Depression as a Mediator of Chronic Fatigue and Post-Traumatic Stress Symptoms in Middle East Respiratory Syndrome Survivors
1
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Objective The relationship among chronic fatigue, depressive symptoms, and post-traumatic stress symptoms (PTSSs) among Middle East respiratory syndrome (MERS) survivors is poorly understood. Methods Of 148 survivors who consented to be registered and underwent assessments at 12 months (T1) and 18 months (T2) after the MERS outbreak, 72 (48.65%) were evaluated for chronic fatigue, depressive symptoms, and PTSSs based on the Impact of Event Scale- Revised (IES-R), the Patient Health Questionnaire-9 (PHQ-9), and the Fatigue Severity Scale (FSS). Data from 52 subjects, who completed both assessments, were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6). Results Bootstrap analyses indicated no direct effects of T1 FSS on T2 IES-R but significant positive indirect effects of T1 FSS on T2 IESR through T1 PHQ-9 and T2 PHQ-9 (B=2.1601, SE=1.3268, 95% confidence interval=0.4250–6.1307). In other words, both T1 PHQ-9 and T2 PHQ-9 fully mediated the relationship between T1 FSS and T2 IES. Conclusion Chronic fatigue 12 months after MERS had indirect effects on prolonged PTSSs 18 months after MERS via persisting depression in MERS survivors. This finding supports the need to promote interventional programs for emerging infectious disease survivors with chronic fatigue to reduce depression and prevent prolonged PTSSs.
Abstract
Objective The relationship among chronic fatigue, depressive symptoms, and post-traumatic stress symptoms (PTSSs) among Middle East respiratory syndrome (MERS) survivors is poorly understood. Methods Of 148 survivors who consented to be registered and underwent assessments at 12 months (T1) and 18 months (T2) after the MERS outbreak, 72 (48.65%) were evaluated for chronic fatigue, depressive symptoms, and PTSSs based on the Impact of Event Scale- Revised (IES-R), the Patient Health Questionnaire-9 (PHQ-9), and the Fatigue Severity Scale (FSS). Data from 52 subjects, who completed both assessments, were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6). Results Bootstrap analyses indicated no direct effects of T1 FSS on T2 IES-R but significant positive indirect effects of T1 FSS on T2 IESR through T1 PHQ-9 and T2 PHQ-9 (B=2.1601, SE=1.3268, 95% confidence interval=0.4250–6.1307). In other words, both T1 PHQ-9 and T2 PHQ-9 fully mediated the relationship between T1 FSS and T2 IES. Conclusion Chronic fatigue 12 months after MERS had indirect effects on prolonged PTSSs 18 months after MERS via persisting depression in MERS survivors. This finding supports the need to promote interventional programs for emerging infectious disease survivors with chronic fatigue to reduce depression and prevent prolonged PTSSs.
참고문헌 (25)
- Cho SY, "MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea : an epidemiological outbreak study", Lancet, 388, pp.994~1001 (2016)
- Moldofsky H, "Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study", BMC Neurol, 11, pp.37~ (2011)
- Tansey CM, "One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome", Arch Intern Med, 167, pp.1312~1320 (2007)
- Lee AM, "Stress and psychological distress among SARS survivors 1 year after the outbreak", Can J Psychiatry, 52, pp.233~240 (2007)
- Wing YK, "Mental health impact of severe acute respiratory syndrome : a prospective study", Hong Kong Med J, 18, pp.24~27 (2012)
- Mohammed A, "An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria : a cross sectional study--2014", BMC Public Health, 15, pp.1~8 (2015)
- Keita MM, "Depressive symptoms among survivors of Ebola virus disease in Conakry(Guinea) : preliminary results of the PostEboGui cohort", BMC Psychiatry, 17, pp.127~ (2017)
- 정현석, "Mental health status of people isolated due to Middle East Respiratory Syndrome", Epidemiology and Health, 38, pp.1~7 (2016), 한국역학회[DOI]
- Park JS, "Mental health of nurses working at a government-designated hospital during a MERS-CoV outbreak : a cross-sectional study", Arch Psychiatr Nurs, 32, pp.2~6 (2018)
- 심민영, "Psychological trauma of Middle East Respiratory Syndrome victims and bereaved families", Epidemiology and Health, 38, pp.1~1 (2016), 한국역학회[DOI]
- Krupp LB, "The fatigue severity scale : application to patients with multiple sclerosis and systemic lupus erythematosus", Arch Neurol, 46, pp.1121~1123 (1989)
- 정규인, "피로와 우울. 불안증 환자에서 Fatigue Severity Scale의 임상적 유용성", 정신신체의학, 9(2), pp.164~173 (2001), 한국정신신체의학회
- Kroenke K, "The PHQ-9 : validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- Kroenke K, "The PHQ-9 : a new depression diagnostic and severity measure", Psychiatr Ann, 32, pp.509~515 (2002)
- 은헌정, "한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구", 신경정신의학, 44(3), pp.303~310 (2005), 대한신경정신의학회
- "PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling (White paper)" (2012)[URL]
- Hayes AF, "Introduction to Mediation, Moderation, and Conditional Process Analysis: a Regression-Based Approach" (2013), The Guilford Press
- Brown RF, "Longitudinal assessment of anxiety, depression, and fatigue in people with multiple sclerosis", Psychol Psychother, 82, pp.41~56 (2009)
- Chang CM, "Predictors of posttraumatic outcomes following the 1999 Taiwan earthquake", J Nerv Ment Dis, 193, pp.40~46 (2005)
- Lam MH, "Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors : long-term follow-up", Arch Intern Med, 169, pp.2142~2147 (2009)
- Mak IWC, "Long-term psychiatric morbidities among SARS survivors", Gen Hosp Psychiatry, 31, pp.318~326 (2009)
- Velden PGV, "Post-disaster mental health problems and the utilization of mental health services : a four-year longitudinal comparative study", Adm Policy Ment Health, 33, pp.279~288 (2006)
- Neria Y, "Post-traumatic stress disorder following disasters : a systematic review", Psychol Med, 38, pp.467~480 (2008)
- Fuller-Thomson E, "Factors associated with depression among individuals with chronic fatigue syndrome : findings from a nationally representative survey", Fam Pract, 25, pp.414~422 (2008)
- Yancey JR, "Chronic fatigue syndrome : diagnosis and treatment", Am Fam Physician, 86, pp.741~746 (2012)