Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease

Sim, Kang; Huak Chan, Yiong; Chong, Phui Nah; Chua, Hong Choon; Wen Soon, Shok

OBJECTIVE: The psychological and coping responses of the noninfected community towards infectious disease outbreaks are relatively understudied. This cross-sectional study sought to determine the prevalence of severe acute respiratory syndrome (SARS)-related psychiatric and posttraumatic morbidities and associated coping styles within the general population visiting community health care services. METHODS: It was conducted on individuals attending community polyclinics in Singapore within the first week of July 2003, 16 weeks after the first national outbreak of SARS. The General Health Questionnaire-28, Impact of Event Scale-Revised, and Brief COPE were used to determine the prevalence rates of psychiatric and posttraumatic morbidities and employed coping strategies respectively. RESULTS: The overall response rate was 78.0%. Of the 415 community health care setting respondents, we found significant rates of SARS-related psychiatric (22.9%) and posttraumatic morbidities (25.8%). The presence of psychiatric morbidity was associated with the presence of high level of posttraumatic symptoms [adjusted odds ratio (OR) 2.26, 95% confidence interval (CI) 1.24–4.13, P=.008]. Psychiatric morbidity was further associated with being seen at fever stations (adjusted OR 1.90, 95% CI 1.08–3.34, P=.026), younger age (adjusted OR 0.97, 95% CI 0.94–0.98, P=.021), increased self blame (adjusted OR 1.67, 95% CI 1.22–2.28, P=.001), less substance use (adjusted OR 0.74, 95% CI 0.56–0.98, P=.034) and posttraumatic morbidity was associated with increased use of denial (adjusted OR 1.31, 95% CI 1.04–1.67, P=.024), and planning (adjusted OR 1.51, 95% CI 1.16–1.95, P=.002) as coping measures. CONCLUSION: These findings could potentially inform the development of practical community mental health programs for future infectious disease outbreaks.