The COVID-19 outbreak in Wuhan, China, in December 2019 caused widespread disruption and significant threats to both physical and mental health. The highly infectious nature of the virus, its mortality rate, and the initial lack of understanding about it led to widespread psychological distress. Lockdowns and isolation, coupled with constant exposure to negative news, exacerbated the psychological burden on the population. Mental health problems among medical professionals impacted their performance, leading to concerns about medical errors. This study aimed to comprehensively describe Wuhan residents' psychological reactions to the COVID-19 epidemic to inform mental health interventions, particularly in light of the National Health Commission of China's call for addressing the mental health consequences of the outbreak. Previous research had provided limited epidemiological data on community mental health during this crisis, highlighting the need for this investigation.

The introduction mentions several studies highlighting the significant mental health impact of the COVID-19 pandemic and similar outbreaks like SARS. These studies showed high rates of anxiety, depression, and insomnia among both patients and the general public. The introduction also emphasizes the lack of comprehensive epidemiological data on community mental health in Wuhan at the time of the study, setting the stage for the current research.

A cross-sectional study was conducted from February 18th to 28th, 2020, among Wuhan residents using a convenience sample recruited through an online survey platform. 1242 valid questionnaires were collected. Inclusion criteria included age 18 or older, residency in Wuhan during the outbreak, and electronic informed consent. Exclusion criteria were pre-existing psychological or sleep disorders, medication for mental or sleep illnesses, and questionnaires with logical errors. Data quality was ensured through limiting one submission per device and incorporating logic checks. The questionnaires included the GAD-7 (Generalized Anxiety Disorder 7-item scale), PHQ-9 (Patient Health Questionnaire 9-item scale), Athens Insomnia Scale (AIS), and Simplified Coping Style Questionnaire (SCSQ). Data analysis involved descriptive statistics, chi-square tests, and multivariate logistic regression using SPSS version 22 to assess associations between demographic factors and anxiety, depression, sleep disorders, and passive coping styles.

The study found that 27.5% of participants experienced anxiety, 29.3% depression, and 30.0% had sleep disorders. 29.8% reported using passive coping mechanisms. Significant differences were observed across various demographic groups. Multivariate logistic regression analysis revealed the following significant associations: **Anxiety:** Being female (OR=1.62), married (OR=1.75), having a monthly income over 1000 CNY (1000-5000: OR=1.44, >5000: OR=1.47), and not exercising (OR=1.45) were risk factors. **Depression:** Monthly income over 1000 CNY (1000-5000: OR=1.83, >5000: OR=1.45), less frequent online communication, and not exercising (OR=1.71) were risk factors. **Sleep Disorders:** Being female (OR=1.36), having a bachelor's degree or higher (OR=1.40), and having a monthly income over 1000 CNY (1000-5000: OR=2.61, >5000: OR=2.14) were risk factors. **Passive Coping:** Not exercising (OR=1.71), living in urban areas (inverse association, OR=0.75), having a bachelor's degree or higher (inverse association, OR=0.54), were associated with passive coping.

The high prevalence rates of anxiety, depression, and sleep disorders among Wuhan residents during the COVID-19 outbreak are comparable to findings from other studies across China, highlighting a widespread need for mental health interventions. The study's findings underscore the importance of addressing the psychosocial needs of the population, providing support through healthcare centers and psychological counselors, and disseminating positive information to counter the negative impacts of the epidemic. The observed associations between demographic factors (gender, marital status, income, and exercise) and mental health outcomes suggest potential targets for tailored interventions. The association between higher education and passive coping suggests the need to explore the complex relationship between education levels and coping strategies.

This study demonstrates a significant mental health burden among Wuhan residents during the COVID-19 epidemic. The high prevalence of anxiety, depression, sleep disorders, and passive coping styles underscores the urgent need for comprehensive mental health support and interventions. Future research could focus on longitudinal studies to track mental health outcomes, investigate the effectiveness of specific interventions, and explore the long-term consequences of the pandemic on mental well-being.

The study's cross-sectional design limits the ability to establish causality. The convenience sampling method may not be fully representative of the entire Wuhan population. The reliance on self-reported data could introduce bias. Further research is needed to address these limitations.