Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak
Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak
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DOI：
10.1176/ps.2008.59.1.91
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发表时间：
2008-01-01
影响因子：
3.8
通讯作者：
Goldbloom, David S.
中科院分区：
文献类型：
--
作者：
Lancee, William J.;Maunder, Robert G.;Goldbloom, David S.
目的：本研究旨在确定2003年严重急性呼吸系统综合征（SARS）爆发后一至两年期间多伦多卫生保健工作者精神疾病的发病率，并检验预测的危险因素。方法：采用DSM-IV结构化临床访谈和临床应用PTSD量表对139名医护人员的精神障碍新发发作进行评估。精神疾病的既往病史、多年的医疗保健经验以及对适当培训和支持的感知作为SARS爆发后新发精神疾病发作的预测因素进行了测试。结果：任何抑郁、焦虑或物质使用诊断的终生患病率为30%。只有一名将SARS经历视为创伤性事件的医护人员被诊断为患有创伤后应激障碍。7名卫生保健工作者（5%）出现精神疾病新发作。精神疾病的新发作与SARS爆发前的精神病史直接相关（p= 0.02），与卫生保健经验年数（p= 0.03）和感知到的培训和支持的充分性（p= 0.03）呈负相关。结论：SARS暴发后精神疾病的新发发生率与社区发病率相似或低于社区发病率，这可能表明SARS暴发后1 - 2年继续在医院工作的医护人员的复原力较强。在为未来事件（如大流行性流感）做准备时，培训和支持可增强卫生保健工作者的复原力，这些工作者由于其精神病史和较少的卫生保健经验而面临更高的风险。
Objective: This study aimed to determine the incidence of psychiatric disorders among health care workers in Toronto in the one- to two-year period after the 2003 outbreak of severe acute respiratory syndrome (SARS) and to test predicted risk factors. Methods: New-onset episodes of psychiatric disorders were assessed among 139 health care workers by using the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale. Past history of psychiatric illness, years of health care experience, and the perception of adequate training and support were tested as predictors of the incidence of new-onset episodes of psychiatric disorders after the SARS outbreak. Results: The lifetime prevalence of any depressive, anxiety, or substance use diagnosis was 30%. Only one health care worker who identified the SARS experience as a traumatic event was diagnosed as having PTSD. New episodes of psychiatric disorders occurred among seven health care workers (5%). New episodes of psychiatric disorders were directly associated with a history of having a psychiatric disorder before the SARS outbreak (p=.02) and inversely associated with years of health care experience (p=.03) and the perceived adequacy of training and support (p=.03). Conclusions: Incidence of new episodes of psychiatric disorders after the SARS outbreak were similar to or lower than community incidence rates, which may indicate the resilience of health care workers who continued to work in hospitals one to two years after the SARS outbreak. In preparation for future events, such as pandemic influenza, training and support may bolster the resilience of health care workers who are at higher risk by virtue of their psychiatric history and fewer years of health care experience.