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

J Psychosom Res. 2010 Feb;68(2):195-202. doi: 10.1016/j.jpsychores.2009.04.004. Epub 2009 May 17.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Community Health Services*
  • Cross-Sectional Studies
  • Denial, Psychological
  • Disease Outbreaks*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Severe Acute Respiratory Syndrome / complications
  • Severe Acute Respiratory Syndrome / epidemiology*
  • Severe Acute Respiratory Syndrome / psychology*
  • Singapore / epidemiology
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology
  • Surveys and Questionnaires