Longitudinal investigation of factors influencing mental health during centralized quarantine for COVID-19

Abstract

Background: Centralized quarantine was applied in response to the coronavirus disease 2019 outbreak. The present study aimed to investigate changes in psychological status of isolated individuals before and after quarantine. Methods: Between August 2020 and July 2021, 648 participants completed the following psychometric evaluations before and after centralized quarantine: 9-item Patient Health Questionnaire for depression, 7-item Generalized Anxiety Disorder for anxiety, the Chinese version of the Connor Davidson Resilience Scale for psychological resilience, the Chinese version of the Simplified Coping Style Questionnaire for coping style, Jiang's revised Chinese version of the Perceived Social Support Scale for social support and the Chinese version of the Impact of Events Scale for stress. Results: At the beginning of centralized quarantine, 83.2% (n=539) of participants had no depressive mood, 11% (n=71) had mild depressive mood and 5.8% (n=38) had moderate-severe depressive mood. At the end of quarantine, 80.8% (n=524) of participants had no depressive mood, 13% (n=84) had mild depressive mood and 6.2% (n=41) had moderate-severe depressive mood. At the beginning of the centralized quarantine, 86.7% (n=562) of participants had no anxiety, 9.6% (n=62) had mild anxiety and 3.7% (n=24) had moderate-severe anxiety. At the end of quarantine, 85.8% (n=556) of participants had no anxiety, 11.6% (n=75) had mild anxiety and 2.6% (n=17) had moderate-severe anxiety. After 2 weeks of centralized quarantine, anxiety (t=2.175, p<0.05), stress (t=7.453, p<0.01) and three stress subscale scores (p<0.01) decreased significantly; psychology resilience (t=-3.63, p<0.01), tenacity (t=-4.747, p<0.01), active coping style (t=-3.83, p<0.01) and support outside family (t=-3.07, p<0.05) all increased significantly. No significant change was observed in depression, strength, optimism, passive coping style or support inside family. Depression and anxiety scores associated significantly with resilience, stress, coping styles and social support scores. Anxiety (B=0.488, β=0.413, p<0.01), psychological resilience (B=-0.047, β=-0.203, p<0.01) and stress (B=1.475, β=0.167, p<0.1) scores before centralized quarantine were associated with depression after quarantine. Depression (B=0.323, β=0.422, p<0.01), psychological resilience (B=-0.022, β=-0.123, p<0.01) and stress (B=1.408, β=0.207, p<0.01) scores before quarantine also influenced anxiety levels after quarantine. A cross-lagged panel model indicated that depression, anxiety, resilience and stress scores at the first assessment were predictive of depression and anxiety levels at the second assessment. Conclusions: Good mental health during centralized quarantine was associated with high scores of psychological resilience, impact of events, coping styles and social support and did not become worse in settings where adequate support was available.