The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Open accessAbstract
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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COVID-19 restrictions may trigger negative psychological effects in patients with endometriosis.
“the COVID-19 restrictions may trigger negative psychological effects (Brooks et al., 2020) in patients with endometriosis”
From Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic (2020) · cites this paper as Brooks et al., 2020
The Abstract and 'What can be done to mitigate the consequences of quarantine?' section report negative psychological effects associated with quarantine. The review does not establish this specifically for patients with endometriosis or for COVID-19 restrictions beyond quarantine. (LLM, conf=0.83)
Experimental — accuracy not yet measuredLoneliness and social isolation arising from disease containment measures in previous outbreaks (SARS and MERS) were associated with significant increases in risk of mental illness in adolescents and poor mental health up to nine years later.
“Existing research shows that the loneliness and social isolation arising from disease containment measures in previous outbreaks (e.g., severe acute respiratory syndrome [SARS] and Middle East respiratory syndrome) were associated with significant increases in risk of mental illness in adolescents and poor mental health up to nine years later (Brooks et al., 2020; Cénat et al., 2020; Loades et al.”
From Adolescents' longitudinal trajectories of mental health and loneliness: The impact of COVID‐19 school closures (2022) · cites this paper as Brooks et al., 2020
The psychological impact of quarantine section reports higher post-traumatic stress scores in quarantined children than in children who were not quarantined, and adverse outcomes among adults up to three years later. The Frustration and boredom section describes isolation as a distressing consequence of quarantine. The review does not establish that loneliness or social isolation increased adolescents’ risk of mental illness, or report poor mental health nine years later. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFew strategies specifically address the unique needs of healthcare personnel.
“However, few strategies specifically address the unique needs of healthcare personnel [7].”
From Mental Health in Healthcare Workers Post-COVID-19: A Latin American Review and Insights into Personalized Management Strategies (2024) · cites this paper as [7]
The section “Health-care workers deserve special attention” identifies concerns specific to quarantined health-care workers and recommends colleague and manager support. It does not say that few strategies address their needs; the scarcity claim is unsupported by our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredRecent international studies have reported increased symptoms of anxiety, depression, sleep disorders, and psychological distress during lockdown.
“recent international studies have reported increased symptoms of anxiety, depression, sleep disorders, and psychological distress during lockdown (4–10)”
From The Evolution of Psychological and Behavioral Consequences of Self-Isolation During Lockdown: A Longitudinal Study Across United Kingdom and Italy (2022) · cites this paper as [5]
The psychological impact of quarantine section (page unavailable) reports depression, insomnia, anxiety and psychological distress among quarantined people; some studies also found worse outcomes than in non-quarantined groups. The review concerns quarantine, however, and does not establish that this full set of symptoms increased during population-wide lockdowns. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSocial distancing has been proven to trigger negative mental health consequences, including intensified anxiety and depression and/or apathy and hypersensitivity, and can exacerbate mental illness.
“social distancing has been proven to trigger negative mental health consequences, including intensified anxiety and depression [9,10] and/or apathy and hypersensitivity; it is especially worrisome that it can also exacerbate mental illness [11,12].”
From Examining the associations between psychological flexibility, mindfulness, psychosomatic functioning, and anxiety during the covid-19 pandemic: A path analysis (2020) · cites this paper as [11]
The ‘Psychological impact of quarantine’ section (page not provided) reports depression, anxiety-related symptoms, and other distress among quarantined people. The ‘Prequarantine predictors’ section links a history of psychiatric illness to later anxiety and anger. But the review concerns quarantine rather than social distancing generally; it does not establish that distancing has been proven to cause these effects, or report apathy, hypersensitivity, or exacerbation of an existing mental illness. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Caregivers with symptoms of anxiety, depression, and traumatic stress are at higher risk of negative consequences due to COVID-19 and the quarantine.
“As stated, caregivers with symptoms of anxiety, depression, and traumatic stress are at higher risk of negative consequences due to COVID-19 and the quarantine (Brooks et al., 2020, Brown et al., 2020, Daks et al., 2020).”
