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      Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza


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          In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak.


          Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure.


          In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57–2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36–2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82–2.73; p < 0.001).


          Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.

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          Interpreting scores on the Kessler Psychological Distress Scale (K10).

          To provide normative data on the Kessler Psychological Distress Scale (K10), a scale that is being increasingly used for clinical and epidemiological purposes. The National Survey of Mental Health And Well-Being was used to provide normative comparative data on symptoms, disability, service utilisation and diagnosis for the range of possible K10 scores. The K10 is related in predictable ways to these other measures. The K10 is suitable to assess morbidity in the population, and may be appropriate for use in clinical practice.
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            Fear of severe acute respiratory syndrome (SARS) among health care workers.

            In this study, the authors examined fear related to severe acute respiratory syndrome (SARS) among 2 samples of hospital staff in Hong Kong. Sample 1 included health care workers (n=82) and was assessed during the peak of the SARS epidemic. Sample 2 included hospital staff who recovered from SARS (n=97). The results show that participants in both samples had equal, if not more, concern about infecting others (especially family members) than being self-infected. Sample 1 participants had stronger fear related to infection than Sample 2 participants, who seemed to be concerned more about other health problems and discrimination. Participants with lower self-efficacy tended to have higher fear related to SARS. Fear related to SARS was also correlated positively with posttraumatic stress symptoms among respondents of Sample 2 (recovered staff). Interventions based on these findings are described. Copyright (c) 2005 APA, all rights reserved
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              Evaluation of 2 measures of psychological distress as screeners for depression in the general population.

              Structured diagnostic interviews are very time-consuming and therefore increase both the expense and the respondent burden in epidemiologic surveys. A 2-staged interview that screens potential cases before the full diagnostic instrument is administered has the potential to greatly reduce the average interview length. In this paper, we evaluate 2 measures of psychological distress (the Kessler 6- and 10-Item Psychological Distress Scales [K6 and K10]) as potential screening instruments for depression. We use data from Cycle 1.2 of the Canadian Community Health Survey and receiver operator characteristic analysis to examine the agreement between the K6 and K10 and the World Mental Health Composite International Diagnostic Interview module for major depression (1-month and 12-month estimates). Of the respondents, 823 were positive for 1-month depression (2.0%; 95% confidence interval [CI], 1.8% to 2.2%), and 1930 were positive for 12-month depression (4.8%; 95%CI, 4.5% to 5.1%). Both the K6 and K10 performed very well as predictors of 1-month depression, with areas under the curve (AUC) of 0.929 (95%CI, 0.908 to 0.949) for the K10 and 0.926 (95%CI, 0.905 to 0.947) for the K6. For 12-month depression, the AUCs remained good at 0.866 (95%CI, 0.848 to 0.883) for the K10 and 0.858 (95%CI, 0.840 to 0.876) for the K6. Both the K6 and the K10 appear to be excellent screening instruments, especially for current depression. Although performance of the 2 instruments is similar, the K6 is more attractive for use as a screening instrument because of the lower response burden.

                Author and article information

                BMC Public Health
                BMC Public Health
                BioMed Central
                3 October 2008
                : 8
                : 347
                [1 ]Science of Mental Health and Adversity Unit, School of Medicine, University of Western Sydney, Australia
                Copyright © 2008 Taylor et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 18 April 2008
                : 3 October 2008
                Research Article

                Public health
                Public health


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