Primary studies included in this systematic review

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Primary study

Unclassified

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

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Authors Jeong H , Yim HW , Song YJ , Ki M , Min JA , Cho J , Chae JH
Journal Epidemiology and health
Year 2016
Links Pubmed DOI PubMed Central

This article is included in 10 Systematic reviews Systematic reviews (10 references)

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OBJECTIVES: Isolation 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. METHODS: Of 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. RESULTS: Of 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. CONCLUSIONS: Mental 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.

Primary study

Unclassified

System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea.

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Authors Yoon MK , Kim SY , Ko HS , Lee MS
Journal International journal of mental health systems
Year 2016
Links Pubmed DOI PubMed Central

This article is included in 5 Systematic reviews Systematic reviews (5 references)

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BACKGROUND: Korea has experienced diverse kind of disasters these days. Among them the 2015 middle eastern respiratory syndrome (MERS) outbreak imposed great psychological stress on almost all Korean citizens. Following the MERS outbreak, government is reviewing overall infectious disease management system and prioritizing the establishment of mental health service systems for infectious disease. This study makes suggestions for implementing disaster-related mental health service systems by analyzing the example of Gyeonggi Province, which proactively intervened with residents' psychological problems caused by the large-scale outbreak of an infectious disease. CASE DESCRIPTION: Mental health service system for MERS victims had the following two parts: a mental health service for people who had been placed in quarantine and a service provided to families of patients who had died or recovered patients. The government of Gyeonggi province, public health centers, regional and local Community Mental Health Centers and the National Center for Crisis Mental Health Management participated in this service system. Among 1221 Gyeonggi people placed in quarantine and who experienced psychological and emotional difficulties, 350 required continuing services; 124 of this group received continuing services. That is, 35 % of people who required psychological intervention received contact from service providers and received the required services. CONCLUSIONS: This study reflects a proactive monitoring system for thousands of people placed under quarantine for the first time in Korea. It is significant that the service utilization rate by a proactive manner, that is the professionals administering it actively approached and contacted people with problems rather than passively providing information was much higher than other general mental health situation in Korea. The core value of public mental health services is adequate public accessibility; it is therefore essential for governments to strengthen their professional competence and establish effective systems. These criteria should also be applied to psychological problems caused by disastrous infectious disease outbreaks.

Primary study

Unclassified

Posttraumatic stress disorder in parents and youth after health-related disasters.

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Authors Sprang G , Silman M
Journal Disaster medicine and public health preparedness
Year 2013
Links Pubmed DOI

This article is included in 7 Systematic reviews Systematic reviews (7 references)

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OBJECTIVES: This study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences. METHODS: A mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C). RESULTS: Disease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports). CONCLUSIONS: These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures.

Primary study

Unclassified

Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic.

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Authors Liu X , Kakade M , Fuller CJ , Fan B , Fang Y , Kong J , Guan Z , Wu P
Journal Comprehensive psychiatry
Year 2012
Links Pubmed DOI PubMed Central

This article is included in 15 Systematic reviews Systematic reviews (15 references)

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AIM: The aim of the study was to examine, among hospital employees exposed to an outbreak of severe acute respiratory syndrome (SARS), post-outbreak levels of depressive symptoms and the relationship between those depressive symptom levels and the types of outbreak event exposures experienced. METHODS: In 2006, randomly selected employees (N = 549) of a hospital in Beijing were surveyed concerning their exposures to the city's 2003 SARS outbreak and the ways in which the outbreak had affected their mental health. Subjects were assessed on sociodemographic factors, on types of exposure to the outbreak, and on symptoms of posttraumatic stress disorder and depression. RESULTS: The results of multinomial regression analyses showed that, with other relevant factors controlled for, being single, having been quarantined during the outbreak, having been exposed to other traumatic events before SARS, and perceived SARS-related risk level during the outbreak were found to increase the odds of having a high level of depressive symptoms 3 years later. Altruistic acceptance of risk during the outbreak was found to decrease the odds of high post-outbreak depressive symptom levels. CONCLUSIONS: Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware that the experience of being quarantined can, in some cases, lead to long-term adverse mental health consequences.

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Wu P et al

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Primary study

Unclassified

Predictive factors of psychological disorder development during recovery following SARS outbreak.

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Journal Health psychology : official journal of the Division of Health Psychology, American Psychological Association
Year 2009
Links Pubmed DOI

This article is included in 8 Systematic reviews Systematic reviews (8 references)

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OBJECTIVE: To investigate strategies for broad mass isolation during outbreaks of infectious diseases. DESIGN: A survey using a self-administered questionnaire was conducted on 300 printing company workers in Beijing, China, which was under mass isolation following the 2003 SARS outbreak, in the 7-8 months after the isolation was lifted. MAIN OUTCOME MEASURES: Individuals with psychological disorders were classified on the basis of scores on the 30-item General Health Questionnaire during the recovery period. Psychological disorders were observed in 49 of 187 respondents (26.2%; 95% CI = 20.2, 32.7). RESULTS: The predicting factor with the highest correlation was income reduction, with an odds ratio of 25.0. Other items obtained were gender, range of activities, eating restrictions, restrictions in going out, disinfection of clothing, and infection control, with odds ratios of 3.2, 5.5, 3.9, 3.2, 0.2, and 0.1, respectively, and the contribution ratio was 87.7%. CONCLUSION: Securing income is suggested to be important in future strategies.