From Brief Transdiagnostic Intervention for Parents With Emotional Disorder Symptoms During the COVID-19 Pandemic: A Case Example (2021) · cites this paper as Brooks et al., 2020
In “Prequarantine predictors of psychological impact,” the review associates a history of psychiatric illness with anxiety and anger after quarantine. Its mitigation section says people with pre-existing poor mental health likely need extra support during quarantine. It does not establish that caregivers with the specified symptoms are at higher risk of negative consequences from COVID-19. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSocial isolation and self-quarantine are associated with psychological distress.
“Social isolation and self-quarantine have been associated with psychological distress (Boyraz et al., 2020; Brooks, 2020; Smith et al., 2020).”
Duration of quarantine, fear of infection, boredom, frustration, lack of necessary supplies, lack of information, financial loss, and stigma appear to increase the risk of negative psychological outcomes.
“Duration of quarantine, fear of infection, boredom, frustration, lack of necessary supplies, lack of information, financial loss, and stigma appear to increase the risk of negative psychological outcomes.1”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [1]
Quarantine in adults generally has negative psychological effects including confusion, anger, and posttraumatic distress.
“Quarantine in adults generally has negative psychological effects including confusion, anger, and posttraumatic distress.1 , 2”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [1]
Patients with endometriosis, like everyone else, are at risk of negative psychological effects from mandated self-isolation.
“In addition to the effects of restrictions on healthcare services, patients with endometriosis, like everyone else, are at risk of negative psychological effects from mandated self-isolation (Brooks et al., 2020).”
From Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic (2020) · cites this paper as Brooks et al., 2020
Lockdown measures intended to curb COVID-19 produced broad social isolation, with potentially serious effects on mental health.
“Government restrictions put in place to slow the spread of the virus have led to widespread social isolation, which can have profound consequences for mental health (Brooks et al. 2020).”
From Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic (2021) · cites this paper as Brooks et al. 2020
Physicians, healthcare professionals, and medical staff directly exposed to patients and quarantine conditions have been identified as at risk for quarantine-related damages.
“Physicians, healthcare professionals, and medical staff who are directly exposed to patients and quarantine conditions have also been identified as at risk for quarantine-related damages (17).”
From Definitions and psychological impacts of quarantine and strategies to reduce it: A review paper (2020) · cites this paper as [17]
Quarantine is associated with adverse psychological effects.
“Quarantine is associated with adverse psychological effects (16-18)”
From Definitions and psychological impacts of quarantine and strategies to reduce it: A review paper (2020) · cites this paper as [17]
Research on prior pandemics shows that quarantines may result in increased mental health concerns for caregivers, particularly posttraumatic stress.
“Research on prior pandemics shows that quarantines may result in increased mental health concerns for caregivers, particularly posttraumatic stress (Brooks et al., 2020).”
From Brief Transdiagnostic Intervention for Parents With Emotional Disorder Symptoms During the COVID-19 Pandemic: A Case Example (2021) · cites this paper as Brooks et al., 2020
The alterations of loss of sleep, unhappiness, and depression among workers away from home can be justified by their perception of increased risk of contagion to themselves or their families, which may exceed the level of psychological distress caused by permanent confinement of those who work from home.
“Such alterations can be justified by their perception of increased risk of contagion to themselves or their families, and which may exceed the level of psychological distress caused by the permanent confinement of those who work from home (Brooks et al., 2020).”
From Health-related factors of psychological distress during the COVID-19 pandemic among non-health workers in Spain (2021) · cites this paper as Brooks et al., 2020
The protective effect of living in a house with exterior views can be understood by the decreased perception of confinement, also observed in previous studies.
“This fact can be understood by the decreased perception of confinement, also observed in previous studies (Brooks et al., 2020).”
From Health-related factors of psychological distress during the COVID-19 pandemic among non-health workers in Spain (2021) · cites this paper as Brooks et al., 2020
Strict confinement and the threat of rising infections led to great psychological suffering and significant adverse mental health consequences, especially in vulnerable groups such as university students.
“This strict confinement, together with the threat derived from the rising number of infections, led to great psychological suffering and significant adverse consequences for mental health (Brooks et al., 2020; González-Sanguino et al., 2020), especially in vulnerable groups such as university students (Araújo et al., 2020; Kaparounaki et al., 2020; Odriozola-González et al., 2020).”
