec sec-type="conclusions" id="sec014"><title>Discussion</title><p>The latest national sample indicated the prevalence of any disorder (excluding dementia), anxiety disorders and depressive disorders was 16.6% (95%CI: 13.0–20.2), 7.6% (95%CI: 6.3–8.8) and 6.9% (95%CI: 6.6–7.2) in China[<xref rid="pone.0231924.ref013" ref-type="bibr">13</xref>]. Comparing with this national data, the current cross-sectional study found that much higher prevalence of depression (48.3%, 95%CI: 46.9%-49.7%), anxiety (22.6%, 95%CI: 21.4%-23.8%) and CDA (19.4%, 95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. These findings are consistent with the previous studies’ that exposing public health emergency can cause public mental health problems, such as Wenchuan and Lushan earthquakes[<xref rid="pone.0231924.ref017" ref-type="bibr">17</xref>], 2014 Ebola Outbreak[<xref rid="pone.0231924.ref007" ref-type="bibr">7</xref>,<xref rid="pone.0231924.ref018" ref-type="bibr">18</xref>], and SARS[<xref rid="pone.0231924.ref019" ref-type="bibr">19</xref>].</p><p>Social media is one of main channels updating the COVID-19 information[<xref rid="pone.0231924.ref003" ref-type="bibr">3</xref>]. This study also found that 82.0% of participants frequently expose them to social media, and frequently SME associated high odds of anxiety and CDA, which is consistent with previous studies [<xref rid="pone.0231924.ref011" ref-type="bibr">11</xref>]. there may be two reasons explaining the association between frequently SME and mental health. During COVID-19 outbreak, disinformation and false reports about the COVID-19 have bombarded social media and stoked unfounded fears among many netizens[<xref rid="pone.0231924.ref020" ref-type="bibr">20</xref>], which may confuse people and harm people’s mental health[<xref rid="pone.0231924.ref009" ref-type="bibr">9</xref>]. Besides, many citizens expressed their negative feelings, such as fear, worry, nervous, anxiety et al. on social media, which are contagious social network[<xref rid="pone.0231924.ref021" ref-type="bibr">21</xref>,<xref rid="pone.0231924.ref022" ref-type="bibr">22</xref>]. So, WHO’s ‘infodemics’ team is working hand in glove with countries’ communications department to deliver information to a broader public audience[<xref rid="pone.0231924.ref023" ref-type="bibr">23</xref>]. Finally, we also found that SME was not different between participants from Hubei province and others, but the formers faced higher odds of anxiety. It indicated that participants from Hubei province- the infectious focus directly expose to public health emergency, and may suffer more mental health problemes[<xref rid="pone.0231924.ref017" ref-type="bibr">17</xref>,<xref rid="pone.0231924.ref019" ref-type="bibr">19</xref>]. Compared with the control measures taken by other cities, Wuhan have sealed off the city from all outside contact to stop the spread of the COVID-19. As the prevention and control measures called new standard by WHO[<xref rid="pone.0231924.ref024" ref-type="bibr">24</xref>], the lockdown of Wuhan is a very effective way to interrupt the transmission of the virus, however, the strictest measures in Wuhan might lead to more serious mental health problems of local people.</p><p>Some potential limitations should be noted in this study. First, this is a cross-sectional study, so it is difficult to accurately elucidate causal relationships between SME and mental health. Additional longitudinal studies, such as cohort studies or nested case-control studies, are essential in the future. Although large sample, the survey was conducted online, which is suitable for rapid assessment, so some respondent bias, such as few elder citizens’ participation, may have affected the results. Finally, although we did control for many covariates, we cannot exclude the possibility of some residual confounding caused by unmeasured factors.</p></sec><sec sec-type="conclusions" id="sec015"><title>Conclusions</title><p>In conclusion, our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health among general population while combating with COVID-19. Fortunately, The China government have provided mental health services by varied channel including hotline, online consultation, online course and outpatient consultation[<xref rid="pone.0231924.ref006" ref-type="bibr">6</xref>], but more attention should be paid to depression and anxiety. The next implication is to combat with “infodemic” by monitoring and filtering out false information and promoting accurate information though cross-section collaborations.</p></sec><sec sec-type="supplementary-material" id="sec016"><title>Supporting information</title><supplementary-material content-type="local-data" id="pone.0231924.s001"><label>S1 Table</label><caption><p>(DOCX)</p></caption><media xlink:href="pone.0231924.s001.docx"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data" id="pone.0231924.s002"><label>S1 Data</label><caption><p>(XLS)</p></caption><media xlink:href="pone.0231924.s002.xls"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material></sec></body><back><ref-list><title>References</title><ref id="pone.0231924.ref001"><label>1</label><mixed-citation publication-type="other">WHO. 