Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : May | Volume : 16 | Issue : 5 | Page : VC01 - VC04 Full Version

Mental Health Status among the Quarantined Population during COVID-19 Pandemic: A Cross-sectional Study from Western Rajasthan


Published: May 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/51765.16308
Charan Singh Jilowa, Parth Singh Meena, Mahendra Jain, Prem Prakash, Pinki Tak

1. Associate Professor, Department of Psychiatry, JLN Medical College, Ajmer, Rajasthan, India. 2. Associate Professor, Department of Psychiatry, JLN Medical College, Ajmer, Rajasthan, India. 3. Senior Professor, Department of Psychiatry, JLN Medical College, Ajmer, Rajasthan, India. 4. Senior Resident, Department of Psychiatry, JLN Medical College, Ajmer, Rajasthan, India. 5. Assistant Professor, Department of Medicine, JLN Medical College, Ajmer, Rajasthan, India.

Correspondence Address :
Dr. Prem Prakash,
Senior Resident, Department of Psychiatry, JLN Medical College,
Ajmer, Rajasthan, India.
E-mail: dr.premverma08@gmail.com

Abstract

Introduction: Although isolation and quarantine are important measures to curb the exponential growth of the prevailing Coronavirus disease 2019 (COVID-19) pandemic, but at same time this can impose psychological issues among the affected population and also to their family members.

Aims: To evaluate the mental health problems, their severity and associated factors in quarantined population during the COVID-19 pandemic.

Materials and Methods: This cross-sectional study was conducted among 207 quarantined subjects at different quarantine centres of Ajmer, associated with JLN Medical College, Ajmer, from August 2020 to October 2020,after getting approval from ethics committee of the centre. All the consenting quarantined subjects who were of age 18 years and above, irrespective of their gender were enrolled in the study. For the assessment of psychiatric morbidity, participants were screened using Mini-International Neuropsychiatric Interview (MINI) 6.0.0. Finally, the relevant psychiatric assessment tools like Hamilton Rating Scale for Depression (HAM-D),Hamilton Anxiety Rating Scale (HAM-A) and Yale-Brown Obsessive Compulsive Scale were applied to assess the severity of the disorders. Pearson correlation analysis was used to evaluate the relationship among various clinical variables.The level of significance was considered at p-value <0.05.

Results: Majority 85 (41%) subjects belonged to the age group 31-40 years of age. Around 116 (77.3%) participants were male. Around 51 (24.6%) presented moderate depression and 25 (12%) presented with severe depression. Also 182 (87.9%) presented with moderate anxiety. The study showed a statistically significant association between depression/anxiety and substance abuse, insomnia, co-morbidities, suicidal ideation/attempts.

Conclusion: The findings of the present study concluded that a significant proportion of the quarantined population suffered from psychological issues. So, the psychological impact of a mandatory quarantine should be weighed more thoughtful and in an evidence based manner.

Keywords

Anxiety, Coronavirus disease 2019, Depression, Isolation, Psychological issues

The word ‘quarantine’ was first used in Venice, Italy in the year 1127 with regard to leprosy. Although it was not until 300 years later that the UK began to impose quarantine in response to the plague (1). Quarantine is the separation and restriction of movement of people who have potentially been exposed to a contagious disease to ascertain if they become unwell, thus reducing the risk of them infecting others (2). This differs from isolation, which is the separation of people who have been diagnosed with a contagious disease from people who are not sick (3).

One of the extreme challenges for the survival of mankind is facing a pandemic of an infectious disease of the COVID-19 type since the last one year (4). The World Health Organisation (WHO) declared COVID-19 as a pandemic on March 11, 2020 (5). A wide range of interventions regarding public health like restricted travelling, physical distancing, home confinement and centralised quarantine, and easy access to medical supplies have enormously contributed to the quick containment of the epidemic in China and set an encouraging example for other countries being affected (6). However, the preventive measures like quarantine and isolation, urgently adopted to manage pandemic might potentially have adverse psychological and social effects especially on those at risk, such as frontline workers, children, and older adults (7),(8),(9). Most of the anticipated direct consequences of quarantine and associated social and physical distancing, including financial insecurity, boredom, frustration, feeling a burden, loneliness, inadequate supplies, inadequate information, and stigma and fear of getting an infection are risk factors for mental health issues including anxiety, depression, suicide, and self-harm (7).

It is well known that quarantine for any cause and in the context of a pandemic (Severe Acute Respiratory distress Syndrome, 2003) has been associated with significant mental health problems such as anxiety, fear of infection or death, low mood, sense of loneliness, sleep disturbances, agitation, anger outburst, etc., just after few days of quarantine, and followed by symptoms of post-traumatic stress disorder and depression after discharge from the hospital (10). Keeping all these facts in mind, this study aimed to evaluate the mental health problems, their severity, and association with clinical variables in quarantined population during the COVID-19 pandemic.

Material and Methods

This cross-sectional study was conducted among quarantined subjects at different quarantine centres of Ajmer, associated with JLN Medical College, Ajmer, from August to October 2020. The ethical clearance from Institutional Ethical Committee was sought (1533Acad-???/MCA/2020 dated on 30th July 2020).

