Stigma Concerns Linked to Depressive Symptoms in COVID-19 Survivors in Hong Kong

People in Hong Kong who had ever tested positive for COVID-19 reported generally low levels of depressive symptoms, but those who felt more stigma about their infection tended to report more symptoms, according to a cross-sectional survey study published in BMC Psychology. The study found that the link between stigma concerns and depressive symptoms appeared to operate largely through elevated perceived stress and maladaptive ways of regulating emotion, particularly rumination and catastrophizing.

Researchers conducted a population-based, random, and anonymous telephone survey among Chinese adults aged 18 or older in Hong Kong who self-reported having ever tested positive for COVID-19. The final sample comprised 277 participants, and data collection took place from June to August 2022, during the territory’s fifth-wave outbreak. Because the design was cross-sectional, the associations reported reflect measurements taken at a single point in time and cannot establish causal relationships between stigma, stress, emotion regulation, and depressive symptoms.

The prevalence of mild or more severe depressive symptoms in the sample was 8%, and overall symptom levels were low. After adjusting for background factors, including employment status, chronic disease status, knowing people with long COVID, and a history of home quarantine due to one’s own COVID-19 infection, the study found that stigma concerns, perceived stress, rumination, and catastrophizing were each positively associated with depressive symptoms.

To test how these variables related to one another, the researchers used structural equation modeling to examine indirect associations. The model indicated that the association between stigma concerns and depressive symptoms was significantly mediated by two types of indirect paths: one running through perceived stress alone, and another running through perceived stress followed by maladaptive cognitive emotion regulation. Notably, after accounting for these indirect paths, the direct association between stigma concerns and depressive symptoms was statistically non-significant, suggesting that the measured psychological processes accounted for the observed relationship.

The authors concluded that among people who had ever contracted COVID-19 and reported generally low depressive symptom levels, stigma concerns were positively associated with depressive symptoms, and that this association was significantly mediated via elevated perceived stress and maladaptive cognitive emotion regulation. They noted that if the findings are corroborated by further research, interventions addressing stigma concerns, stress management, and emotional regulation skills may benefit this population, and that stigma-related distress warrants early monitoring in future outbreaks of emerging respiratory infectious diseases.

The study’s authors, Yanqiu Yu, Mason M.C. Lau, and Joseph T.F. Lau, published the work as open access research in BMC Psychology, with the article released on 31 August 2026. As with any cross-sectional mediation analysis, the reported indirect paths describe statistical associations consistent with the proposed model rather than demonstrated causal chains, and the findings are specific to Chinese adults in Hong Kong who self-reported prior COVID-19 infection during the fifth-wave outbreak period.

Subject of Research: Cross-sectional associations between COVID-19-related stigma concerns and depressive symptoms among people ever infected in Hong Kong, mediated by perceived stress and maladaptive cognitive emotion regulation.

Article Title: Stigma concerns and depressive symptoms among people ever infected with COVID-19 in Hong Kong: cross-sectional mediation via perceived stress and maladaptive cognitive emotion regulation

Article References: Yu, Y., Lau, M. M. C., & Lau, J. T. F. (2026). Stigma concerns and depressive symptoms among people ever infected with COVID-19 in Hong Kong: cross-sectional mediation via perceived stress and maladaptive cognitive emotion regulation. BMC Psychology. https://doi.org/10.1186/s40359-026-05473-7

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05473-7

Keywords: COVID-19, stigma, depressive symptoms, perceived stress, rumination, catastrophizing, Hong Kong, cross-sectional survey, structural equation modeling, mental health, cognitive emotion regulation, concerns