Academic journal article Canadian Psychology

Psychological Impact on SARS Survivors: Critical Review of the English Language Literature

Academic journal article Canadian Psychology

Psychological Impact on SARS Survivors: Critical Review of the English Language Literature

Article excerpt

Severe acute respiratory syndrome (SARS) has been labelled a mental health catastrophe, an infectious atypical pneumonia condition that spread to 29 countries in 2002/2003, infecting over 8,000 people, 774 of whom died. A literature search on electronic databases, including MEDLINE, PsycINFO, CINAHL, and Cochrane Library was used to conduct a critical review of the English language literature on the psychological impact of SARS for survivors. Twenty original studies pertaining to the psychological experience of patients revealed prominent symptoms: in the acute and early recovery stages, psychotic symptomatology, fear for survival, and fear of infecting others; across all timeframes, stigmatization, reduced quality of life, and psychological distress; posttraumatic stress symptoms were prevalent across all stages post-SARS. Health care workers with SARS were found to be at increased risk. Limitations within many studies restrict the optimal usefulness of the findings. Studies included in our review consistently reported high rates of emotional distress among survivors, persisting for years postinfection. Recommendations to enhance comparability across studies for future outbreaks were proposed.

Keywords: SARS, psychological, posttraumatic stress disorder, health care workers, infectious diseases

Résumé

Le syndrome respiratoire aigu sévère (SRAS) a été qualifié de catastrophe de santé mentale. Cette pneumonie atypique infectieuse s'est répandue dans 29 pays en 2002-2003, infectant plus de 8000 personnes, parmi lesquelles 774 en sont mortes. Une recherche a été effectuée au moyen des bases de données électroniques MEDLINE, PsycINFO, CINAHL et la Cochrane Library, en vue d'un résumé critique des articles en anglais sur les répercussions psychologiques du SRAS sur les survivants. Vingt études originales sur l'expérience psychologique de patients ont révélé les symptômes dominants suivants : dans les stades aigus et au début du rétablissement, on note des symptômes psychotiques, la peur pour la survie, la peur d'infecter autrui; à tous les stades, on note la stigmatisation, une qualité de vie amoindrie, la détresse psychologue; à tous les stades après le rétablissement, on note des symptômes de stress post-traumatique. Les travailleurs de la santé ayant eu le SRAS présentaient des risques plus élevés. Les limites de nombre des études restreignent l'utilité optimale des résultats. Les études utilisées dans notre revue de littérature rapportaient systématiquement de hauts taux de troubles émotifs parmi les survivants, lesquels persistaient des années après l'infection. Des recommandations sont formulées en vue d'améliorer la comparabilité des études advenant de nouvelles poussées.

Mots-clés : SRAS, psychologie, syndrome de stress posttraumatique, travailleurs de la santé, maladies infectieuses.

After its first emergence in Asia in November 2002, severe acute respiratory syndrome (SARS) spread throughout several parts of the world and was finally contained by July 2003. This epidemic, with its rapid spread and high mortality rate, generated considerable panic and anxiety around the globe (Campbell, 2006). The origin of SARS was traced to a novel strain of the corona-virus that causes flu-like symptoms, which for many sufferers escalated into clinical pneumonia. In 29 countries, 8,096 individuals were infected, and a wide range of severity was reported, from asymptomatic infection to severe illness and death. Between 20% and 25% of SARS patients became critically ill, requiring intensive care, and ^10%, or 774 individuals, died worldwide (World Health Organization, 2004). In the few studies reviewed to date that pertain to the psychological impact on SARS survivors, high rates of emotional distress were reported, including anxiety, depression, fearfulness, and stigmatization (Chan et al., 2003; Cheng & Wong, 2005; Tsang, Scudds, & Chan, 2004; Zhang, Liu, & He, 2004). However, because most of these studies looked at the period covering the acute phase of the illness and up to 6 months postinfection, we know very little about the longer-term psychological effects of SARS, and we know even less about how the psychological effects of SARS changed over time. …

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