Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study
Abstract Background The COVID-19 pandemic has had a significant impact on the physical and mental health of human beings. Most adolescents in mainland of China have been infected with COVID-19 after the adjustment of the dynamic zero-COVID-19 policy. This study aims to analyze the relationship betwe...
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2025-02-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06525-9 |
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| author | Yong Yang Yi Lin Feng Wang Si Jia Wang Jing Hui Wang Feng Tong Qing Hai Gong |
| author_facet | Yong Yang Yi Lin Feng Wang Si Jia Wang Jing Hui Wang Feng Tong Qing Hai Gong |
| author_sort | Yong Yang |
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| description | Abstract Background The COVID-19 pandemic has had a significant impact on the physical and mental health of human beings. Most adolescents in mainland of China have been infected with COVID-19 after the adjustment of the dynamic zero-COVID-19 policy. This study aims to analyze the relationship between the COVID-19 pandemic effect and depressive symptoms among adolescents in mainland China. Methods This school-based repeated cross-sectional study was conducted on students aged 11–19 years from September to October 2022 and September to October 2023 in Ningbo, Zhejiang Province, China, using a stratified cluster, multistage sampling method. Data analysis occurred from January to June 2024. Depression symptoms and bullying victimization, exclusion of cyberbullying, were assessed using the 20-item Center for Epidemiological Studies Depression Scale (CES-D) and Bully/Victim Questionnaire, respectively. Results In the first survey wave in 2022 during the dynamic zero-COVID-19 policy period in Mainland China, 10,224 participants completed the questionnaires. In wave 2 survey in 2023 which was the first year after lifting of the dynamic zero-COVID-19 policy, 11,604 participants completed the questionnaires. This resulted in a sample of 10,224 in wave 1 and 11,604 in wave 2. The mean age in wave 1 was 15.2 (SD = 1.7) and 15.1 (SD = 1.8) in wave 2. The prevalence of depression symptoms in adolescents in wave 2 was higher than in wave 1 (17.0% vs. 14.6%, P < 0.05). The prevalence of bullying victimization and types of bullying victimization in school among adolescents were higher in 2023 than in 2022. A total of 3.2% of the 2023 participants and 1.7% of the 2022 participants experienced bullying victimization in school (P < 0.05). The odds ratio of experiencing depression (CES-D Score ≧ 16) and bullying victimization in school were 1.18 (95% CI, 1.10–1.28) and 1.86 (95% CI, 1.55–2.24) times higher, respectively, in 2023 than in 2022 (P < 0.01). The mediated regression analysis revealed that after lifting of the dynamic zero-COVID-19 had a significant association with an increase in depression symptoms, which was partially mediated by bullying victimization in school (total association:β = 0.175; SE = 0.038; P < 0.001; direct association:β = 0.138; SE = 0.039; P < 0.001; indirect association: a*b = 0.037; P < 0.001; the proportion of mediation: 20.88%, P < 0.001). Conclusions The findings of this repeated cross-sectional study suggest that an increased risk of depression symptoms or bullying victimization has been associated with the COVID-19 pandemic in mainland China after lifting the dynamic zero-COVID-19 policy. In addition, bullying victimization may play a mediating role in the associations between the pandemic and depression symptoms. These findings indicated that additional support should be offered to Chinese adolescents in the period of post-pandemic COVID-19. