Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors Long-term Follow-up
Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors Long-term Follow-up
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DOI：
10.1001/archinternmed.2009.384
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发表时间：
2009-12-14
影响因子：
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通讯作者：
Lam, Siu-Ping
中科院分区：
文献类型：
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作者：
Lam, Marco Ho-Bun;Wing, Yun-Kwok;Lam, Siu-Ping
背景资料：对严重急性呼吸系统综合症（萨斯）幸存者的短期跟踪研究表明，他们的身体状况在第一年不断改善，但他们的心理健康没有改善。我们调查了SARS幸存者的长期精神病发病率和慢性疲劳。方法：所有SARS幸存者从香港当地的一个地区的医院进行了评估的一系列心理测量问卷和半结构化的临床访谈的诊断和统计手册的精神障碍（第四版），以确定是否存在精神疾病和慢性疲劳问题。结果：在369名SARS幸存者中，233人（63.1%）参加了研究（SARS后平均时间为41.3个月）。超过40%的受访者患有活动性精神疾病，40.3%的人报告有慢性疲劳问题，27.1%的人符合1994年疾病控制和预防中心修订的慢性疲劳综合征标准。Logistic回归分析提示，SARS流行时从事医务工作者（比值比[OR]，3.24; 95%置信区间[CI]，1.12-9.39; P = .03），随访时失业（OR，4.71; 95% CI，1.50-14.78; P = 0.008），有社会耻辱感（OR，3.03; 95%CI，1.20-7.60-1 P = .02），并已申请SARS幸存者基金（OR，2.92; 95%CI，1.18-7.22; P = 0.02）与随访时精神病发病风险增加相关，而SARS幸存者基金的应用（OR，2.64; 95%CI，1.07-6.51; P = 0.04）与慢性疲劳问题的风险增加相关。结论：精神病发病率和慢性疲劳持续存在，并在4年随访的幸存者中继续具有临床意义。需要通过多学科方法优化精神疾病的治疗，以期实现长期康复，特别是针对精神和疲劳问题以及功能和职业康复。
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.