Posttraumatic stress disorder in convalescent severe acute respiratory syndrome patients: a 4-year follow-up study.

Objective: To measure the incidence and impact of posttraumatic stress disorder (PTSD) in a cohort of 70 subjects with severe acute respiratory syndrome (SARS).

Methods: Clinical assessments of PTSD were conducted at 2, 7, 10, 20 and 46 months after discharge from medical hospitalization for treatment of SARS. Diagnoses of PTSD were established by a trained psychiatrist using the Chinese Classification of Mental Disorders (CCMD-III) and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria. To study the impact of PTSD, we used the Impact of Event Scale (IES), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Symptom Checklist 90 (SCL-90), Short Form-36 (SF-36 Health Survey) and Social Disability Screening Schedule (SDSS).

Results: Of the 68 subjects who finished at least two follow-up interviews, 30 developed PTSD over the study period (44.1%). Scores on IES, SAS, SDS and SCL-90 (P<.0001) were higher, and functional impairment as measured by SF-36 (P<.0001) and SDSS was more severe (P=.0073) for subjects with PTSD.

Conclusion: PTSD occurs in a significant percentage of subjects who recover from SARS, and the occurrence of PTSD predicts persistent psychological distress and diminished social functioning in the 4 years after SARS treatment.