Mitigating the psychological effects of social isolation during the covid-19 pandemic

by

Mohammad S Razai, Pippa Oakeshott, Hadyn Kankam, Sandro Galea, Helen Stokes-Lampard

Published 21 May 2020

Note

Patient Health Questionnaire-4 (PHQ-4) screening questions for anxiety and depression

Over the last two weeks, how often have you been bothered by the following problems:

1. Feeling nervous, anxious or on edge?

2. Not being able to stop or control worrying?

3. Little interest or pleasure in doing things?

4. Feeling down, depressed, or hopeless?

To score answers, the responses should be coded as follows:

Add the scores for each question together to give a possible total score from 0 to 12, with categories of psychological distress being:

  • Scores 0-2 = None
  • Scores 3-5 = Mild
  • Scores 6-8 = Moderate
  • Scores 9-12 = Severe
  • Anxiety subscale = Sum of items 1 and 2 (score range 0 to 6)
  • Depression subscale = Sum of items 3 and 4 (score range 0 to 6)

The UCLA Loneliness Scale

  1. How often do you feel that you lack companionship?
  2. How often do you feel left out?
  3. How often do you feel isolated from others?

To score answers, the responses should be coded as follows:

Add the scores for each question together to give a possible total score from 3 (least lonely) to 9 (most lonely):

  • Scores 3-5 = Not lonely
  • Scores 6-9 = Lonely

WHO advice for people in isolation

  • Stay connected and maintain your social networks
  • Keep your daily routines or create new ones if circumstances change
  • During social distancing, stay connected to friends, family, and community members via telephone, email, social media, or video conference
  • During times of stress, pay attention to your own needs and feelings
  • Engage in healthy activities that you enjoy and find relaxing
  • Exercise regularly, keep regular sleep routines, and eat healthy food
  • A near constant stream of news reports can cause anyone to feel anxious or distressed. Seek information updates and practical guidance at specific times during the day from health professionals or reliable sources such as the WHO
  • Avoid listening to or following rumours that make you feel uncomfortable

Reference

The BMJ – DOI: https://www.doi.org/10.1136/bmj.m1904 

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