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(accessed Feb 15, 2020)</mixed-citation></ref></ref-list></back><sub-article id="pone.0231924.r001" article-type="aggregated-review-documents"><front-stub><article-id pub-id-type="doi">10.1371/journal.pone.0231924.r001</article-id><title-group><article-title>Decision Letter 0</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hashimoto</surname><given-names>Kenji</given-names></name><role>Section Editor</role></contrib></contrib-group><permissions><copyright-statement>© 2020 Kenji Hashimoto</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Kenji Hashimoto</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><related-article id="rel-obj001" ext-link-type="doi" xlink:href="10.1371/journal.pone.0231924" related-article-type="reviewed-article"></related-article><custom-meta-group><custom-meta><meta-name>Submission Version</meta-name><meta-value>0</meta-value></custom-meta></custom-meta-group></front-stub><body><boxed-text id="pone-0231924-box001" position="float" specific-use="prior_peer_review_unavailable" orientation="portrait"><sec id="sec017"><title>Transfer Alert</title><p>This paper was transferred from another journal. As a result, its full editorial history (including decision letters, peer reviews and author responses) may not be present.</p></sec></boxed-text><p><named-content content-type="letter-date">1 Apr 2020</named-content></p><p>PONE-D-20-06332</p><p>Mental health problems and social media exposure during COVID-19 outbreak</p><p>PLOS ONE</p><p>Dear Dr. Gao,</p><p>Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.</p><p>Your manuscript is timely and interesting for the readers of the journal. But the reviewer #1 addressed several major concerns about your manuscript. Please revise your manuscript carefully and ASAP.</p><p>We would appreciate receiving your revised manuscript by May 16 2020 11:59PM. When you are ready to submit your revision, log on to <ext-link ext-link-type="uri" xlink:href="https://www.editorialmanager.com/pone/">https://www.editorialmanager.com/pone/</ext-link> and select the 'Submissions Needing Revision' folder to locate your manuscript file.</p><p>If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.</p><p>To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: <ext-link ext-link-type="uri" xlink:href="http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols">http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols</ext-link></p><p>Please include the following items when submitting your revised manuscript:</p><p><list list-type="bullet"><list-item><p>A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.</p></list-item><list-item><p>A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.</p></list-item><list-item><p>An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.</p></list-item></list></p><p>Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.</p><p>We look forward to receiving your revised manuscript.</p><p>Kind regards,</p><p>Kenji Hashimoto, PhD</p><p>Academic Editor</p><p>PLOS ONE</p><p>Journal Requirements:</p><p>When submitting your revision, we need you to address these additional requirements.</p><p>1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf">https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf</ext-link> and <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf">https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf</ext-link></p><p>2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was suitably informed and (2) what type you obtained (for instance, written or verbal). If the need for consent was waived by the ethics committee, please include this information.</p><p>3. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. If you developed and/or translated a questionnaire as part of this study and it is not under a copyright license more restrictive than Creative Commons Attribution (CC-BY), please include a copy, in both the original language and English, as Supporting Information.</p><p>4. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see <ext-link ext-link-type="uri" xlink:href="http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions">http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions</ext-link>.</p><p>In your revised cover letter, please address the following prompts:</p><p>a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent.</p><p>b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see <ext-link ext-link-type="uri" xlink:href="http://www.bmj.com/content/340/bmj.c181.long">http://www.bmj.com/content/340/bmj.c181.long</ext-link> for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see <ext-link ext-link-type="uri" xlink:href="http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories">http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories</ext-link>.</p><p>5. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files</p><p>We will update your Data Availability statement on your behalf to reflect the information you provide.</p><p>Additional Editor Comments (if provided):</p><p>[Note: HTML markup is below. Please do not edit.]</p><p>Reviewers' comments:</p><p>Reviewer's Responses to Questions</p><p><bold>Comments to the Author</bold></p><p>1. Is the manuscript technically sound, and do the data support the conclusions?</p><p>The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. </p><p>Reviewer #1: Partly</p><p>Reviewer #2: Yes</p><p>**********</p><p>2. Has the statistical analysis been performed appropriately and rigorously? </p><p>Reviewer #1: Yes</p><p>Reviewer #2: Yes</p><p>**********</p><p>3. Have the authors made all data underlying the findings in their manuscript fully available?</p><p>The <ext-link ext-link-type="uri" xlink:href="http://www.plosone.org/static/policies.action#sharing">PLOS Data policy</ext-link> requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.</p><p>Reviewer #1: Yes</p><p>Reviewer #2: Yes</p><p>**********</p><p>4. Is the manuscript presented in an intelligible fashion and written in standard English?</p><p>PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.</p><p>Reviewer #1: No</p><p>Reviewer #2: Yes</p><p>**********</p><p>5. Review Comments to the Author</p><p>Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)</p><p>Reviewer #1: 1、In the result sections “Anxiety and SME” and “Combination of depression and Anxiety and SME”, the author also used the keyword “depression”.