Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis

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Abstract

COVID-19 has imposed a very substantial direct threat to the physical health of those infected, although the corollary impact on mental health may be even more burdensome. Here we focus on assessing the mental health impact of COVID-19 and of other epidemics in the community. We searched five electronic databases until December 9, 2020, for all peer-reviewed original studies reporting any prevalence or correlates of mental disorders in the general population following novel epidemics in English, Chinese or Portuguese. We synthesised prevalence estimates from probability samples during COVID-19 and past epidemics. The meta-analytical effect size was the prevalence of relevant outcomes, estimated via random-effects model. I ² statistics, Doi plots and the LFK index were used to examine heterogeneity and publication bias. This study is pre-registered with PROSPERO, CRD42020179105. We identified 255 eligible studies from 50 countries on: COVID-19 ( n = 247 studies), severe acute respiratory syndrome (SARS; n = 5), Ebola virus disease ( n = 2), and 1918 influenza ( n = 1). During COVID-19, we estimated the point prevalence for probable anxiety (20.7%, 95% CI 12.9–29.7), probable depression (18.1%, 13.0–23.9), and psychological distress (13.0%, 0–34.1). Correlates for poorer mental health include female sex, lower income, pre-existing medical conditions, perceived risk of infection, exhibiting COVID-19-like symptoms, social media use, financial stress, and loneliness. Public trust in authorities, availability of accurate information, adoption of preventive measures and social support were associated with less morbidity. The mental health consequences of COVID-19 and other epidemics could be comparable to major disasters and armed conflicts. The considerable heterogeneity in our analysis indicates that more random samples are needed. Health-care professionals should be vigilant of the psychological toll of epidemics, including among those who have not been infected.

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

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

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Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

Emily A. Holmes, Rory C O'Connor, V. Perry … (2020)

Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

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Author and article information

Contributors

Michael Y. Ni:

ORCID: http://orcid.org/0000-0002-1217-5858

nimy@hku.hk

Journal

Journal ID (nlm-ta): Transl Psychiatry

Journal ID (iso-abbrev): Transl Psychiatry

Title: Translational Psychiatry

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2158-3188

Publication date (Electronic): 17 May 2022

Publication date PMC-release: 17 May 2022

Publication date Collection: 2022

Volume: 12

Electronic Location Identifier: 205

Affiliations

[1 ]GRID grid.194645.b, ISNI 0000000121742757, School of Public Health, LKS Faculty of Medicine, , The University of Hong Kong, ; Hong Kong, Special Administrative Region China

[2 ]GRID grid.411249.b, ISNI 0000 0001 0514 7202, Department of Psychiatry, , Universidade Federal de São Paulo, ; São Paulo, Brazil

[3 ]GRID grid.189504.1, ISNI 0000 0004 1936 7558, School of Public Health, , Boston University, ; Boston, MA USA

[4 ]GRID grid.194645.b, ISNI 0000000121742757, World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, , The University of Hong Kong, ; Hong Kong, Special Administrative Region China

[5 ]GRID grid.194645.b, ISNI 0000000121742757, The State Key Laboratory of Brain and Cognitive Sciences, , The University of Hong Kong, ; Hong Kong, Special Administrative Region China

[6 ]GRID grid.194645.b, ISNI 0000000121742757, Healthy High Density Cities Lab, HKUrbanLab, , The University of Hong Kong, ; Hong Kong, Special Administrative Region China

Author information

Hugo Cogo-Moreira http://orcid.org/0000-0001-9411-9237

Sandro Galea http://orcid.org/0000-0002-7534-0945

Gabriel M. Leung http://orcid.org/0000-0002-2503-6283

Michael Y. Ni http://orcid.org/0000-0002-1217-5858

Article

Publisher ID: 1946

DOI: 10.1038/s41398-022-01946-6

PMC ID: 9110635

PubMed ID: 35581186

SO-VID: c53f1f63-5897-4208-a1b1-1fc12005c965

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.