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Cited by 250COVID-19 and Mental HealthLong-Term Effects of COVID-19Posttraumatic Stress Disorder Research

Stress and Psychological Impact on SARS Patients during the Outbreak

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Chua, Siew E, Cheung, Vinci, McAlonan, Grainne M, Cheung, Charlton, Wong, Josephine WS, Cheung, Erik PT, Chan, Marco TY, Wong, Teresa KW +4 more·2004·The Canadian Journal of Psychiatry
DOI 10.1177/070674370404900607
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Abstract

Objective: To examine stress and psychological impact in severe acute respiratory syndrome (SARS) patients during the 2003 outbreak. SARS is a novel, highly infectious pneumonia, and its psychological impact is still unclear. Method: At the peak of the outbreak, SARS patients ( n = 79) and healthy control subjects ( n = 145) completed the Perceived Stress Scale (PSS) and documented a range of psychological responses. Groups were balanced for age, sex, education, and living circumstances. Results: Stress was significantly higher in SARS patients than in healthy control subjects. Stress correlated significantly with negative psychological effects. Of SARS patients, 39% ( n = 30) were infected health care workers; these individuals reported significantly more fatigue and worries about health than did other patients. Of patients, 25% ( n = 20) requested psychological follow-up. Conclusions: General stress and negative psychological effects are increased in SARS patients, particularly among infected health care workers. This may increase the risk of mood and stress-related disorders. Functional impairment is apparent in the postrecovery phase.

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  • In the early SARS outbreak, SARS patients reported psychiatric conditions including high stress, depressive symptoms, anxiety, insomnia, nightmares, and poor concentration.

    “Consistently, in the early stage of the SARS outbreak, the emergency of which had parallels with the COVID-19 epidemic, a range of psychiatric conditions, including high levels of stress, depressive symptoms, anxiety, insomnia, nightmares, and poor concentration, were reported by SARS patients (Chua et al., 2004).”

    From Efficacy of internet-based integrated intervention on depression and anxiety symptoms in patients with COVID-19 (2020) · cites this paper as Chua et al., 2004

  • The immediate aftermath of the SARS epidemic saw the emergence of various psychiatric comorbidities, with the most common presenting problems involving increased levels of anxiety, depression, and features of post-traumatic stress reactions.

    “For example, the immediate aftermath of the SARS epidemic saw the emergence of various psychiatric comorbidities, with the most common presenting problems involving increased levels of anxiety, depression, and features of post-traumatic stress reactions [3,4,5,6].”

    From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [4]

  • In prior SARS, MERS, and Ebola outbreaks, about half of survivors had at least one of the psychiatric conditions reviewed here.

    “Past epidemics caused by SARS, MERS, or ebola have demonstrated that half of the survivors suffered from at least one of the psychiatric conditions examined in this review (Chua et al., 2004; Keita et al., 2017).”

    From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Chua et al., 2004

  • Even allowing for over-sensitive diagnosis, anxiety was less common than in SARS, MERS, and Ebola outbreaks and than in short-term symptom studies.

    “Even when disregarding the potential for over-sensitivity of diagnosis in the included studies, the overall prevalence for anxiety was lower compared with SARS, MERS, and ebola epidemics (Chua et al., 2004; Keita et al., 2017; Jeong et al., 2016) than studies that looked at short-term symptoms (Krishnamoorthy et al., 2020).”

    From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Chua et al., 2004

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Authors
Chua, S. E., Cheung, V., McAlonan, G. M., Cheung, C., Wong, J. W., Cheung, E. P., Chan, M. T., Wong, T. K., Choy, K. M., Chu, C. M., Lee, P. W., & Tsang, K. W.
Affiliations
  • Queen Mary Hospital (CN)
  • Hospital Authority (HK)
  • United Christian Hospital (CN)
Corresponding author
Chua, Siew E
ORCID
Venue
The Canadian Journal of Psychiatry
Publisher
SAGE Publications
Published
2004-06
Volume
49
Issue
6
Pages
385-390
ISSN
  • 0706-7437 (ISSN-L)
  • 1497-0015
DOI
10.1177/070674370404900607
OpenAlex
W2148469445
Cited by
250
References
12
Citations by year
2026: 3 · 2025: 4 · 2024: 10 · 2023: 25 · 2022: 45 · 2021: 59 · 2020: 65 · 2019: 3 · 2016: 1 · 2014: 2 · 2013: 2 · 2012: 2
FWCI
6.39
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The Canadian Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
Queen Mary University of London
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, psychological stress, psychological impact, 2003 SARS outbreak, healthcare workers, fatigue, psychological follow-up, stress-related disorders
MeSH terms
Adolescent, Adult, Major Depressive Disorder, Disease Outbreaks, Follow-Up Studies, Humans, Judgment, Middle Aged, Psychometrics, Surveys and Questionnaires, Stress, Psychological, Health Behavior, Severe Acute Respiratory Syndrome

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