</p><p>2、The authors revealed the positive relationship between SME and anxiety, however, the value of this finding has not been described clearly and the advice for application is not rational. Because of the lack of causal evidence, we cannot know whether the higher SME is the reason or the result of higher anxiety. There seems no convincing reason to leave both the general suggestion of combating with “infodemic”, as well as the specific suggestions against false information and rumors, since there is no data at all in this article to distinguish the influence from true or false social media information on those cases with anxiety.</p><p>If the authors could provide more data on WHY frequent SME associated with high odds of anxiety and CDA, their implications about infodemic would be more reasonable.</p><p>Reviewer #2: The authors investigated the relationship between social media exposure and the prevalence of mental health problems during a novel coronavirus disease (COVID-19) outbreak in Wuhan, China. They found that there are high prevalence of</p><p>mental health problems, which positively associated with frequently social media exposure during this infectious outbreak.</p><p>The subject of this manuscript is important and interesting in the present world situation, and the findings may be helpful for the design of future infectious disease outbreak management. I recommend this for the publication in this journal.</p><p>**********</p><p>6. PLOS authors have the option to publish the peer review history of their article (<ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/s/editorial-and-peer-review-process#loc-peer-review-history">what does this mean?</ext-link>). If published, this will include your full peer review and any attached files.</p><p>If you choose “no”, your identity will remain anonymous but your review may still be made public.</p><p><bold>Do you want your identity to be public for this peer review?</bold> For information about this choice, including consent withdrawal, please see our <ext-link ext-link-type="uri" xlink:href="https://www.plos.org/privacy-policy">Privacy Policy</ext-link>.</p><p>Reviewer #1: No</p><p>Reviewer #2: No</p><p>[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]</p><p>While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, <ext-link ext-link-type="uri" xlink:href="https://pacev2.apexcovantage.com/">https://pacev2.apexcovantage.com/</ext-link>. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at <email>figures@plos.org</email>. Please note that Supporting Information files do not need this step.</p></body></sub-article><sub-article id="pone.0231924.r002" article-type="author-comment"><front-stub><article-id pub-id-type="doi">10.1371/journal.pone.0231924.r002</article-id><title-group><article-title>Author response to Decision Letter 0</article-title></title-group><related-article id="rel-obj002" ext-link-type="doi" xlink:href="10.1371/journal.pone.0231924" related-article-type="editor-report"></related-article><custom-meta-group><custom-meta><meta-name>Submission Version</meta-name><meta-value>1</meta-value></custom-meta></custom-meta-group></front-stub><body><p><named-content content-type="author-response-date">2 Apr 2020</named-content></p><p>Dear editor and reviewers,</p><p>We would like to thank you for your constructive comments and suggestions. We have revised the manuscript accordingly and would like to resubmit it for your consideration. Below, we have outlined our responses to each of the comments provided by the academic editor and reviewers. </p><p>Thank you for your consideration. We look forward to hearing from you soon.</p><p>Yours sincerely,</p><p>Junling Gao</p><p>Journal Requirements:</p><p>1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming.</p><p>Response: the manuscript’s style was revised according to the journal style requirements.</p><p>2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was suitably informed and (2) what type you obtained (for instance, written or verbal). If the need for consent was waived by the ethics committee, please include this information.</p><p>Response: a written consent was given to every participant before filling the questionnaire. The following sentences were revised in the manuscript.</p><p>A written consent in the first section of online survey was given to all participants before filling the questionnaire. This study has been approved by the Institutional Review Board of Fudan University, School of Public Health(IRB#2020-01-0800). </p><p>3. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. If you developed and/or translated a questionnaire as part of this study and it is not under a copyright license more restrictive than Creative Commons Attribution (CC-BY), please include a copy, in both the original language and English, as Supporting Information.</p><p>Response: the questionnaires were used to measure SME and depression and anxiety were provided as Supporting Information.</p><p>4. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly.</p><p>Response: the minimal anonymized data set was shared</p><p>5. Please include your tables as part of your main manuscript and remove the individual files.</p><p>Response: table was added in the revised manuscript.</p><p>Reviewers’ comments</p><p>Reviewer #1: </p><p>1、In the result sections “Anxiety and SME” and “Combination of depression and Anxiety and SME” , the author also used the keyword “depression”.