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Abstract
The COVID-19 pandemic has greatly affected public health and wellbeing. In response to the pandemic threat of the coronavirus epidemic, several countries, including China, adopted lockdown and quarantine policies, which may cause psychological distress. This study aimed to explore the psychological impact of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China as well as the corresponding risk factors and protective factors. We examined the immediate (2-week) and delayed (2-month) impact of province-wide lockdown and personal quarantine on psychological distress in a national sample of 1390 Chinese residents. No immediate impact of province-wide lockdown on psychological distress was observed, whereas personal quarantine increased individuals' anxiety, fear, and anger. Despite the lack of initial association, psychological distress increased among those in province-wide lockdown. Self-stigma and personal control both significantly moderated the association between lockdown and psychological distress, but in different directions. Those with higher self-stigma and lower personal control were more impacted by the lockdown. Government support moderated the impact of quarantine on psychological distress, but not that of lockdown. The delayed effects of lockdown and quarantine on psychological distress were observed, and self-stigma, social support, and perceived control moderate the relationships. This study is the first to demonstrate the psychological costs of province-wide lockdowns on individuals' mental health, providing evidence of the need for mitigation strategies and timely public mental health preparedness in countries with recent outbreaks of COVID-19.
Highlights
In December 2019, coronavirus disease (COVID-19) emerged in Wuhan, Hubei Province, China and rapidly spread across China and into other countries, with over 1.9 million people infected and over 115 000 deaths to date
Attrition analyses for demographic and outcome variables were performed between people who participated in follow-up (n = 1390), and those who were lost to follow-up (n = 1843)
Self-stigma and personal control significantly moderated the effect of lockdown on psychological distress, but in different directions
Summary
In December 2019, coronavirus disease (COVID-19) emerged in Wuhan, Hubei Province, China and rapidly spread across China and into other countries, with over 1.9 million people infected and over 115 000 deaths to date. In response to the announcement on 11 March 2020 by the World Health Organization (WHO) that the coronavirus epidemic was a pandemic threat, several other countries initiated their own lockdowns This unprecedented public health emergency response delayed the growth and limited the magnitude of the COVID-19 epidemic in China, averting thousands of cases by 19 February (Tian et al, 2020), which limited the total number of cases to roughly 80 000 people. This study aimed to explore the psychological impact of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China as well as the corresponding risk factors and protective factors. No immediate impact of province-wide lockdown on psychological distress was observed, whereas personal quarantine increased individuals’ anxiety, fear, and anger. This study is the first to demonstrate the psychological costs of province-wide lockdowns on individuals’ mental health, providing evidence of the need for mitigation strategies and timely public mental health preparedness in countries with recent outbreaks of COVID-19
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