title: Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic.
abstract: OBJECTIVE
  The aim of the study was to examine, among hospital employees exposed to an outbreak of severe acute respiratory syndrome (SARS), post-outbreak levels of depressive symptoms and the relationship between those depressive symptom levels and the types of outbreak event exposures experienced.
  
  
  METHODS
  In 2006, randomly selected employees (N = 549) of a hospital in Beijing were surveyed concerning their exposures to the city's 2003 SARS outbreak and the ways in which the outbreak had affected their mental health. Subjects were assessed on sociodemographic factors, on types of exposure to the outbreak, and on symptoms of posttraumatic stress disorder and depression.
  
  
  RESULTS
  The results of multinomial regression analyses showed that, with other relevant factors controlled for, being single, having been quarantined during the outbreak, having been exposed to other traumatic events before SARS, and perceived SARS-related risk level during the outbreak were found to increase the odds of having a high level of depressive symptoms 3 years later. Altruistic acceptance of risk during the outbreak was found to decrease the odds of high post-outbreak depressive symptom levels.
  
  
  CONCLUSIONS
  Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware that the experience of being quarantined can, in some cases, lead to long-term adverse mental health consequences.
authors.affiliation: Mailman School of Public Health, Columbia University, NY10032, USA.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Liu
authors.forename: Meghana
authors.initials: M
authors.lastname: Kakade
authors.forename: Cordelia J
authors.initials: CJ
authors.lastname: Fuller
authors.forename: Bin
authors.initials: B
authors.lastname: Fan
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Fang
authors.forename: Junhui
authors.initials: J
authors.lastname: Kong
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Guan
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology