Mental toll of self-isolation can be severe


The complete toll of self-isolation to flatten the curve of COVID-19 remains unknown, but a new research letter from China shows that stay-at-home measures have increased depression and anxiety symptoms among children.

Much of the focus on COVID-19 research has understandably been about discovering more about the disease, finding treatments to help save lives, and creating the vaccine that will mean the end of the pandemic. The toll of the current home confinement on children has been less studied, but a new research letter published in JAMA Pediatrics provides some information, using students from the Hubei province in China.1

Children in Wuhan were restricted to their homes from January 23, 2020, to April 8, 2020, and those in Huangshi, a city about 52 miles from Wuhan, were confined from January 24, 2020, to March 23, 2020. The investigators sent invitations for a survey to 2330 students in grades 2 through 6: 845 in Wuhan and 1485 in Huangshi. The respondents answered questions about their sex, school grade, optimism about the epidemic, and if they were worried about being infected by COVID-19. Depressive symptoms were measured using the Children’s Depression Inventory–Short Form (CDI-S), and the Screen for Child Anxiety Related Emotional Disorders was used to measure anxiety symptoms.

A total of 1784 children who had been restricted to their home for an average of 33.7 days completed the survey. Investigators found that students from Wuhan, which was the epicenter of the pandemic in China, had significantly higher CDI-S scores than students from Huangshi and a greater risk of depressive symptoms.

Children who said they were either slightly or not worried about being affected by COVID-19 were found to have significantly lower CDI-S scores than children who said that they were quite worried. Children who were not optimistic about the epidemic also had significantly higher CDI-S scores and an increased risk of depressive symptoms when compared with children who said they were quite optimistic. Overall, the 22.6% of students reporting depressive symptoms was higher than other investigations of primary school children in China (17.2%). When compared with other surveys, the 18.9% rate of students reporting anxiety symptoms also was higher.

The researchers concluded that their findings, along with data about the psychologic toll of severe acute respiratory syndrome in 2003 on Chinese students, suggest that serious infectious disease likely has a similar influence on the mental health of children as other traumatic experiences.


1.    Xie X, Xue Q, Zhou Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei province, China. JAMA Pediatr. April 24, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.1619

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