SARS outbreak caused psychological trauma: physicians also affected.(Clinical Rounds)

CHICAGO -- The Toronto outbreak of severe acute respiratory syndrome led to many cases of posttraumatic stress disorder--both in infected patients and in the health care professionals providing care for them, researchers reported at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy

Among the factors that combined to create a psychologically devastating condition were the high lethality of SAPS, the lack of information about the nature of the disease during the early stages of the outbreak, the isolation and quarantine entailed in its management, incessant media reminders of the danger, and the way SARS swept through families, often leaving multiple members seriously ill or dead.

Should SAPS outbreaks occur elsewhere in coming respiratory illness seasons, physicians can expect to encounter rates of posttraumatic stress disorder (PTSD) as high as the 58% rate observed in Toronto And even if SARS doesn't resurface in Toronto during the upcoming respiratory illness season, it's likely that the experience of encountering people with other less serious febrile respiratory illnesses will trigger worsening of PTSD symptoms in individuals who developed the psychiatric disorder during the spring 2003 outbreak, according to Toronto investigators.

University of Toronto psychiatrist Rima Styra reported on a sample of 33 patients who underwent psychiatric assessment 4-8 weeks after being diagnosed with SARS and treated at three Toronto hospitals. They had an extremely high mean score of 24.8 on the Impact of Event Scale-Revised (IES-R), a standardized measure of PTSD symptoms. In comparison, the mean score was 20.2 in a recent study of war correspondents.

Overall, 58% of the SAPS patients met criteria for PTSD. That's a higher rate than previously reported among ICU patients or women with HIV ...