</p><p>Response: the keywords and titles were revised according to the journal requirements</p><p>2、The authors revealed the positive relationship between SME and anxiety, however, the value of this finding has not been described clearly and the advice for application is not rational. Because of the lack of causal evidence, we cannot know whether the higher SME is the reason or the result of higher anxiety. There seems no convincing reason to leave both the general suggestion of combating with “infodemic”, as well as the specific suggestions against false information and rumors, since there is no data at all in this article to distinguish the influence from true or false social media information on those cases with anxiety.</p><p>If the authors could provide more data on WHY frequent SME associated with high odds of anxiety and CDA, their implications about infodemic would be more reasonable.</p><p>Response: thank you for your crucial suggestion. Because this is a cross-sectional study, we can elucidate causal relationships between SME and mental health, which has been mentioned in the limitation section.</p><p>Based on literature, we think there may be two reasons as following</p><p> During COVID-19 outbreak, disinformation and false reports about the COVID-19 have bombarded social media and stoked unfounded fears among many netizens[20], which may confuse people and harm people’s mental health[9]. This study found that frequently SME associated high odds of anxiety and CDA, which is consistent with previous studies.11 Besides, many citizens expressed their negative feelings, such as fear, worry, nervous, anxiety et al. on social media, which are contagious social network[21,22].</p><p>As for this limitation, we revised the implications in order to make them consisting with results according to your suggestions.</p><p>Reviewer #2: The authors investigated the relationship between social media exposure and the prevalence of mental health problems during a novel coronavirus disease (COVID-19) outbreak in Wuhan, China. They found that there are high prevalence of</p><p>mental health problems, which positively associated with frequently social media exposure during this infectious outbreak.</p><p>The subject of this manuscript is important and interesting in the present world situation, and the findings may be helpful for the design of future infectious disease outbreak management. I recommend this for the publication in this journal.</p><p>Response: thank you for your comments.</p><supplementary-material content-type="local-data" id="pone.0231924.s003"><label>Attachment</label><caption><p>Submitted filename: <named-content content-type="submitted-filename">Response to Reviewers.docx</named-content></p></caption><media xlink:href="pone.0231924.s003.docx"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material></body></sub-article><sub-article id="pone.0231924.r003" article-type="editor-report"><front-stub><article-id pub-id-type="doi">10.1371/journal.pone.0231924.r003</article-id><title-group><article-title>Decision Letter 1</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hashimoto</surname><given-names>Kenji</given-names></name><role>Section Editor</role></contrib></contrib-group><permissions><copyright-statement>© 2020 Kenji Hashimoto</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Kenji Hashimoto</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><related-article id="rel-obj003" ext-link-type="doi" xlink:href="10.1371/journal.pone.0231924" related-article-type="reviewed-article"></related-article><custom-meta-group><custom-meta><meta-name>Submission Version</meta-name><meta-value>1</meta-value></custom-meta></custom-meta-group></front-stub><body><p><named-content content-type="letter-date">6 Apr 2020</named-content></p><p>Mental health problems and social media exposure during COVID-19 outbreak</p><p>PONE-D-20-06332R1</p><p>Dear Dr. Gao,</p><p>We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.</p><p>Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.</p><p>Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at <ext-link ext-link-type="uri" xlink:href="https://www.editorialmanager.com/pone/">https://www.editorialmanager.com/pone/</ext-link>, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at <email>authorbilling@plos.org</email>.</p><p>If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact <email>onepress@plos.org</email>.</p><p>With kind regards,</p><p>Kenji Hashimoto, PhD</p><p>Section Editor</p><p>PLOS ONE</p><p>Additional Editor Comments (optional):</p><p>Reviewers' comments:</p></body></sub-article><sub-article id="pone.0231924.r004" article-type="editor-report"><front-stub><article-id pub-id-type="doi">10.1371/journal.pone.0231924.r004</article-id><title-group><article-title>Acceptance letter</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hashimoto</surname><given-names>Kenji</given-names></name><role>Section Editor</role></contrib></contrib-group><permissions><copyright-statement>© 2020 Kenji Hashimoto</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Kenji Hashimoto</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><related-article id="rel-obj004" ext-link-type="doi" xlink:href="10.1371/journal.pone.0231924" related-article-type="reviewed-article"></related-article></front-stub><body><p><named-content content-type="letter-date">9 Apr 2020</named-content></p><p>PONE-D-20-06332R1 </p><p>Mental health problems and social media exposure during COVID-19 outbreak </p><p>Dear Dr. Gao:</p><p>I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. </p><p>If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact <email>onepress@plos.org</email>.</p><p>For any other questions or concerns, please email <email>plosone@plos.org</email>. </p><p>Thank you for submitting your work to PLOS ONE.</p><p>With kind regards,</p><p>PLOS ONE Editorial Office Staff</p><p>on behalf of</p><p>Prof. Kenji Hashimoto </p><p>Section Editor</p><p>PLOS ONE</p></body></sub-article></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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