A systematic review of fear, stigma, and mental health outcomes of pandemics

J Ment Health. 2023 Oct;32(5):920-934. doi: 10.1080/09638237.2022.2091754. Epub 2022 Jul 6.


Background: The COVID-19 pandemic has negatively affected the mental health of people globally. Despite substantial research on the short-term psychological impact of COVID-19, its long-term consequences on mental health remain relatively unexplored.

Aims: We aimed to examine mental health literature on prior outbreaks to provide recommendations for developing effective strategies to mitigate the short- and long-term psychological impact of the current pandemic.

Methods: We conducted a narrative review of 41 studies to analyze the adverse impact of the following epidemics and pandemics on the mental health of individuals, groups, and communities: Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome, Influenza A/H1N1, and Ebola Virus Disease.

Results: We noted that these past epidemics and pandemics escalated stress, distress, anxiety, fear, and stigma that persisted in countries and communities. We also identified the role of misinformation in propagating discrimination and prejudice towards certain groups.

Conclusions: We discuss how the mental health outcomes of previous pandemics differed from the COVID-19 outbreak. We believe that strategies that reduce misinformation, educational initiatives, and mental health programs when introduced at the individual and community level have the potential to effectively diminish the negative psychological impact of COVID-19.

Prisma: This study followed the PRISMA guidance and was not registered in PROSPERO. This is a narrative review that used qualitative thematic analysis. Publishing a protocol on a protocol repository for such reviews is not the standard of practice.

Keywords: COVID-19; Mental health; anxiety; narrative review; pandemic planning; stigma.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Fear
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Mental Health
  • Outcome Assessment, Health Care
  • Pandemics
  • SARS-CoV-2