Epidemics and pandemics

How are epidemics and pandemics related to PTSD?

Exposure to at least one trauma is required for a diagnosis of PTSD. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) determines direct traumas as threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Indirect traumas include witnessing the trauma, or learning that a relative or close friend was exposed to a trauma. Differences in trauma characteristics, including the severity and type of exposure, can affect the risk of developing PTSD. Personal characteristics such as age and sex also influence risk.

What is the evidence regarding epidemics and pandemics and risk of PTSD?

Moderate to high quality evidence found the overall prevalence of PTSD symptoms during coronavirus outbreaks (Middle East respiratory syndrome [MERS], severe acute respiratory syndrome [SARS], and coronavirus disease 2019 [COVID-19]) is around 18%. PTSD symptoms are more common in coronavirus patients (29-32%) than in healthcare workers (18%) or in the general population (12%). Rates of depression and anxiety disorders are both around 15% during coronavirus outbreaks.

Rates of PTSD symptoms were higher during the MERS and SARS outbreaks than during the COVID-19 outbreak, although the full effects of the COVID-19 outbreak have not yet been established. Rates of PTSD symptoms were higher in healthcare workers during the outbreaks than after the outbreaks. Patients and the general population showed higher rates of PTSD symptoms after the outbreaks than during the outbreaks. In coronavirus patients, rates of PTSD symptoms were highest in females, in infected healthcare workers, in people with a previous physical illness, and in people with avascular necrosis. Rates were highest in people with functional impairment, pain, or a sense of lack of control. For COVID-19 specifically, there were small increases in the rates of PTSD in patients compared to non-patients, and in people exposed to longer versus shorter COVID-19 media reporting.

The prevalence of PTSD during and following pandemic infections that required quarantine measures for their management was 21.65%. This was similar to the rates of distress, depression, and anxiety during and following these pandemics.

August 2021

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Last updated at: 12:54 am, 12th October 2021
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