Over half of patients treated in intensive care units (ICUs) in the United Kingdom experience significant symptoms of anxiety, depression and posttraumatic stress disorder (PTSD) post-discharge, a new research suggests. More worryingly, patients with depression following ICU care showed increased mortality risk in the first 2 years after discharge.
The prospective study of 4943 patients aged 16 years and older who had received at least 24 hours of level 3 care at 26 UK ICUs. Hospital Anxiety and Depression Score and the PTSD Check List-Civilian were performed at 3 and 12 months following ICU discharge.
The findings, published in the journal Critical Care, show that 55% per cent of respondents met thresholds for 1 or more condition at 3 or 12 months. Forty-six per cent reported symptoms of anxiety, 40% reported symptoms of depression and 22% reported symptoms of PTSD. Eighteen per cent of patients reported symptoms of all 3 psychological conditions.
When symptoms of 1 psychological disorder were present, there was a 65% chance of coexisting symptoms of 1 of the other 2 disorders.
One in 10 patients who met thresholds for significant anxiety or depression at 12 months had not fulfilled these criteria at 3-month assessment. Similarly, 7% of responders met the threshold for PTSD at 12 months who had not met the threshold at 3 months.
Patients with depression were 47% more likely to die during the first 2 years after discharge (HR, 1.47; 95% CI, 1.19-1.80).
The findings suggest that depression following ICU care may be a marker of declining health. The authors advise that clinicians involved in the follow-up and assessment of ICU survivors should be aware of the co-occurrence of psychopathological conditions when assessing for post-intensive care syndrome.