Inclusion criteria: Subjects who consented to participate in the study, of age 18 years and above, and of either gender were included in the study.

Exclusion criteria: Subjects unwilling to give consent or suffering from severe medical illness or already a diagnosed and documented case of psychiatric disorder were excluded.

Study Procedure

The format of the study and the method adopted were explained to participants. Written informed consent of participants was taken prior to the recruitment in the study. After getting consent, a socio-demographic profile was noted down using a pretested semi-structured proforma. For the assessment of psychiatric morbidity participants (N=207) were screened by using MINI version 6 (11). Finally, the relevant psychiatric assessment tools like HAM-D, HAM-A, Y-BOCS were applied to assess the severity of the disorder (12),(13),(14).

There were six different quarantine centers. All the quarantine centers were taken for the study. Permission from the concerned authorities were sought Minimum two and maximum five participants were interviewed at bedside from 9:00 am to 5:00 pm, each day. It was an interviewer administered proforma filled at bedside ensuring privacy. Every participant was quarantined for 14 days and he/she was interviewed once on day 14 of his quarantine.

Psychiatric assessment tools:

1. Semi-structured proforma: It included the socio-demographic profile sheet and clinical profile sheet.
2. MINI 6.0.0: It was designed as a brief structured interview for the major Axis I psychiatric disorders mentioned in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and International Classification of Diseases (ICD-10) (11). Reliability and validity studies, done by comparing MINI to the Structured Clinical Interview for DSM Disorders-Patient Edition (SCID-P) for DSM-III-R and Composite International Diagnostic Interview (CIDI) (developed by WHO for interviewers for ICD-10). For this study following modules were used- major depressive disorder, Obsessive Compulsive Disorder (OCD), suicidality, generalised anxiety disorder (11).
3. Hamilton Rating Scale for Depression (HAM-D): It is available in two versions with either 17 or 21 items. It is scored on 5 point scale between 0 to 4 points. Severity of depression was measured by first 17 items whereas the remaining 4 items on the 21 item version measure the factors related to depression. Scores of 0-7 are supposed as normal, 8-16 mild depression, 17-23 moderate depression, and scores more than 24 indicates severe depression. The maximum score being 52 on the 17-point scale (12).
4. (Hamilton Anxiety Rating Scale (HAM-A): It measures the severity of both psychic anxiety and somatic anxiety symptoms. It consists of 14 items. Each item is scored on a four point scale, where <17 indicates mild severity, 18-24 mild to moderate severity, and 25-30 moderate to severe, with a score range of 0-56 (13).
5. B#BY-BOCS:B?B It is a standardised rating scale. Two versions viz., clinician-administered and self-report versions are available. It measures 10 items of obsessions and compulsions on a five point Likert scale. A total score can range from 0 to 40 and is calculated by summing items 1 to 10 (14).

Statistical Analysis

Statistical analysis was done by using SPSS Version 23 and results were tabulated. Descriptive statistics were used to report frequencies. Pearson correlation analysis was used to evaluate the relationship among various clinical variables. Statistically significant difference was considered at p-value <0.05.

Results

In total, 248 people were quarantined during this period at six different quarantine centers of the city. Seven of them had advanced illness, so the total eligible participants were 241. Out of them 34 refused to give consent. The final sample size was 207. The socio-demographic profile of the participants is shown in (Table/Fig 1). Majority of them belonged to the age group 31-40 years 85 (41.1%) followed by the age group 41-50 years 66 (31.1%). Most of the participants were male 160 (77.3), married 158 (76.3%), hindu 158 (76.3%), educated up to secondary/senior level 98 (47.3%), belonged to nuclear family 119 (57.5%).

The severity of depression over the HAM-D rating scale is shown in (Table/Fig 2). About 60% of the participants reported depression of different severity. Around 8 (3.8%) of the participants reported very severe depression, whereas 25 (12%) of them reported severe depression and 51 (24.6%) showed moderate depression.

The severity of anxiety over the HAM-A is shown in (Table/Fig 3). Only 2 (0.9%) percent of the participants were severely anxious, whereas 23 (11.1%) of them were moderately anxious and 182 (87.9%) of them reported mild anxiety symptoms.

The clinical variables of the participants is shown in (Table/Fig 4). Around 6 (2.9%) of the participants had suicidal ideation whereas 1 (0.5%) attempted suicide. The OC symptoms were present in 3 (1.4%) participants. Insomnia was present in 54 (26.1%) of participants. Around 28 (13.5%) of the participants watched news continuously/updated themselves continuously about pandemic. Around forty percent of the participants consumed different substances namely alcohol 65 (31.4%), tobacco 14 (6.7%), whereas 12 (5.7%) of them concomitantly took both alcohol and tobacco.

The association of depression and anxiety with other co-variates of the participants is shown in (Table/Fig 5). It shows the statistically significant association between the HAM-A and different variables such as substance abuse, OC symptoms, watching the news, suicide, insomnia and other co-morbidities such as Diabetes Mellitus (DM), Hypertension and cardiac problems. It also showed a statistically significant association between the HAM-D and variables such as substance abuse, watching news, suicide ideas, insomnia and other co-morbidities such as diabetes mellitus, hypertension, and cardiac problems.

