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Long-term psychiatric morbidities among SARS survivors
Open accessAbstract
Objective Severe acute respiratory syndrome (SARS) was the first massive infectious disease outbreak of the 21st century. However, it is unlikely that this outbreak will be the last. This study aimed to evaluate the long-term psychiatric morbidities in survivors of SARS.Method This is a cohort study designed to investigate psychiatric complications among SARS survivors treated in the United Christian Hospital 30 months after the SARS outbreak. Psychiatric morbidities were assessed by the Structured Clinical Interview for DSM-IV, the Impact of Events Scale-Revised and the Hospital Anxiety and Depression Scale. Functional outcomes were assessed by the Medical Outcomes Study 36-Item Short-Form Health Survey.Results Ninety subjects were recruited, yielding a response rate of 96.8%. Post-SARS cumulative incidence of DSM-IV psychiatric disorders was 58.9%. Current prevalence for any psychiatric disorder at 30 months post-SARS was 33.3%. One-fourth of the patients had post-traumatic stress disorder (PTSD), and 15.6% had depressive disorders.Conclusion The outbreak of SARS can be regarded as a mental health catastrophe. PTSD was the most prevalent long-term psychiatric condition, followed by depressive disorders. Our results highlight the need to enhance preparedness and competence of health care professionals in detecting and managing the psychological sequelae of future comparable infectious disease outbreaks.
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“Disruption to daily routine and future plans were associated with lower mental wellbeing in previous health crises (Jeong et al., 2016; Mak et al., 2009; Mihashi et al., 2009) and during the COVID-19 pandemic (Williams et al., 2020).”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Mak et al., 2009
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It indicated that participants from Hubei province- the infectious focus directly expose to public health emergency, and may suffer more mental health problemes[17,19].”
From Mental health problems and social media exposure during COVID-19 outbreak (2020) · cites this paper as [19]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“These findings are consistent with the previous studies’ that exposing public health emergency can cause public mental health problems, such as Wenchuan and Lushan earthquakes[17], 2014 Ebola Outbreak[7,18], and SARS[19].”
From Mental health problems and social media exposure during COVID-19 outbreak (2020) · cites this paper as [19]
In the citing paper
“Having experienced epidemics or natural disasters increases long-term levels of depression in populations (Mak et al., 2009; Lee et al., 2018; Morganstein and Ursano, 2020) and may also increase their future suicide rates (Cheung et al., 2008).”
From Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression (2020) · cites this paper as Mak et al., 2009
In the citing paper
“For example, the SARS outbreak in 2003 resulted in a “mental health catastrophe,” in which 59% of patients in a hospitalized cohort developed a diagnosable psychiatric disorder, most commonly post-traumatic stress disorder and depression.”
From Chatbots in the fight against the COVID-19 pandemic (2020) · cites this paper as [14]
In the citing paper
“After 30 months, less than half of this cohort psychologically recovered14.”
From Chatbots in the fight against the COVID-19 pandemic (2020) · cites this paper as [14]
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“The pooled prevalence was also lower compared to rates reported in the MERS (Park et al., 2020a) and SARS epidemics (Mak et al., 2009).”
From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Mak et al., 2009
In the citing paper
“Subsequent studies demonstrated that outbreak-specific stressors resulted in poorer mental health outcomes for all groups, with increased rates of sleep disturbance, post-traumatic stress disorder (PTSD), depression, and anxiety in the short and long term (Mak et al., 2009; Tucci et al., 2017; Wu et al., 2009; Vetter et al., 2016).”
From Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review (2020) · cites this paper as Mak et al., 2009
In the citing paper
“Post-SARS, there has been some research into this area but little is known about the psychological impact during infectious disease outbreaks (Mak et al., 2009).”
From The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review (2020) · cites this paper as Mak et al., 2009
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Metadata
- Authors
- Mak, I. W. C., Chu, C. M., Pan, P. C., Yiu, M. G. C., & Chan, V. L.
- Affiliations
- United Christian Hospital (CN)
- Corresponding author
- Mak, Ivan Wing Chit
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 31
- Issue
- 4
- Pages
- 318-326
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC7112501
- OpenAlex
- W1989377012
- Cited by
- 1,018
- References
- 60
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 38 · 2023: 91 · 2022: 199 · 2021: 324 · 2020: 310 · 2019: 6 · 2018: 4 · 2017: 2 · 2014: 2 · 2013: 2 · 2012: 3
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- General Hospital Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Keywords
- SARS, post-traumatic stress disorder, depressive disorders, psychiatric morbidity, long-term psychological effects, infectious disease outbreaks, healthcare workers
- MeSH terms
- Adult, Depressive Disorder, Disaster Planning, Female, Health Services Needs and Demand, Health Surveys, Hong Kong, Hospitals, General, Humans, Length of Stay, Male, Middle Aged, Morbidity, Psychiatric Status Rating Scales, Quality of Life, Retrospective Studies, Stress Disorders, Post-Traumatic, Cohort Studies, Incidence, Prevalence, Hospitals, Religious, Survivors, Severe Acute Respiratory Syndrome
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