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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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In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Social isolation and self-quarantine have been associated with psychological distress (Boyraz et al., 2020; Brooks, 2020; Smith et al., 2020).”
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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
In the citing paper
“with the potential for some effects to be long-lasting, even after restrictions have lifted.”
In the citing paper
“For many CYP, this includes psychological impacts relating to isolation and disrupted educational provision and attainment at critical timepoints [6,7].”
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Metadata
- 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
- 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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