Psychiatric Findings in Suspected and Confirmed Middle East Respiratory Syndrome Patients Quarantined in Hospital: A Retrospective Chart Analysis

Kim, Hyun-Chung; Yoo, So-Young; Lee, Bun-Hee; Lee, So Hee; Shin, Hyoung-Shik

The recent outbreaks of SARS in Asia and Canada provide the most recent data on emerging infectious diseases (EIDs). Psychiatric disorders and chronic fatigue were prevalent among SARS survivors 3 years after contracting the disease and were associated with various functional impairments. 7 However, to our knowledge, our study is the first to use selfreported measures to assess risk factors for the development of psychiatric symptoms during the acute treatment period. About 35% of SARS survivors reported moderate-to-severe or severe anxiety and/or depressive symptoms 1 month after recovery. 8 Moreover, SARS survivors had elevated levels of psychological distress 1 year after the outbreak, and 64% scored above the General Health Questionnaire cut-off for psychiatric morbidity. 9 The current prevalence for any psychiatric disorder 30 months post-SARS is 33.3%. 10 A biopsychosocial model may explain the development of psychiatric symptoms in patients with MERS. Relevant biological factors may be weight loss of 10 kg to 20 kg, 11 antiviral agent side effects, 12 pre-existing disabilities (e.g., blindness or hearing impairment), or a history of psychiatric disorders. Relevant psychological factors include tension, fear, anger, mistrust, and depressed mood due to MERS and subsequent isolation during quarantine. 2 Additionally, we found that the level of daily distress over the past month and post-traumatic stress symptoms may be risk factors for depression during acute hospital quarantine. Social factors that may have led to unhappiness during treatment include financial losses attributable to isolation and separation from young children or parents at home.