Discussion

Review of literature revealed that any epidemic or pandemic may give rise to new psychiatric symptoms/disorders or causes relapse/recurrence of previous psychiatric disorder. Across the globe, various measures have been taken to halt the progression of pandemics. It has been observed that implementing early quarantine was taken as a prime measure of control (15). Those who are quarantined have their freedom restricted, to prevent spread of transmissible diseases. It can have various consequences at personal and population level both on mental health and wellbeing apart from physical sufferings. All these facts develop immense interest to work on the hot topic of the current scenario. This study is most likely the first, in the specific geographical area, to explore the likely impacts of quarantine measures on the mental health of the quarantined population.

It was noticed that there is around twenty-fold rise in the prevalence of depression (60%) and around thirtyfold rise in the prevalence of anxiety (90%) in quarantined participants as compared to baseline statistics in the Indian population as per Global burden of disease study 1990-2017 (3.1–3.6% for depressive disorders and 3.0–3.5% for anxiety disorders) (16). This study was conducted when the pandemic was at its peak which may be a reason for such a sharp rise in the prevalence of depression and anxiety. The stressors such as uncertainty of disease progression, an insufficient supply of essentials, financial losses, perceived higher risk of getting infected, vague information, and improper communications through media related to the quarantine may be contributing to the much hike in the prevalence of depression and anxiety (7),(17),(18). Rumours about the pandemic and continue being active in different social media platforms might also be imposing a psychological burden on participants. It was also noticed that 26.1% subjects reported insomnia, around 2.9% reported suicidal ideation with suicidal attempts in less than 1% of the participants. Around two percent of the participants complained of OC symptoms with 1 participant fulfilling the diagnostic criteria of OCD as per ICD-10. More than forty percent had a history of substance abuse namely alcohol, tobacco, or both concomitantly along with other drugs. Several other studies that only investigated those who were quarantined, reported a high prevalence of depression (31.2%), insomnia (34.2%) (18),(19).

It is evident form previous outbreaks that there is various psychological impact of quarantine. It can vary from immediate effects, like irritability, fear of infection to family members, anger, confusion, frustration, loneliness, denial, anxiety, depression, insomnia, despair, to extremes of consequences, including suicide (7),(20),(21),(22),(23). Other adverse outcomes included avoidance behaviours (avoiding crowded or public places), detachment from others, symptoms of alcohol use disorder and post-traumatic stress disorder, excessive preoccupation with distressing somatic symptoms, and stigma, as well as domestic violence and suicidal ideation and behaviour (7),(24). Statistically significant association was found in a positive direction between different clinical variables in the present study. It showed that both anxiety and depression were more in those who were having a history of substance abuse, co-morbidities namely hypertension, diabetes, and other cardiac complications. Suicidal ideation, OC symptoms and insomnia were also associated positively with anxiety and depression. It was seen that those who were having co-morbidities are more prone to death (25), so the increased anxiety and depression might be all because of that. Abrupt deterioration in health parameters, sudden death, and uncertain progression of the disease might cause the rise of psychological burden. Scarcity of resources, poor medical facility, stigmatisation, fear of death might prone for a candidate for suicidal ideation, OC symptoms.

Limitation(s)

Sample size was not pre-estimated, all the eligible and consenting participants were recruited in the study. It was a cross-sectional study so association does not imply causation. The confounders such as baseline insomnia, anxiety, depression, suicidal tendency, OC symptoms were not studied.

Conclusion

Psychological impact of quarantine is varied, substantial, and can be long lasting. A significant proportion of the quarantined population suffered from psychological issues. Though, it helps in controlling the prevailing pandemic at one hand, on the other hand it looks like the beginning of another pandemic of depression, anxiety and other psychiatric disorders. So, the psychological impact of a mandatory quarantine should be weighed more thoughtful and in an evidence based manner.

References

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Newman KL. Shutt up: bubonic plague and quarantine in early modern England. Journal of Social History. 2012;45 (3):809-34. [crossref] [PubMed]
2.
Centers for Disease Control and Prevention. (2017). Quarantine and isolation. https://www.cdc.gov/quarantine/index.htm (accessed Jan 30, 2020).
3.
Manuell ME, Cukor J. Mother Nature versus human nature: public compliance with evacuation and quarantine. Disasters. 2011;35 (2):417-42. [crossref] [PubMed]
4.
Coronavirus. Available from: https: //www. who.int/ emergencies /diseases /novel coronavirus 2019. [Last accessed on 2020 Mar 21].
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DOI and Others

DOI: 10.7860/JCDR/2022/51765.16308

Date of Submission: Aug 12, 2021
Date of Peer Review: Sep 29, 2021
Date of Acceptance: Feb 09, 2022
Date of Publishing: May 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 13, 2021
• Manual Googling: Feb 07, 2022
• iThenticate Software: Mar 09, 2022 (17%)

ETYMOLOGY: Author Origin

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