title: [Mental health status and effects on daily life of patients of a large outbreak of Legionnaires Disease].
abstract: OBJECTIVE
  The aim of this study was to survey mental health status among patients of a large outbreak of Legionnaires Disease (LD) occurring at a public bath in Hyuga City, Miyazaki Prefecture, from June through July, 2002. It also aimed to provide a basis for establishing a mental health care support system for persons suffering from ill health.
  
  
  METHODS
  Some 295 patients were reported by medical institutions to public health centers as being infected with LD or having suspected infection after using a hot springs bath, where hygiene was assumed to be maintained by regular water circulation, from 6/20 through 7/23, 2002 in Hyuga City, Miyazaki Prefecture. A total of 153 subjects consented to interviews after being informed of the objectives. They were visited and interviewed with a questionnaire from 10/12 through 12/5, 2002. Questions about mental health were written to identify "feeling stressed", based on diagnostic criteria for Post Traumatic Stress Disorder (PTSD) as noted in the DSM-IV. The Japanese version of the General Health Questionnaire (GHQ28) was used to identify high risk subjects for mental disorder, as well as the following four symptoms: "somatic symptoms", "anxiety and insomnia", "social dysfunction", and "severe depression". Factors associated with these were assessed with regard to knowledge and/or information about LD and its effects on daily life.
  
  
  RESULTS
  Regarding mental health, 27 (17.6%) were "feeling stressed". High risk patients for mental disorder numbered 39 (25.5%) according to the GHQ28. Patients with "somatic symptoms" numbered 44 (28.8%), those with "anxiety and insomnia" 21 (13.7%), those with "social dysfunction" 18 (11.8%) and with "severe depression" 5 (3.3%). Among the effects on daily life, "changes of human relationships" was related with "feeling stressed" in those suspected of LD infections (P = 0.022). High risk was related to "economic support" (P = 0.009) in LD, and also to "cause and survey" (P = 0.035) in those cases suspected of LD.
  
  
  CONCLUSIONS
  At 3 to 4 months after the outbreak, the patients still exhibited mental health problems. Therefore we should provide health and social support that deals with the factors identified on a longer-term or continuous basis.
authors.affiliation: School of Nursing, Miyazaki Medical College, University of Miyazaki.
authors.forename: Kurumi
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujii
authors.forename: Hitomi
authors.initials: H
authors.lastname: Maeda
authors.forename: Tazuko
authors.initials: T
authors.lastname: Murakata
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kato
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D005260:Female; D006306:Health Surveys; D006801:Humans; D007877:Legionnaires' Disease / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires