Mental health status of people isolated due to Middle East Respiratory Syndrome

Abstract

OBJECTIVESIsolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months.METHODSOf 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS.RESULTSOf 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss.CONCLUSIONSMental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

“…However, another study 16 release from quarantine. 17 Healthcare workers 25 who had been quarantined had more severe symptoms of post traumatic stress than members of the general public who had been quarantined, scoring significantly higher on all dimensions. Healthcare workers also felt greater stigmatisation than the general public, exhibited more avoidance behaviours after quarantine, reported greater lost income, and were consistently more affected psychologically: they reported substantially more anger, annoyance, fear, frustration, guilt, helplessness, isolation, loneliness, nervousness, sadness, worry, and were less happy.…”

“…Participants in eight studies reported fears about their own health or fears of infecting others 9,13,14,16,17,21,25,26 and were more likely to fear infecting family members than those not quarantined. 9 They also became particularly worried if they experienced any physical symptoms potentially related to the infection 14 and fear that the symptoms could reflect having the infection continued to be related to psychological outcomes several months later.…”

“…9 They also became particularly worried if they experienced any physical symptoms potentially related to the infection 14 and fear that the symptoms could reflect having the infection continued to be related to psychological outcomes several months later. 17 Conversely, one study 11 found that although very few participants were extremely concerned about becoming infected or transmitting the virus to others, those who were concerned tended to be pregnant women and those with young children.…”

“…Having inadequate basic supplies (eg, food, water, clothes, or accommodation) during quarantine was a source of frustration 10,31 and continued to be associated with anxiety and anger 4-6 months after release. 17 Being unable to get regular medical care and prescriptions also appeared to be a problem for some participants. 10 Four studies found that supplies from public health authorities were insufficient.…”

“…In the reviewed studies, the financial loss as a result of quarantine created serious socioeconomic distress 24 and was found to be a risk factor for symptoms of psychological disorders 22 and both anger and anxiety several months after quarantine. 17 One study 28 found that respondents who were quarantined because of equine influenza, whose principal source of income was from a horserelated industry, were more than twice as likely to have high distress than those whose income was not from the industry. This finding is probably linked to economic effects but could also be related to disruption of social networks and loss of leisure activities.…”