survivors: Long-term follow-up
Arch Intern Med. 2009 Dec 14;169(22):2142-7.
Lam MH, Wing YK, Yu MW, Leung CM, Ma RC, Kong AP, So WY, Fong SY, Lam SP.
Department of Psychiatry, The Chinese University of Hong Kong, China.
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% CI, 1.50-14.78; P = .008),
having a perception of social stigmatization (OR, 3.03; 95% CI, 1.20-7.60; P
= .02), and having applied to the SARS survivors' fund (OR, 2.92; 95% CI,
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% CI, 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.
PMID: 20008700 [PubMed - in process]
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