Psychological Outcome, Fatigue, and Quality of Life After Infection With Shiga Toxin-Producing Escherichia coli O104

TY - JOUR

T1 - Psychological Outcome, Fatigue, and Quality of Life After Infection With Shiga Toxin-Producing Escherichia coli O104

AU - Löwe, Bernd

AU - Andresen, Viola

AU - Zimmermann-Fraedrich, Katharina

AU - Gappmayer, Kerrin

AU - Wegscheider, Karl

AU - Treszl, András

AU - Riegel, Björn

AU - Rose, Matthias

AU - Lohse, Ansgar W

AU - Broicher, Wiebke

N1 - Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

PY - 2014/3/13

Y1 - 2014/3/13

N2 - BACKGROUND & AIMS: From May through July 2011 in northern Germany, there was a large outbreak of hemolytic uremic syndrome and bloody diarrhea, which was related to infections from Shiga toxin-producing Escherichia coli O104 (STEC). We investigated the depression, posttraumatic symptoms, fatigue, and health-related quality of life among patients within the first 6 months after STEC infection and aimed to identify factors associated with poor outcome.METHODS: In a cohort study, we performed baseline assessments of 389 patients (69% female) 3 months after STEC infection (82 ± 36 days) and follow-up assessments of 308 of the patients 6 months afterward (199 ± 17 days). Data were collected at 13 hospitals in northern Germany. Patients completed validated self-report scales and a diagnostic interview.RESULTS: At baseline, hemolytic uremic syndrome was diagnosed in 31% of the patients. Six months after the infection, mean self-reported severity of depression and posttraumatic symptoms and fatigue were significantly greater than in the general population, and the mean score from the mental component of health-related quality of life survey was significantly lower than average. Posttraumatic stress disorder had recently developed in 3% of patients (95% confidence interval, 1%-5%), and 43% of patients had clinically relevant fatigue (95% confidence interval, 41%-45%). The most important baseline factors associated with poor psychological health 6 months after STEC infection were previous traumatic events, neuroticism, and low social support (all P < .05).CONCLUSIONS: Six months after the major outbreak of STEC infection in northern Germany, a substantial number of patients had poor psychological health, persistent fatigue, and impaired quality of life. For future outbreaks, patients' premorbid risk factors should be considered, which might minimize the long-term effects of infections on mental health.

AB - BACKGROUND & AIMS: From May through July 2011 in northern Germany, there was a large outbreak of hemolytic uremic syndrome and bloody diarrhea, which was related to infections from Shiga toxin-producing Escherichia coli O104 (STEC). We investigated the depression, posttraumatic symptoms, fatigue, and health-related quality of life among patients within the first 6 months after STEC infection and aimed to identify factors associated with poor outcome.METHODS: In a cohort study, we performed baseline assessments of 389 patients (69% female) 3 months after STEC infection (82 ± 36 days) and follow-up assessments of 308 of the patients 6 months afterward (199 ± 17 days). Data were collected at 13 hospitals in northern Germany. Patients completed validated self-report scales and a diagnostic interview.RESULTS: At baseline, hemolytic uremic syndrome was diagnosed in 31% of the patients. Six months after the infection, mean self-reported severity of depression and posttraumatic symptoms and fatigue were significantly greater than in the general population, and the mean score from the mental component of health-related quality of life survey was significantly lower than average. Posttraumatic stress disorder had recently developed in 3% of patients (95% confidence interval, 1%-5%), and 43% of patients had clinically relevant fatigue (95% confidence interval, 41%-45%). The most important baseline factors associated with poor psychological health 6 months after STEC infection were previous traumatic events, neuroticism, and low social support (all P < .05).CONCLUSIONS: Six months after the major outbreak of STEC infection in northern Germany, a substantial number of patients had poor psychological health, persistent fatigue, and impaired quality of life. For future outbreaks, patients' premorbid risk factors should be considered, which might minimize the long-term effects of infections on mental health.

U2 - 10.1016/j.cgh.2014.02.035

DO - 10.1016/j.cgh.2014.02.035

M3 - SCORING: Journal article

C2 - 24632347

JO - CLIN GASTROENTEROL H

JF - CLIN GASTROENTEROL H

SN - 1542-3565

ER -