title: Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up.
abstract: BACKGROUND
  Short-term follow-up studies of severe acute respiratory syndrome (SARS) survivors suggested that their physical conditions continuously improved in the first year but that their mental health did not. We investigated long-term psychiatric morbidities and chronic fatigue among SARS survivors.
  
  
  METHODS
  All SARS survivors from the hospitals of a local region in Hong Kong were assessed by a constellation of psychometric questionnaires and a semistructured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) to determine the presence of psychiatric disorders and chronic fatigue problems.
  
  
  RESULTS
  Of 369 SARS survivors, 233 (63.1%) participated in the study (mean period of time after SARS, 41.3 months). Over 40% of the respondents had active psychiatric illnesses, 40.3% reported a chronic fatigue problem, and 27.1% met the modified 1994 Centers for Disease Control and Prevention criteria for chronic fatigue syndrome. Logistic regression analysis suggested that being a health care worker at the time of SARS infection (odds ratio [OR], 3.24; 95% confidence interval [CI], 1.12- 9.39; P = .03), being unemployed at follow-up (OR, 4.71; 95% CI, 1.50-14.78; P = .008), having a perception of social stigmatization (OR, 3.03; 95% CI, 1.20-7.60; P = .02), and having applied to the SARS survivors' fund (OR, 2.92; 95% CI, 1.18-7.22; P = .02) were associated with an increased risk of psychiatric morbidities at follow-up, whereas application to the SARS survivors' fund (OR, 2.64; 95% CI, 1.07-6.51; P = .04) was associated with increased risk of chronic fatigue problems.
  
  
  CONCLUSIONS
  Psychiatric morbidities and chronic fatigue persisted and continued to be clinically significant among the survivors at the 4-year follow-up. Optimization of the treatment of mental health morbidities by a multidisciplinary approach with a view for long-term rehabilitation, especially targeting psychiatric and fatigue problems and functional and occupational rehabilitation, would be needed.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, China.
authors.forename: Marco Ho-Bun
authors.initials: MH
authors.lastname: Lam
authors.forename: Yun-Kwok
authors.initials: YK
authors.lastname: Wing
authors.forename: Mandy Wai-Man
authors.initials: MW
authors.lastname: Yu
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Leung
authors.forename: Ronald C W
authors.initials: RC
authors.lastname: Ma
authors.forename: Alice P S
authors.initials: AP
authors.lastname: Kong
authors.forename: W Y
authors.initials: WY
authors.lastname: So
authors.forename: Samson Yat-Yuk
authors.initials: SY
authors.lastname: Fong
authors.forename: Siu-Ping
authors.initials: SP
authors.lastname: Lam
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000150:complications*; D013997:Time Factors