Blog
About

14
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors

      , F.H.K.C.Psych., F.H.K.A.M. (psychiatry), M.R.C.Psych. (UK), D.C.Psyc., R.C.P.&S. (Irel), M.Sc. Epidemiology and Biostatistics (CUHK) a , b , * , , M.D., F.R.C.P. a , c , , F.H.K.C.Psych., F.H.K.A.M. (psychiatry), M.R.C.Psych. (UK) b , , F.H.K.C.Psych., F.H.K.A.M. (psychiatry), M.R.C.Psych. (UK) b , , M.Sc., M.P.H., Ph.D., F.A.C.E. d , , F.H.K.A.M. (Medicine), M.R.C.P. (UK) a , c

      General Hospital Psychiatry

      Elsevier Inc.

      Severe acute respiratory syndrome, SARS survivors, Post-traumatic stress disorder, Risk factors

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS).

          Objectives

          The objective of this study was to identify the predictors of chronic PTSD in SARS survivors.

          Design

          PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV. Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis.

          Results

          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.

          Conclusion

          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.

          Related collections

          Most cited references 26

          • Record: found
          • Abstract: found
          • Article: not found

          Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents.

          A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Sex differences in posttraumatic stress disorder.

             Naomi Breslau (1997)
            Epidemiologic surveys in the general population documented a higher rate of posttraumatic stress disorder (PTSD) in women than in men. To date, the finding has received little scientific attention. This study examines the extent to which sex differences in PTSD might be explained by previously identified risk factors and whether the sex difference in PTSD varied by age at exposure to traumatic events. The NIMH-DIS (NIMH Diagnostic Interview Schedule, Version III Revised) was used to measure DSM-IIIR disorders in a random sample of 1007 young adults. Cox proportional hazards models were used to estimate changes in the hazards ratio for PTSD associated with sex when potential risk factors were included. Lifetime prevalence of exposure to traumatic events and number of traumatic events did not vary by sex. The prevalence of PTSD was higher for women than for men exposed to traumatic events (hazards ratio, 2.3; 95% confidence interval, 1.5-3.6). Preexisting anxiety disorders or major depressive disorders played a part in the observed sex difference in PTSD. Family history of anxiety disorder and early separation from parents, although significant risk factors for PTSD in subjects of both sexes, were unrelated to the sex difference in PTSD. The sex difference in PTSD was markedly greater if exposure occurred in childhood than later on. Posttraumatic stress disorder is more likely to develop in females than in males after exposure to a traumatic event. Susceptibility to PTSD in females might be greater in childhood than after age 15 years. Explanations of the sex difference might involve characteristics of individuals and of the traumatic experiences.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Osteonecrosis of hip and knee in patients with severe acute respiratory syndrome treated with steroids.

              To evaluate whether there is a relationship between steroid treatment and risk for osteonecrosis of the hip and knee in patients with severe acute respiratory syndrome (SARS). The hospital ethics committee approved the study, and all patients provided written informed consent. A total of 254 patients with confirmed SARS treated with steroids underwent evaluation with magnetic resonance (MR) imaging for osteonecrosis. Clinical profiles, joint symptoms, relevant past medical and drug history, steroid dose, and radiographic and MR imaging evidence of osteonecrosis and other bone abnormalities were evaluated. Mann-Whitney, Kruskal-Wallis, and Pearson exact chi(2) tests were performed, and univariate and multivariate logistic regression analyses were applied. One hundred thirty-four (53%) of 254 patients had recent onset of large joint pain, but 211 (80%) of 264 painful joints were not associated with abnormality on MR images. MR images in 12 (5%) of 254 patients showed evidence of subchondral osteonecrosis in the proximal femur (n = 9), distal femur (n = 2), and proximal and distal femora and proximal tibiae (n = 1). Additional nonspecific subchondral and intramedullary bone marrow abnormalities were present in 77 (30%) of 254 patients. Results of multiple logistic regression analysis confirmed cumulative prednisolone-equivalent dose to be the most important risk factor for osteonecrosis. The risk of osteonecrosis was 0.6% for patients receiving less than 3 g and 13% for patients receiving more than 3 g prednisolone-equivalent dose. No relationship was found between additional nonspecific bone marrow abnormalities and steroid dose. An appreciable dose-related risk was found for osteonecrosis in patients receiving steroid therapy for SARS. Additional nonspecific bone marrow abnormalities were frequent. Joint pain was common after SARS infection and was not a useful clinical indicator of osteonecrosis. (c) RSNA, 2005.
                Bookmark

                Author and article information

                Contributors
                Journal
                Gen Hosp Psychiatry
                Gen Hosp Psychiatry
                General Hospital Psychiatry
                Elsevier Inc.
                0163-8343
                1873-7714
                15 September 2010
                November-December 2010
                15 September 2010
                : 32
                : 6
                : 590-598
                Affiliations
                [a ]Integrated Post-SARS Clinic, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
                [b ]Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
                [c ]Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
                [d ]School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong
                Author notes
                [* ]Corresponding author. Department of Psychiatry, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong. Tel.: +852 35136474; fax: +852 35135505. ucmakwc1@ 123456ha.org.hk
                Article
                S0163-8343(10)00145-3
                10.1016/j.genhosppsych.2010.07.007
                7132390
                21112450
                Copyright © 2010 Elsevier Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                Categories
                Article

                Comments

                Comment on this article