Data_Sheet_1_A Systematic Review of the Impact of Viral Respiratory Epidemics on Mental Health: An Implication on the Coronavirus Disease 2019 Pandemic.DOCX

Background: The twenty-first century viral respiratory epidemics have taught us valuable lessons. Our systematic review examined the impact of these epidemics, including coronavirus disease 2019 (COVID-19), on mental health among different population groups, drawing on their insights for recommendations for the current COVID-19 pandemic.
Methods: Searches were performed on PubMed, Embase, PsycINFO, Web of Science, Scopus, CINAHL, and Cochrane on April 4, 2020. Studies that had undefined mental health outcomes or did not use a validated scale for measure were excluded. Quality assessment was carried out via the Newcastle–Ottawa Scale.
Results: We included 95 studies, most of which were conducted in Hong Kong (31.6%) and China (21.4%). A total of 30 (30.9%) studies are on the general public, 41 (42.2%) on healthcare workers, and 26 (26.6%) on patients and quarantined individuals. Furthermore, 36 (37.1%) of the studies are of high quality, 48 (49.5%) are of moderate quality, and 13 (13.4%) are of low quality. The most significant mental health outcomes reported include anxiety, depression, and post-traumatic stress disorder symptoms. The subgroups identified to have a higher risk of psychiatric symptoms among the general public include females, the elderly, individuals with chronic illness, migrant workers, and students. Long-term mental health impact was reported in some healthcare workers and epidemic patients, even up to 3 years in the former. Interestingly, when compared to non-quarantined groups, quarantine was not significantly associated with worse mental health outcomes.
Conclusion: Important implications for the COVID-19 pandemic were highlighted. Respiratory epidemics pose a significant psychological morbidity onto many population groups. Psychological support for vulnerable groups, including healthcare workers and patients, should be implemented to prevent them from spiraling into clinical psychiatric conditions.

背景：21世纪以来的病毒性呼吸道传染病疫情为我们带来了诸多宝贵经验教训。本系统综述探讨了包括新型冠状病毒肺炎（Coronavirus Disease 2019, COVID-19）在内的此类疫情对不同人群心理健康的影响，并基于研究结论为当前新冠疫情防控提供参考建议。
方法：本研究于2020年4月4日在PubMed、Embase、PsycINFO、Web of Science、Scopus、CINAHL及Cochrane数据库中开展文献检索。排除未明确心理健康结局指标或未使用经过验证的量表进行测评的文献。采用纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale）进行文献质量评价。
结果：本研究共纳入95项文献，其中大部分研究开展于中国香港（31.6%）与中国内地（21.4%）。纳入文献中，30项（30.9%）针对普通人群，41项（42.2%）针对医疗卫生工作者，26项（26.6%）针对患者及隔离人员。按文献质量分级，36项（37.1%）为高质量研究，48项（49.5%）为中等质量研究，13项（13.4%）为低质量研究。报告的主要心理健康结局包括焦虑、抑郁及创伤后应激障碍（post-traumatic stress disorder）症状。在普通人群中，女性、老年人、慢性病患者、外来务工人员及学生被识别为精神症状高风险亚群。部分医疗卫生工作者及疫情相关患者出现了长期心理健康影响，其中前者的影响甚至可持续长达3年。值得注意的是，与未隔离人群相比，隔离措施并未显著加剧心理健康不良结局。
结论：本研究为当前新冠疫情防控提供了重要启示。病毒性呼吸道传染病会对众多人群造成显著的心理疾病负担。应针对医疗卫生工作者及患者等脆弱群体提供心理支持，以防止其进展为临床精神疾病。