Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence

Epidemiol Health. 2020;42:e2020038. doi: 10.4178/epih.e2020038. Epub 2020 Jun 2.

Abstract

Objectives: Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent coronavirus disease 2019 (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases.

Methods: We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population.

Results: Among 1,364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes.

Conclusions: This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.

Keywords: Communicable diseases; Mental disorders; Mental health; Meta-analysis; Quarantine; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control*
  • Global Health / statistics & numerical data*
  • Humans
  • Mental Disorders / epidemiology*
  • Pandemics / prevention & control*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control*
  • Quarantine / psychology*
  • Social Isolation / psychology*