Primary study

Unclassified

Understanding, compliance and psychological impact of the SARS quarantine experience.

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Journal Epidemiology and infection
Year 2008
Links Pubmed DOI PubMed Central

This article is included in 12 Systematic reviews Systematic reviews (12 references)

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This study examines a cohort of persons quarantined during the 2003 SARS outbreak in Canada and describes their understanding of, difficulties and compliance with, and the psychological impact of the quarantine experience. A mailed questionnaire was administered to 1912 eligible adults and included the Impact of Events Scale - Revised (IES-R) to assess symptoms of post-traumatic stress disorder (PTSD). Self-reported compliance with all required quarantine measures was low (15.8+/-2.3%), although significantly higher when the rationale for quarantine was understood (P=0.018). Health-care workers (HCW) experienced greater psychological distress, including symptoms of PTSD (P<0.001). Increasing perceived difficulty with compliance, HCW, longer quarantine and compliance with quarantine requirements were significant contributors to higher IES-R scores. The low compliance with quarantine requirements introduces concerns about the effectiveness of quarantine as a public health measure. Improvements in compliance and reduced psychological distress may be possible by minimizing duration, revising requirements, and providing enhanced education and support.

Primary study

Unclassified

The experience of quarantine for individuals affected by SARS in Toronto.

Journal Public health nursing (Boston, Mass.)
Year 2005
Links Pubmed DOI

This article is included in 6 Systematic reviews Systematic reviews (6 references)

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OBJECTIVE: The purpose of this study was to explore the experience of home quarantine during the severe acute respiratory syndrome (SARS) outbreak in Toronto in 2003. DESIGN: Qualitative descriptive design. SAMPLE: Stratified random sampling techniques were used to generate a list of potential participants, who varied in terms of gender and closeness of exposure to someone with suspected SARS (contact level). Twenty-one individuals participated in the study. MEASUREMENTS: All interviews were audiotaped and followed a semistructured interview guide. Participants were invited to describe their experience of quarantine in detail including their advice for Public Health. RESULTS: The experience followed a trajectory of stages beginning before quarantine and ending after quarantine. Despite individual differences, common themes of uncertainty, isolation, and coping intersected the data. CONCLUSIONS: Public Health has a dual role of monitoring compliance and providing support to people in quarantine. This study has implications for public health policy and practice in planning for future public health emergencies in terms of the information and the resources required to mount an effective response.

Primary study

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Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak.

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Journal Biosecurity and bioterrorism : biodefense strategy, practice, and science
Year 2004
Links Pubmed DOI

This article is included in 7 Systematic reviews Systematic reviews (7 references)

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The purpose of this study was to cull lessons from Toronto's experiences with large-scale quarantine during the outbreak of Severe Acute Respiratory Syndrome in early 2003. We focused on issues that affected the population's willingness to comply with quarantine. Information was acquired from interviews, telephone polling, and focus groups. Issues of quarantine legitimacy, criteria for quarantine, and the need to allow some quarantined healthcare workers to leave their homes to go to work were identified. Also important was the need to answer questions from people entering quarantine about the continuation of their wages, salaries, and other forms of income while they were not working, and about the means by which they would be supplied with groceries and other services necessary for daily living. The threat of enforcement had less effect on compliance than did the credibility of compliance-monitoring. Fighting boredom and other psychological stresses of quarantine, muting the forces of stigma against those in quarantine, and crafting and delivering effective and believable communications to a population of mixed cultures and languages also were critical. The need for officials to develop consistent quarantine policies, procedures, and public messages across jurisdictional boundaries was paramount.

Primary study

Unclassified

SARS control and psychological effects of quarantine, Toronto, Canada.

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Journal Emerging infectious diseases
Year 2004
Links Pubmed DOI PubMed Central

This article is included in 11 Systematic reviews Systematic reviews (11 references)

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As a transmissible infectious disease, severe acute respiratory syndrome (SARS) was successfully contained globally by instituting widespread quarantine measures. Although these measures were successful in terminating the outbreak in all areas of the world, the adverse effects of quarantine have not previously been determined in a systematic manner. In this hypothesis-generating study supported by a convenience sample drawn in close temporal proximity to the period of quarantine, we examined the psychological effects of quarantine on persons in Toronto, Canada. The 129 quarantined persons who responded to a Web-based survey exhibited a high prevalence of psychological distress. Symptoms of posttraumatic stress disorder (PTSD) and depression were observed in 28.9% and 31.2% of respondents, respectively. Longer durations of quarantine were associated with an increased prevalence of PTSD symptoms. Acquaintance with or direct exposure to someone with a diagnosis of SARS was also associated with PTSD and depressive symptoms.