Changing Trends in Suicidal Ideation and Its Influencing Factors During the Transition From Quarantine to Post-Quarantine Among Chinese University Students During the COVID-19 Surge: Six-Wave Panel Study.

BACKGROUND

To mitigate the rapid spread of COVID-19, numerous countries have adopted lockdowns and quarantine measures. Despite their public health benefits, the effects of these measures on suicidal ideation have not been well documented.

OBJECTIVE

This study aims to examine the relationship among COVID-19 infection, perceived beliefs, uncertainty stress, and suicidal ideation during the transition from quarantine to post-quarantine periods amid China's COVID-19 surge.

METHODS

A prospective longitudinal observational design was used. Changing trends across the 6 time points were assessed using the Mann-Kendall test and the Cochran-Armitage test. A generalized estimating equation was used to analyze the associations between independent variables and suicidal ideation.

RESULTS

A total of 221 (96.5%) participants completed all 6 observation waves. The prevalence of suicidal ideation during the quarantine period was 16.7% (n=37), 14.5% (n=32), and 14.5% (n=32), while during the post-quarantine period, it was 13.8% (n=30), 10.9% (n=24), and 10.0% (n=22), respectively. A significant downward trend in suicidal ideation was observed. In contrast, perceived risk, perceived severity, and the number of new infections exhibited significant upward trends (z scores of 9.56, 7.13, and 3.69, respectively; P<.001, P<.001 and P=.002, respectively). However, uncertainty stress remained stable over time (z=0.71; P=.48). The generalized estimating equation indicated that perceived risk (β=0.5482; P<.001), perceived severity (β=0.0817; P=.007), and uncertainty stress (β=0.1776; P<.001) were positively associated with suicidal ideation. The number of new infections (β=0.0041; P=.49) was not significantly associated with suicidal ideation.

CONCLUSIONS

This study found that suicidal ideation gradually declined following the lifting of quarantine measures. Perceived risk, perceived severity, and uncertainty stress, rather than numbers of infected cases, were significantly associated with suicidal ideation. These findings highlight the importance of addressing individuals' perceptions with real-world context when developing effective strategies to manage COVID-19 and future infectious disease outbreaks.