Situational impact, psychosocial risk factors, and suicidality among young adults in Hong Kong during and after the COVID-19 pandemic: A repeated cross-sectional network analysis.

Background: The COVID-19 pandemic has brought substantial impacts and mental distress to young adults. No existing studies have investigated the roles of situational impact and psychosocial risk factors on suicidality under the pandemic context.

Objective: The present study examined the relationships between situational impact, psychosocial factors, and suicidality via a network approach during and after the COVID-19 pandemic.

Methods: Cross-sectional telephone surveys recruited three samples of young adults in Hong Kong via random sampling in autumns of 2021 to 2023 (N = 1,226-1,472). The respondents completed measures on situational impact, meaning in life, societal pessimism, Patient Health Questionnaire-4 (PHQ-4), hikikomori, and suicidality. Mixed graphical modeling was used to estimate the network and identify the partial correlations among the study variables in the three waves.

Results: The 2023 wave showed lower levels of COVID-19 distress and PHQ-4 but higher suicidality than 2021 and 2022 waves. Social impact, physical impact, and PHQ-4 were the central nodes in the 2021 and 2023 networks. Meaning in life showed negative linkages with other psychosocial factors. Suicidality showed positive linkages with societal pessimism, hikikomori, and PHQ-4 in the networks. Network comparison found no significant differences in network structure and global strength across gender, age, and waves. Societal pessimism showed significantly stronger linkages with financial impact, meaning in life, and suicidality in 2023 than 2021.

Conclusions: Our results enhance the understanding of comorbidity among psychosocial and situational risk factors of suicidality, which have implications for future interventions to improve mental health outcomes among young adults at risk.