Neurological and Psychological Characteristics of Young Nitrous Oxide Abusers and Its Underlying Causes During the COVID-19 Lockdown

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.

Highlights • A significant reduction in psychological impact 4 weeks after COVID outbreak. • The mean scores of respondents in both surveys were above PTSD cut-offs. • Female gender, physical symptoms associated with a higher psychological impact. • Hand hygiene, mask-wearing & confidence in doctors reduced psychological impact. • Online trauma-focused psychotherapy may be helpful to public during COVID-19.

Coronavirus disease 2019 (COVID-19) is changing family life. The United Nations Educational, Scientific and Cultural Organization estimates 1·38 billion children are out of school or child care, without access to group activities, team sports, or playgrounds. Parents and caregivers are attempting to work remotely or unable to work, while caring for children, with no clarity on how long the situation will last. For many people, just keeping children busy and safe at home is a daunting prospect. For those living in low-income and crowded households, these challenges are exacerbated. This has serious implications. Evidence shows that violence and vulnerability increase for children during periods of school closures associated with health emergencies. 1 Rates of reported child abuse rise during school closures. Parents and children are living with increased stress, media hype, and fear, all challenging our capacity for tolerance and long-term thinking. For many, the economic impact of the crisis increases parenting stress, abuse, and violence against children. But times of hardship can also allow for creative opportunity: to build stronger relationships with our children and adolescents. WHO, UNICEF, the Global Partnership to End Violence Against Children, the United States Agency for International Development USAID, the US Centers for Disease Control and Prevention (CDC), Parenting for Lifelong Health, and the UK Research and Innovation Global Challenges Research Fund Accelerating Achievement for Africa's Adolescents Hub are collaborating to provide openaccess online parenting resources during COVID-19. These resources focus on concrete tips to build positive relationships, divert and manage bad behaviour, and manage parenting stress. They are shared through social media, and they are accessible on non-smartphones through the Internet of Good Things. A team of international volunteers are producing translations in 55 languages. Importantly, these parenting resources are based on robust evidence from randomised controlled trials in low-income and middle-income countries.2, 3, 4 COVID-19 is not the first virus to threaten humanity, and it will not be the last. We need to utilise effective strategies to strengthen families to respond, care, and protect a future for the world's children. 5 For WHO's information on parenting in the time of COVID-19 see https://www.who.int/emergencies/diseases/novelcoronavirus-2019/advice-forpublic/healthy-parenting For UNICEF's tips for parenting during the COVID-19 outbreak see https://www.unicef.org/coronavirus/covid-19-parentingtips For Parenting for Lifelong Health's COVID-19 resources see https://www.covid19parenting.com/ For CDC's guidance for schools see https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html This online publication has been corrected. The corrected version first appeared at thelancet.com on April 9, 2020