Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS)
Abstract
Background. Severe acute respiratory syndrome (SARS) is a novel disease. The authors have limited knowledge of its impact on mental health. The present study aimed to examine the level and extent of psychological distress of SARS survivors following 1-month recovery, to explore patients' negative appraisals of the impact of SARS, and to evaluate the associations between psychological distress and negative appraisals. Method. The Beck Anxiety Inventory, the Beck Depression Inventory, and a newly developed measure, the SARS Impact Scale (SIS), were mailed to 453 Hong Kong Chinese SARS survivors discharged from hospital for 4 weeks or more. Results. A total of 425 patients received the questionnaires and 180 (mean age 36·9 years; 120 women) gave valid replies. The response rate was 42·4%. The participants also represented 13·6% of all adult survivors in Hong Kong. About 35% of respondents reported ‘moderate to severe’ or ‘severe’ ranges of anxiety and/or depressive symptoms. It was found that those working as healthcare workers or having family members killed by SARS were more prone to develop subsequent high levels of distress. Factor analyses extracted three meaningful factors of the SIS, namely ‘survival threat’, ‘physical impact’, and ‘social impact’. Negative appraisals at the acute phase and 1-month recovery significantly accounted for substantial portions of variances for anxiety and depressive symptoms, after the effects of other psychosocial variables were controlled. Conclusions. Psychological distress of SARS survivors at 1-month recovery is real and significant. Negative appraisals may play a pivotal role in the development of psychological distress for SARS survivors, at least in the short term.
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Previous reports have documented high levels of anxiety and depression among SARS survivors (35%), quarantined individuals (31%), and nurses (38.5%).
“This is in agreement with previous reports which have also documented high levels of anxiety, depression amongst survivors of SARS (35%) [35], quarantined individuals (31%) [36], and nurses (38.5%) [34].”
From Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease (2010) · cites this paper as [35]
SARS survivors reported psychiatric symptoms including PTSD, depression, panic disorder, and OCD at 1 to 50 months follow-up.
“SARS survivors reported psychiatric symptoms, including post-traumatic stress disorder (PTSD), depression, panic disorder, and obsessive-compulsive disorder (OCD) at 1 to 50 months follow up (Wu et al., 2020, Cheng et al., 2004, Lam et al., 2009).”
From Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors (2020) · cites this paper as Cheng et al., 2004
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Self-citation
- Authors
- CHENG, S. K. W., WONG, C. W., TSANG, J., & WONG, K. C.
- Affiliations
- Kwai Chung Hospital (CN)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2004-10
- Volume
- 34
- Issue
- 7
- Pages
- 1187-1195
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2066347032
- Cited by
- 347
- References
- 10
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 12 · 2023: 26 · 2022: 73 · 2021: 107 · 2020: 90 · 2019: 1 · 2018: 1 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- SARS, SARS survivors, psychological distress, anxiety, depression, negative appraisals, survival threat, social impact, healthcare workers, post-discharge recovery, Hong Kong Chinese
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Depression, Female, Hong Kong, Humans, Life Change Events, Male, Middle Aged, Personality Inventory, Psychometrics, Sick Role, Survivors, Severe Acute Respiratory Syndrome
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