Journal of Modern Medical

Introduction
The coronavirus disease 2019 (COVID-19) was first detected in Wuhan, China on December 31, 2019, and quickly spread to other countries [1]. During the outbreak of COVID-19, due to its unknown nature, rapid transmission, and high infection rate, many people around the world experienced various emotions and lost the ability to make the right decision. Emotion regulation strategies are among the variables that can affect people’s mental health during the COVID-19 pandemic [9, 10]. Emotion regulation helps people in reducing, increasing or maintaining emotional components; in case of stressful and critical situations such as the COVID-19 pandemic, these strategies can play a significant role in reducing the intensity of negative emotions [11, 12]. Studies conducted during the COVID-19 pandemic have shown that people with self-blame, rumination and non-acceptance experience high anxiety and depression [17]. On the other hand, people who used adaptive cognitive emotion regulation strategies such as positive reappraisal and positive refocusing on planning had better psychological and physical health [18, 19]. Considering that COVID-19 is still evolving, the use of adaptive emotion regulation strategies is one of the ways for reducing people’s anxiety and tension during this pandemic. The current study aims to investigate the effect of emotion regulation strategies in the mental health of people during the COVID-19 pandemic.
Methods
This is a systematic review study that was conducted in 2021 by searching in Google Scholar, PubMed, Springer, Web of Science, Scopus, and Science Direct databases using the keywords COVID-19, Psychological Implications, Mental Health, Emotion Regulation Strategies, and Pandemic for the studies published in English from Feb. 2020 to Dec. 2021. After founding articles, irrelevant and duplicate articles were removed. In the next stage, the full texts of the remaining articles were examined. After removing the irrelevant ones, the results of the selected articles were categorized and analyzed in the final stage. In this study, the PRISMA guidelines for systematic reviews was used for reporting [22]. The articles for the review were selected using a purposive method based on the exclusion criteria (unavailability of the full text, letters to the editor, case reports, and lack of abstract) and entry criteria (relevance to the study objectives, having a structured framework, and publication in a reputable journal).
Results
The findings of the two reviewed articles regarding the role of emotion regulation strategies in mental health during the COVID-19 pandemic are reported in Table 1 as an example.


Among 538 articles related to the role of emotion regulation strategies in mental health during the COVID-19 pandemic, 23 articles were selected and reviewed. The studies showed that emotion regulation strategies during the COVID-19 pandemic had positive effects on students, nurses, doctors, parents, athletes and patients with COVID-19. The use of adaptive emotion regulation strategies reduced anxiety, depression, insomnia, fear, burnout, anger, distress, cognitive bias, rumination, and catastrophizing, which resulted in an increase in people’s quality of life and mental health.
Discussion
This review study was conducted with the aim of investigating the role of emotion regulation strategies in mental health during the COVID-19 pandemic. The results showed that people who used adaptive emotion regulation strategies such as positive reappraisal and positive refocusing on planning coped better with the anxiety and stress of COVID-19. On the other hand, it was found that the use of maladaptive emotion regulation strategies such as catastrophizing, rumination, and blaming others aggravated the psychological disorders during the pandemic. During the outbreak of COVID-19, many people were influenced by the news related to the number of infected and dead people; regardless of the source of the news, they only followed the events surrounding this deadly virus. On the other hand, with the severe social restrictions and the closure of many schools, universities and high-risk jobs, the social interactions of the people were reduced which affected their mental health. Studies conducted during the COVID-19 pandemic showed that infected patients who used adaptive cognitive emotion regulation strategies had better psychological and physical health. On the other hand, using maladaptive emotion regulation strategies increased anxiety, stress and fear in people [18, 19, 20, 21, 22, 23, 24]. Considering that the COVID-19 is still mutating, it is necessary to pay more attention to the psychological consequences of this disease.

Ethical Considerations
Compliance with ethical guidelines
This article is a meta-analysis with no human or animal sample.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
All authors equally contributed to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.


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