Quarantine, distress and interpersonal relationships during COVID-19

[...]isolation measures have been associated with increased depression, stress and emotional disturbance.1–3 However, major traumatic events can amplify both positive and negative aspects of interpersonal relations, leading to competing narratives of both harm and enhancement.4 5 Quarantine can create family dependencies, threaten livelihoods and lead to the stigmatisation of those infected.3 6 School closures and disruption of family care seriously disrupt regular domestic practices.2 7 Domestic abuse may burgeon in a situation of forced confinement.1 2 Community relations may become strained as individuals fear infection from others. Anxiety may quickly spread through social networks via a process of ‘emotional contagion’ in which people ‘catch’ the worry of others.8 At the same time, however, large-scale containment may promote common solidarities.3 6 Romantic relationships can provide a sense of security during a time of existential concern.9 New liaisons may arise within and across communities, with community-level support associated with lower levels of distress.10 At present, it is unclear the extent to which relationship enhancement or decline will apply across different forms of relationships. Table 1 Participant characteristics, COVID-19-related aspects, relationships and psychological distress Demographics China (n=1134)* Mean SD N % Age, years 30.99 6.82 Sex, female 607 53.5 In relationship 893 78.7 Rest of China 920 81.1 Hubei region (excluding Wuhan) 86 7.6 Wuhan versus rest of China 128 11.3 Isolation In quarantine versus not in quarantine 142 12.5 Perceived general health 3.95 0.73 Relationships Relationship quality (for those in a relationship) 4.05 1.12 Partner – change since COVID-19 (for those in a relationship) 3.62 1.07 Friendship – change since COVID-19 2.93 1.03 Local community – change since COVID-19 2.75 1.05 Chinese in China – change since COVID-19 2.92 1.16 International relationship (Chinese outside China change) – change since COVID-19 2.45 1.14 Psychological distress K6 ≥13 217 19.1 K6, Kessler distress scale. Supplementary regression analysis, which included the item on partnership quality (rather than change), found a negative correlation between distress and positive relationship change, which persisted when controlling for relationship quality, with no significant curvilinear effect (online supplemental table 1: quadratic term for K6: B=0.002, t=1.67, p=0.10).