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      Forced social isolation and lockdown during the COVID-19 pandemic: depression, anxiety, trauma-distress and coping mechanisms of a Greek sample

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          Abstract

          Aim

          The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association between social restriction measures, an mental health and coping strategies employed by a Greek adult sample.

          Subject and methods

          An online questionnaire was used to collect data during the second national lockdown (February to May 2021). A total of 650 participants ( M age 33.13, 71.5% female) comprised the final sample.

          Results

          The results show 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, of younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants reported moving away from social support and into more individual strength and resilience-based coping strategies to cope with challenges.

          Conclusion

          These findings suggest that in addition to the detrimental effects on physical health, social restriction measures related to COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s10389-023-01907-3.

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          Most cited references50

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)
          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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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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              A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

              Jasper Chan, Shuofeng Yuan, Kin-Hang Kok … (2020)
              Summary Background An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36–66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3–6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6–10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
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                Author and article information

                Contributors
                Vasiliki Varela:
                ORCID: http://orcid.org/0000-0002-2907-8237
                vasiliki.varela@gmail.com
                Journal
                Journal ID (nlm-ta): Z Gesundh Wiss
                Journal ID (iso-abbrev): Z Gesundh Wiss
                Title: Zeitschrift Fur Gesundheitswissenschaften
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 2198-1833
                ISSN (Electronic): 1613-2238
                Publication date (Electronic): 13 April 2023
                Pages: 1-10
                Affiliations
                [1 ]Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, SCG - Scientific College of Greece, Athens, Greece
                [2 ]GRID grid.414037.5, ISNI 0000 0004 0622 6211, Neuropsychology Department, 1st & 2nd Neurology Clinic, , Henry Dunant Hospital Center, ; Athens, Greece
                [3 ]Department of Psychology, SCG – Scientific College of Greece in Collaboration with the University of Strasbourg, Athens, Greece
                [4 ]GRID grid.5216.0, ISNI 0000 0001 2155 0800, 1st Department of Psychiatry, Eginition Hospital, , Medical School National & Kapodistrian University of Athens, ; Athens, Greece
                [5 ]Laboratory of Experimental and Applied Psychology, SCG - Scientific College of Greece, Athens, Greece
                [6 ]GRID grid.98913.3a, ISNI 0000 0004 0433 0314, Center for Health Sciences, SRI International, ; Menlo Park, CA USA
                [7 ]GRID grid.224260.0, ISNI 0000 0004 0458 8737, Department of Psychology, , Virginia Commonwealth University, ; Richmond, VA USA
                [8 ]GRID grid.11480.3c, ISNI 0000000121671098, Biomedical Research Doctorate Program, , University of the Basque Country, ; Leioa, Spain
                [9 ]Giunti Psychometrics, Madrid, Spain
                Author information
                http://orcid.org/0000-0002-2907-8237
                Article
                Publisher ID: 1907
                DOI: 10.1007/s10389-023-01907-3
                PMC ID: 10097449
                SO-VID: 59a127d9-60a2-476e-a955-ee409f4b5c61
                Copyright © © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 21 September 2022
                Date accepted : 28 March 2023
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: covid-19 social distancing,depression,anxiety,trauma,stress,coping,greece
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: covid-19 social distancing, depression, anxiety, trauma, stress, coping, greece

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