Abstract
OBJECTIVESTransmission 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. METHODSWe 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. RESULTSAmong 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. CONCLUSIONSThis 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.
Highlights
Isolation aims to separate infected individuals from those who have not contracted the infection, whereas quarantine takes a different approach by separating and restricting the movements of people who have been exposed to an infectious disease to monitor whether they develop the disease over time [1]
We found a total of 603 citations from MEDLINE (n = 128), Embase (n = 114), PubMed (n= 131), Academic Search Ultimate (n= 43), Health Source: Nursing/Academic Edition (n= 16), Health Policy Reference Center (n= 2), American Psychological Association (APA) PsycInfo (n= 17), CINAHL (n= 48), and Web of Science (n = 104)
An umbrella review evaluates reviews, rather than synthesizing study-level evidence [21]; such meta-epidemiological analyses may have different objectives or outcomes, which were beyond the scope of this review. These limitations should be considered in translating the evidence of this review into practice and conducting future research in this area. This umbrella review synthesized the global evidence on mental health outcomes of quarantine and isolation for infection prevention
Summary
Quarantine and isolation are public health measures used to prevent the transmission of infectious diseases among individuals. Quarantine and isolation share the same purpose of infection prevention; these terms have distinct meanings in practice. Isolation aims to separate infected individuals from those who have not contracted the infection, whereas quarantine takes a different approach by separating and restricting the movements of people who have been exposed to an infectious disease to monitor whether they develop the disease over time [1]. Quarantine was one of the few known measures to protect lives and cities during the plague epidemics in Europe during the 14th century [3]. Quarantine became relevant for addressing cholera epidemics and many other historical events related to infectious
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