From Feasibility of a Brief Online Mindfulness and Compassion-Based Intervention to Promote Mental Health Among University Students During the COVID-19 Pandemic (2021) · cites this paper as Brooks et al., 2020
Many expected consequences of quarantine and social/physical distancing are themselves major risk factors for mental health problems.
“Many of the anticipated consequences of quarantine14 and associated social and physical distancing measures are themselves key risk factors for mental health issues.”
From Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science (2020) · cites this paper as [14]
Altruism in UK Government health messages probably improved wellbeing relative to compulsory stay-at-home orders.
“The inclusion of altruism in UK Government health messages has likely had a positive effect on wellbeing compared with compulsory orders to stay at home.14”
From Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science (2020) · cites this paper as [14]
Pandemic worries and uncertainties are common, and for some they cause disproportionate distress and impaired social and occupational functioning.
“Although worries and uncertainties about a pandemic are common, for some they can cause undue distress and impairment to social and occupational functioning.14, 59, 60”
From Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science (2020) · cites this paper as [14]
Previous epidemic research suggested that many of these factors also predicted worse mental health during isolation.
“Findings from previous epidemics have suggested that many of these factors have also been risk factors for worse mental health during periods of isolation,15”
From Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study (2021) · cites this paper as [15]
The proliferation of online and home-based leisure activities and extensive use of virtual and digital communication during the COVID-19 pandemic might have helped ease the burden of lockdown.
“Finally, the proliferation of online and home-based leisure activities and the extensive use of virtual and digital communication during the COVID-19 pandemic might have helped to ease the burden of lockdown itself, in contrast to previous epidemics in which the fear of missing out was reported to be a challenge.27”
From Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study (2021) · cites this paper as [27]
Levels of mental health did not continue to worsen in this period, which is slightly at odds with data from previous epidemics where mental health was found to worsen during quarantine.
“The fact that levels of mental health did not continue to worsen in this period is slightly at odds with data from previous epidemics, in which mental health was found to worsen during (or as a result of) quarantine.15”
From Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study (2021) · cites this paper as [15]
Externalizing symptoms might also be affected by public health measures and restrictions.
“Moreover, we only assessed internalizing symptoms like depressive or anxiety symptoms, while externalizing symptoms (e.g., anger, aggression, alcohol abuse) might also be affected by public health measures and restrictions (Brooks et al., 2020).”
From Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany (2020) · cites this paper as Brooks et al., 2020
If effectively designed and deployed, chatbots could lessen the psychological damage caused by fear and isolation during the COVID-19 pandemic.
“Chatbots, if effectively designed and deployed, could help us by sharing up-to-date information quickly, encouraging desired health impacting behaviors, and lessening the psychological damage caused by fear and isolation.”
From Chatbots in the fight against the COVID-19 pandemic (2020) · cites this paper as [13]
Infection countermeasures such as social distancing and quarantine are psychologically damaging.
“Fourth, infection countermeasures (e.g., social distancing and quarantine) are psychologically damaging13.”
From Chatbots in the fight against the COVID-19 pandemic (2020) · cites this paper as [13]
If effectively designed and deployed, chatbots may lessen the long-term harm of pandemic-related isolation, trauma, and depression.
“If effectively designed and deployed, chatbots may lessen the long-term harm of pandemic-related isolation, trauma, and depression13,26.”
From Chatbots in the fight against the COVID-19 pandemic (2020) · cites this paper as [13]
Four review articles have identified negative implications of quarantine affecting public mental health and access to education.
“Four review articles have identified negative implications of quarantine affecting public mental health and access to education.9–12”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [10]
The review found negative psychological impacts of mass quarantine, such as low life satisfaction, emotional isolation and fear of infection.
“Consistent with previous studies,10,36,37 our review presents a range of negative psychological impacts of mass quarantine, such as low life satisfaction, emotional isolation and fear of infection.23–25,30,32,34,35”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [10]
Psychological stressors such as fear of illness, uncertainty, stigma, traumatic memories, and social isolation may interact in defining psychopathological outcome.
“In addition to the immunological mechanisms, fear of illness, uncertainty of the future, stigma, traumatic memories of severe illness, and social isolation experienced by patients during the COVID-19 are significant psychological stressors that may interact in defining psychopathological outcome (Brooks et al., 2020, Carvalho et al., 2020).”
From Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors (2020) · cites this paper as Brooks et al., 2020
Results of this study are largely consistent with prior studies in China and elsewhere highlighting adverse psychological consequences in the general population of both quarantine and disease outbreak.
“Results of this large-scale, cross-sectional study are largely consistent with prior studies in China and elsewhere highlighting the adverse psychological consequences in the general population of both quarantine and disease outbreak [10, 14, 57].”
From Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China (2021) · cites this paper as [10]
A recent review of virus outbreaks and pandemics documented stressors such as infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma.
“A recent review of virus outbreaks and pandemics documented stressors such as infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma [5].”
From Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study (2020) · cites this paper as [5]
Quarantine and lockdown measures introduced early in the pandemic have been shown to be risk factors for psychiatric disorders.
“External environmental factors such as quarantine and lockdown measures introduced during the onset of the pandemic have been shown to act as risk factors for psychiatric disorders.”
From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Brooks et al., 2020
Indirect psychosocial factors could be the primary mechanism behind any rise in anxiety and depression.
“It is possible that indirect psychosocial factors may be the overriding mechanism for any increased level of anxiety and depression(Brooks et al., 2020, Yu et al., 2020).”
From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Brooks et al., 2020
The effects of pandemic-related measures on youth have the potential to be long-lasting, even after restrictions have lifted.
“with the potential for some effects to be long-lasting, even after restrictions have lifted.”
For many children and young people, the pandemic includes psychological impacts relating to isolation and disrupted educational provision and attainment at critical timepoints.
“For many CYP, this includes psychological impacts relating to isolation and disrupted educational provision and attainment at critical timepoints [6,7].”
Previous studies found that people in quarantine reported higher rates of psychological symptoms (stress, depression, anxiety, insomnia) compared to people not in quarantine or the general population.
“Previous studies have found that people in quarantine reported higher rates of psychological symptoms, such as stress symptoms, depression, anxiety, and insomnia, compared to people not in quarantine or in the general population.”
From The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study (2020) · cites this paper as [11]
The negative psychological effects of quarantine were due to relatively long periods of quarantine, fears of infection, frustration, boredom, inadequate supplies, inadequate information, and stigma.
“The negative psychological effects were due to relatively long periods of quarantine, fears of infection, frustration, boredom, inadequate supplies, inadequate information, and stigma [11].”
From The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study (2020) · cites this paper as [11]
Concerns have arisen about the potential psychological impact of confinement measures.
“concerns have arisen about their potential psychological impact [11].”
From The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study (2020) · cites this paper as [11]
The stresses of quarantine and social isolation have negative psychological effects, including heightened stress and anxiety.
“The stresses of quarantine and social isolation are known to have negative psychological effects, including heightened stress and anxiety (Brooks et al., 2020; Pfefferbaum and North, 2020; Tsamakis et al., 2020).”
From Media for Coping During COVID-19 Social Distancing: Stress, Anxiety, and Psychological Well-Being (2020) · cites this paper as Brooks et al., 2020
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- Authors
- Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J.
- Affiliations
- King's College London (GB)
- Corresponding author
- Brooks, Samantha K
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 395
- Issue
- 10227
- Pages
- 912-920
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC7158942
- OpenAlex
- W3006659024
- Cited by
- 16,378
- References
- 45
- Citations by year
- 2026: 263 · 2025: 617 · 2024: 1253 · 2023: 2351 · 2022: 3785 · 2021: 4886 · 2020: 3191 · 2019: 5 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 3 · 2013: 2
- FWCI
- 277.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- SSRN Electronic Journal (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- reponame:Expeditio Repositorio Institucional UJTL
- Funders
- University of East Anglia
- National Institute for Health Research
- Newcastle University
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
- Social Sciences › Communication › Communication and COVID-19 Impact
- Keywords
- quarantine, psychological impact, COVID-19 pandemic, post-traumatic stress, isolation, fear of infection, stigma, quarantine duration, boredom, financial losses, altruism, public health communication
- MeSH terms
- COVID-19, Financing, Personal, Humans, Pneumonia, Viral, Public Health, Quarantine, Social Conditions, Stress Disorders, Post-Traumatic, Stress, Psychological, Coronavirus Infections, Social Stigma
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