ANDREA ELEAZAR
In the blink of an eye, we now find ourselves over two years into a pandemic amidst a virus that continues to afflict millions globally with the disease COVID-19. And for many of us, a great deal of this time has been spent caged within our own walls, locked behind closed doors.
From the onset of the pandemic, our homes were automatically deemed our safe havens to retreat within. As time has evolved, quarantine seems to have become a near-universal experience. By definition, quarantine is the separation and restriction of movement of people who have been exposed to a contagious disease to wait for any symptoms to present. This public health measure is meant to keep others safe by preventing potential disease transmission. Although the practice itself dates back hundreds of years, it has long and often been an emotionally taxing trial for those who have gone through it. From a lack of social interaction, to worries about disease status and stigmatization, previous studies have linked quarantine to negative psychological effects, including distress, anger, anxiety, and even post-traumatic stress disorder and depression symptoms.
Among groups hit particularly hard by the pandemic, some researchers have turned their attention to those who have had to juggle a myriad of responsibilities during these unprecedented times: university students. What was supposed to be a formative period in these students’ lives and, for some, a first taste of independence, was instead spent in the confines of their homes. So, after quarantining at home, how are university students faring mentally, and how can they be helped? Al Refaei, Shewaikani, and colleagues from the University of Jordan, University of Baghdad, and University of Damascus gathered the experiences of university students across three Middle Eastern countries to gauge the psychological impacts of home quarantine and associated risk factors in the latest issue of the Journal of Young Investigators.
An online survey circulated by the researchers on popular social media platforms like Instagram and Facebook amassed responses from 4955 university students across Jordan, Iraq, and Syria who underwent home quarantine for at least 7 days during the COVID-19 pandemic. This survey collected information on the sociodemographics of respondents including country of study, gender, age, education, and income, as well as behaviors and living conditions like smoking, the number and health status of other co-occupants at home during their quarantine period, and adherence to quarantine. It also screened for clinical depression symptoms using an Arabic version of the Center for Epidemiologic Studies Depression Scale (CES-D Scale). This scale consists of 20 self-report items, where each can be rated on a scale 0-3; thus, it has a maximum achievable score of 60, with a score of >16 indicating a presence of depressive symptoms.
After analyzing survey data, straight away, researchers noticed a concerningly high prevalence of depressive symptoms among respondents: over 75% had a CES-D score greater than 16, indicating a high risk of developing or having depression. Furthermore, the analysis revealed significant predictors of depression among the variables measured: studying in Iraq, female gender, younger age (age 25 and under), low/middle income, and living alone or with individuals at higher risk for severe illness from COVID-19. In other words, students who fit one or more of these characteristics may be at higher risk for developing or having depression compared to others and should therefore be given particular attention. Additionally, a predictor of high quarantine adherence was having more depressive symptoms, further corroborating the psychological impact of quarantine.
Although quarantine is an important and effective strategy for containing infection, it leaves one to endure in grueling isolation the physical ramifications of the disease if infected, compounded by psychological hardships which should not be overlooked. This study illustrates the heightened need for post-quarantine, post-pandemic psychiatric interventions for university students and overall preparation for future disease outbreaks. Since depression is a complex disorder that manifests differently among individuals, knowing its predictors related to home quarantine can help inform the development of these interventions. Given the heterogeneity of depression, it is important to note that two of the surveyed regions – Iraq and Syria – are conflict zones overrun by war and political instability, which the authors acknowledged as a potential confounder. Nevertheless, the entanglement of such circumstances with a global pandemic offers all the more reason to support the wellbeing of university students now and beyond the age of COVID-19. In the face of adversity, we often hear that resilience is the key to seeing ourselves through. But in a pandemic, how can we persevere and keep our bodies healthy, if the mind is not?
References:
Al Refaei, A., Shewaikani, N., et al. (2022) ‘Depressed Middle Eastern University Students in Home-Based Quarantine: A Forgotten Issue’, Journal of Young Investigators, 25(10), available: https://www.jyi.org/current-issue-1
Ballard, E.D., et al. (2018) ‘Parsing the heterogeneity of depression: An exploratory factor analysis across commonly used depression rating scales’, Journal of Affective Disorders, 231, 51-57, available: https://doi.org/10.1016/j.jad.2018.01.027
Brooks, S.K., et al. (2020) ‘The psychological impact of quarantine and how to reduce it: rapid review of the evidence’, The Lancet, 395(10227), 912-920, available: https://doi.org/10.1016/S0140-6736(20)30460-8
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