Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors Long-term Follow-up

被引:521
作者
Lam, Marco Ho-Bun [1 ]
Wing, Yun-Kwok [1 ]
Yu, Mandy Wai-Man [1 ]
Leung, Chi-Ming [1 ]
Ma, Ronald C. W. [2 ]
Kong, Alice P. S. [2 ]
So, W. Y. [2 ]
Fong, Samson Yat-Yuk [1 ]
Lam, Siu-Ping [1 ]
机构
[1] Chinese Univ Hong Kong, Dept Psychiat, Shatin, Hong Kong, Peoples R China
[2] Chinese Univ Hong Kong, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China
关键词
SYNDROME SARS; PSYCHOLOGICAL DISTRESS; STRESS; SCALE; EXPERIENCE; ACTIVATION; OUTBREAK; VERSION;
D O I
10.1001/archinternmed.2009.384
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Short-term follow-up studies of severe acute respiratory syndrome (SARS) survivors suggested that their physical conditions continuously improved in the first year but that their mental health did not. We investigated long-term psychiatric morbidities and chronic fatigue among SARS survivors. Methods: All SARS survivors from the hospitals of a local region in Hong Kong were assessed by a constellation of psychometric questionnaires and a semistructured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) to determine the presence of psychiatric disorders and chronic fatigue problems. Results: Of 369 SARS survivors, 233 (63.1%) participated in the study (mean period of time after SARS, 41.3 months). Over 40% of the respondents had active psychiatric illnesses, 40.3% reported a chronic fatigue problem, and 27.1% met the modified 1994 Centers for Disease Control and Prevention criteria for chronic fatigue syndrome. Logistic regression analysis suggested that being a health care worker at the time of SARS infection (odds ratio [OR], 3.24; 95% confidence interval [CI], 1.12-9.39; P = .03), being unemployed at follow-up (OR, 4.71; 95% Cl, 1.50-14.78; P = .008), having a perception of social stigmatization (OR, 3.03; 95% Cl, 1.20-7.60-1 P = .02), and having applied to the SARS survivors' fund (OR, 2.92; 95% Cl, 1.18-7.22; P = .02) were associated with an increased risk of psychiatric morbidities at follow-up, whereas application to the SARS survivors' fund (OR, 2.64; 95% Cl, 1.07-6.51; P = .04) was associated with increased risk of chronic fatigue problems. Conclusions: Psychiatric morbidities and chronic fatigue persisted and continued to be clinically significant among the survivors at the 4-year follow-up. Optimization of the treatment of mental health morbidities by a multidisciplinary approach with a view for long-term rehabilitation, especially targeting psychiatric and fatigue problems and functional and occupational rehabilitation, would be needed.
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收藏
页码:2142 / 2147
页数:6
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