Lam Marco Ho-Bun, Wing Yun-Kwok, Yu Mandy Wai-Man, Leung Chi-Ming, Ma Ronald C W, Kong Alice P S, So W Y, Fong Samson Yat-Yuk, Lam Siu-Ping
Department of Psychiatry, The Chinese University of Hong Kong, China.
Arch Intern Med. 2009 Dec 14;169(22):2142-7. doi: 10.1001/archinternmed.2009.384.
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.
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.
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.
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.
对严重急性呼吸综合征（SARS）幸存者的短期随访研究表明，他们的身体状况在第一年持续改善，但心理健康状况并非如此。我们调查了SARS幸存者的长期精神疾病和慢性疲劳情况。
通过一系列心理测量问卷和针对《精神疾病诊断与统计手册》（第四版）的半结构化临床访谈，对香港当地一个地区医院的所有SARS幸存者进行评估，以确定是否存在精神疾病和慢性疲劳问题。
在369名SARS幸存者中，233人（63.1%）参与了研究（SARS后的平均时间为41.3个月）。超过40%的受访者患有活动性精神疾病，40.3%报告有慢性疲劳问题，27.1%符合1994年美国疾病控制与预防中心修订的慢性疲劳综合征标准。逻辑回归分析表明，SARS感染时为医护人员（比值比[OR]，3.24；95%置信区间[CI]，1.12 - 9.39；P = 0.03）、随访时失业（OR，4.71；95%CI，1.50 - 14.78；P = 0.008）、有社会污名感（OR，3.03；95%CI，1.20 - 7.60；P = 0.02）以及申请过SARS幸存者基金（OR，2.92；95%CI，1.18 - 7.22；P = 0.02）与随访时精神疾病发病风险增加相关，而申请SARS幸存者基金（OR，2.64；95%CI，1.07 - 6.51；P = 0.04）与慢性疲劳问题风险增加相关。
在4年随访时，精神疾病和慢性疲劳在幸存者中持续存在且仍具有临床意义。需要采用多学科方法优化心理健康疾病的治疗，以期进行长期康复，尤其针对精神和疲劳问题以及功能和职业康复。
