Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors
Identifieur interne : 000091 ( Psycho/Analysis ); précédent : 000090; suivant : 000092Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors
Auteurs : Ivan Wing Chit Mak [Hong Kong] ; Chung Ming Chu [Hong Kong] ; Pey Chyou Pan [Hong Kong] ; Michael Gar Chung Yiu [Hong Kong] ; Suzanne C. Ho [Hong Kong] ; Veronica Lee Chan [Hong Kong]Source :
- General Hospital Psychiatry [ 0163-8343 ] ; 2010.
Abstract
Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS).
The objective of this study was to identify the predictors of chronic PTSD in SARS survivors.
PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the
Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity.
The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.
Url:
DOI: 10.1016/j.genhosppsych.2010.07.007
PubMed: 21112450
PubMed Central: 7132390
Affiliations:
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wicri:level="1"><nlm:aff id="af0005">Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation></author><author><name sortKey="Chu, Chung Ming" sort="Chu, Chung Ming" uniqKey="Chu C" first="Chung Ming" last="Chu">Chung Ming Chu</name><affiliation wicri:level="1"><nlm:aff id="af0005">Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af0015">Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation></author><author><name sortKey="Pan, Pey Chyou" sort="Pan, Pey Chyou" uniqKey="Pan P" first="Pey Chyou" last="Pan">Pey Chyou Pan</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation></author><author><name sortKey="Yiu, Michael Gar Chung" sort="Yiu, Michael Gar Chung" uniqKey="Yiu M" first="Michael Gar Chung" last="Yiu">Michael Gar Chung Yiu</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation></author><author><name sortKey="Ho, Suzanne C" sort="Ho, Suzanne C" uniqKey="Ho S" first="Suzanne C." last="Ho">Suzanne C. Ho</name><affiliation wicri:level="4"><nlm:aff id="af0020">School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong</wicri:regionArea><placeName><settlement type="city">Sha Tin</settlement></placeName><orgName type="university">Université chinoise de Hong Kong</orgName></affiliation></author><author><name sortKey="Chan, Veronica Lee" sort="Chan, Veronica Lee" uniqKey="Chan V" first="Veronica Lee" last="Chan">Veronica Lee Chan</name><affiliation wicri:level="1"><nlm:aff id="af0005">Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af0015">Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon</wicri:regionArea><wicri:noRegion>Kowloon</wicri:noRegion></affiliation></author></analytic><series><title level="j">General Hospital Psychiatry</title><idno type="ISSN">0163-8343</idno><idno type="eISSN">1873-7714</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS).</p></sec><sec><title>Objectives</title><p>The objective of this study was to identify the predictors of chronic PTSD in SARS survivors.</p></sec><sec><title>Design</title><p>PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the <italic>DSM-IV</italic>. Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis.</p></sec><sec><title>Results</title><p>Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity.</p></sec><sec><title>Conclusion</title><p>The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maunder, R G" uniqKey="Maunder R">R.G. Maunder</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hong, N" uniqKey="Hong N">N. Hong</name></author><author><name sortKey="Du, X K" uniqKey="Du X">X.K. 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Schultz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holbrook, T L" uniqKey="Holbrook T">T.L. Holbrook</name></author><author><name sortKey="Hoyt, D B" uniqKey="Hoyt D">D.B. Hoyt</name></author><author><name sortKey="Stein, M B" uniqKey="Stein M">M.B. Stein</name></author><author><name sortKey="Sieber, W J" uniqKey="Sieber W">W.J. Sieber</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cheng, S K W" uniqKey="Cheng S">S.K.W. Cheng</name></author><author><name sortKey="Wong, C W" uniqKey="Wong C">C.W. Wong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tam, W C" uniqKey="Tam W">W.C. Tam</name></author><author><name sortKey="Pang, P F" uniqKey="Pang P">P.F. Pang</name></author><author><name sortKey="Lam, C W" uniqKey="Lam C">C.W. Lam</name></author><author><name sortKey="Chiu, F K" uniqKey="Chiu F">F.K. Chiu</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Hong Kong</li></country><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><country name="Hong Kong"><noRegion><name sortKey="Mak, Ivan Wing Chit" sort="Mak, Ivan Wing Chit" uniqKey="Mak I" first="Ivan Wing Chit" last="Mak">Ivan Wing Chit Mak</name></noRegion><name sortKey="Chan, Veronica Lee" sort="Chan, Veronica Lee" uniqKey="Chan V" first="Veronica Lee" last="Chan">Veronica Lee Chan</name><name sortKey="Chan, Veronica Lee" sort="Chan, Veronica Lee" uniqKey="Chan V" first="Veronica Lee" last="Chan">Veronica Lee Chan</name><name sortKey="Chu, Chung Ming" sort="Chu, Chung Ming" uniqKey="Chu C" first="Chung Ming" last="Chu">Chung Ming Chu</name><name sortKey="Chu, Chung Ming" sort="Chu, Chung Ming" uniqKey="Chu C" first="Chung Ming" last="Chu">Chung Ming Chu</name><name sortKey="Ho, Suzanne C" sort="Ho, Suzanne C" uniqKey="Ho S" first="Suzanne C." last="Ho">Suzanne C. Ho</name><name sortKey="Mak, Ivan Wing Chit" sort="Mak, Ivan Wing Chit" uniqKey="Mak I" first="Ivan Wing Chit" last="Mak">Ivan Wing Chit Mak</name><name sortKey="Pan, Pey Chyou" sort="Pan, Pey Chyou" uniqKey="Pan P" first="Pey Chyou" last="Pan">Pey Chyou Pan</name><name sortKey="Yiu, Michael Gar Chung" sort="Yiu, Michael Gar Chung" uniqKey="Yiu M" first="Michael Gar Chung" last="Yiu">Michael Gar Chung Yiu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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