Posttraumatic stress disorder in convalescent severe acute respiratory syndrome patients: a 4-year follow-up study☆
Received 13 January 2009; accepted 29 June 2009. published online 28 August 2009.
Abstract
Objective
To measure the incidence and impact of posttraumatic stress disorder (PTSD) in a cohort of 70 subjects with severe acute respiratory syndrome (SARS).
Methods
Clinical assessments of PTSD were conducted at 2, 7, 10, 20 and 46 months after discharge from medical hospitalization for treatment of SARS. Diagnoses of PTSD were established by a trained psychiatrist using the Chinese Classification of Mental Disorders (CCMD-III) and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria. To study the impact of PTSD, we used the Impact of Event Scale (IES), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Symptom Checklist 90 (SCL-90), Short Form-36 (SF-36 Health Survey) and Social Disability Screening Schedule (SDSS).
Results
Of the 68 subjects who finished at least two follow-up interviews, 30 developed PTSD over the study period (44.1%). Scores on IES, SAS, SDS and SCL-90 (P<.0001) were higher, and functional impairment as measured by SF-36 (P<.0001) and SDSS was more severe (P=.0073) for subjects with PTSD.
Conclusion
PTSD occurs in a significant percentage of subjects who recover from SARS, and the occurrence of PTSD predicts persistent psychological distress and diminished social functioning in the 4 years after SARS treatment.
aDepartment of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
bDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA
cDepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
dDepartment of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
☆ This study was supported by Peking Union Medical College Hospital (HX, ZXH, JYN, ZW, WJ); the National Institutes of Health, Fogarty International Center (D43TW005814) (E.D. Caine, PI) (HX); and the National Institute of Mental Health Center (P20MH071897) (E.D. Caine, PI) (GC).
ABSTRACT