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-5635d246529943e288e5b7e3afd98c33 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-5635d246529943e288e5b7e3afd98c332025-02-09T12:49:22ZengBMCBMC Psychiatry1471-244X2025-02-0125111010.1186/s12888-025-06525-9Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional studyYong Yang0Yi Lin1Feng Wang2Si Jia Wang3Jing Hui Wang4Feng Tong5Qing Hai Gong6The First Affiliated Hospital of Ningbo UniversityCenter for Health Economics, Faculty of Humanities and Social Sciences, University of Nottingham Ningbo ChinaNingbo Municipal Center for Disease Control and PreventionNingbo Municipal Center for Disease Control and PreventionDepartment of Children and Adolescents Health, Ningbo Municipal Center for Disease Control and PreventionNingbo Municipal Center for Disease Control and PreventionNingbo Municipal Center for Disease Control and PreventionAbstract Background The COVID-19 pandemic has had a significant impact on the physical and mental health of human beings. Most adolescents in mainland of China have been infected with COVID-19 after the adjustment of the dynamic zero-COVID-19 policy. This study aims to analyze the relationship between the COVID-19 pandemic effect and depressive symptoms among adolescents in mainland China. Methods This school-based repeated cross-sectional study was conducted on students aged 11–19 years from September to October 2022 and September to October 2023 in Ningbo, Zhejiang Province, China, using a stratified cluster, multistage sampling method. Data analysis occurred from January to June 2024. Depression symptoms and bullying victimization, exclusion of cyberbullying, were assessed using the 20-item Center for Epidemiological Studies Depression Scale (CES-D) and Bully/Victim Questionnaire, respectively. Results In the first survey wave in 2022 during the dynamic zero-COVID-19 policy period in Mainland China, 10,224 participants completed the questionnaires. In wave 2 survey in 2023 which was the first year after lifting of the dynamic zero-COVID-19 policy, 11,604 participants completed the questionnaires. This resulted in a sample of 10,224 in wave 1 and 11,604 in wave 2. The mean age in wave 1 was 15.2 (SD = 1.7) and 15.1 (SD = 1.8) in wave 2. The prevalence of depression symptoms in adolescents in wave 2 was higher than in wave 1 (17.0% vs. 14.6%, P < 0.05). The prevalence of bullying victimization and types of bullying victimization in school among adolescents were higher in 2023 than in 2022. A total of 3.2% of the 2023 participants and 1.7% of the 2022 participants experienced bullying victimization in school (P < 0.05). The odds ratio of experiencing depression (CES-D Score ≧ 16) and bullying victimization in school were 1.18 (95% CI, 1.10–1.28) and 1.86 (95% CI, 1.55–2.24) times higher, respectively, in 2023 than in 2022 (P < 0.01). The mediated regression analysis revealed that after lifting of the dynamic zero-COVID-19 had a significant association with an increase in depression symptoms, which was partially mediated by bullying victimization in school (total association:β = 0.175; SE = 0.038; P < 0.001; direct association:β = 0.138; SE = 0.039; P < 0.001; indirect association: a*b = 0.037; P < 0.001; the proportion of mediation: 20.88%, P < 0.001). Conclusions The findings of this repeated cross-sectional study suggest that an increased risk of depression symptoms or bullying victimization has been associated with the COVID-19 pandemic in mainland China after lifting the dynamic zero-COVID-19 policy. In addition, bullying victimization may play a mediating role in the associations between the pandemic and depression symptoms. These findings indicated that additional support should be offered to Chinese adolescents in the period of post-pandemic COVID-19. Clinical trial number Not applicable.https://doi.org/10.1186/s12888-025-06525-9BullyingDepressionAdolescentsCOVID-19Cross-sectional studies |
| spellingShingle | Yong Yang Yi Lin Feng Wang Si Jia Wang Jing Hui Wang Feng Tong Qing Hai Gong Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study BMC Psychiatry Bullying Depression Adolescents COVID-19 Cross-sectional studies |
| title | Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study |
| title_full | Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study |
| title_fullStr | Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study |
| title_full_unstemmed | Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study |
| title_short | Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study |
| title_sort | comparison of bullying victimization and depression symptoms among chinese adolescents before and after the end of the dynamic zero covid 19 policy a repeated cross sectional study |
| topic | Bullying Depression Adolescents COVID-19 Cross-sectional studies |
| url | https://doi.org/10.1186/s12888-025-06525-9 |
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