Psychological impact and coping strategies in persons who experienced institutional quarantine for COVID-19 in Sri Lanka

Background: Quarantine is described to be associated with negative psychological consequences. Assessment of the local contexts need to be done in order to design culturally accepted quarantine measures. Aims: We aimed to assess depression, anxiety, stress and coping strategies in those undergoing institutionalized quarantine in Sri Lanka. Methods: A cross sectional descriptive study was done at selected quarantine centers from April to July 2020. All consenting adults under quarantine were included in the study. Depression Anxiety and Stress Scale (DASS-21) and 28-item Brief COPE were used to assess psychological consequences and coping strategies. A telephone interview was conducted 6 months after discharge from quarantine to reassess the psychological status. Results: Of the 367 participants majority (78.7%, n=289) were males, between 25-45 years (60%, n=220) and married (61.9%, n=227). Depression, anxiety and stress was seen in 6% (n=22), 2% (n=7) and 6% (n=22) respectively. Depression, anxiety and stress were significantly higher in females (p<0.05) and in those in quarantine for more than 10 days (p<0.01). Stress was significantly higher in participants with comorbid medical conditions (p<0.05). Active coping, planning, positive reframing, self-blame and venting were associated with a higher degree of psychological impact (p<0.05). The prevalence of depression, anxiety and stress on follow-up was 1.4%, 0% and 3.6% respectively. Conclusions: The levels of depression, anxiety and stress in this study was much lower than in previous literature and improved without specific interventions.