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 PHQ-9 is used to monitor the severity of depression. The questionnaire consists of nine items based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for depression, each scored from 0 to 3 providing a severity score ranging from 0 to 27. Accordingly, depression severity was defined as: no depression (1-4), mild depression (5-9), moderate depression (10-14), moderately severe depression (15-19), and severe depression (20-27). The Korean version of the PHQ-9 has been shown to be a reliable and valid tool for the screening and assessment of depressed patients (Cronbach's alpha coefficient=0.81). 3 The IES-R was designed to assess symptoms associated with post-traumatic stress disorder (PTSD) following a traumatic life event (MERS infection in our study). Symptoms are measured on 22 self-reported items for a total subjective stress assessment that can be further divided into intrusion, avoidance, and hyperarousal subscales. Individual items describe difficulties associated with stressful events, and participants were asked to indicate the extent to which each item distressed or bothered them over the last 7 days using a rating scale of 0-4. The Korean IES-R has shown good reliability (Cronbach alpha coefficient=0.93), test-retest reliability (Cronbach alpha coefficient=0.91), and validity for the assessment of PTSD symptom severity. 4 The KNHANES-short form is a shortened version of the KNHANES developed by the Korea Centers for Disease Control and Prevention to assess current stress perception. Most measures of distress are derived from pre-existing structured tools that capture the amount of stress or change associated with stressful events that have occurred over the past month. The KNHANES has been shown to be reliable and valid, suggesting that it may be a useful instrument for assessing current feelings of stress such as burn-out, depression, and anger. 5 The KNHANES-short form is composed of nine items and responses are rated using a five-point Likert scale.