Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study

Abstract

BackgroundSurvivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multicentre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU).MethodsDesign: prospective multicentre follow-up study of survivors of ICU in the UK.Setting: patients from 26 ICUs in the UK.Inclusion criteria: patients who had received at least 24 h of level 3 ICU care and were 16 years of age or older.Interventions: postal follow up: Hospital Anxiety and Depression Score (HADS) and the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian (PCL-C) at 3 and 12 months following discharge from ICU.Main outcome measure: caseness of anxiety, depression and PTSD, 2-year survival.ResultsIn total, 21,633 patients admitted to ICU were included in the study. Postal questionnaires were sent to 13,155 survivors; of these 38% (4943/13155) responded and 55% (2731/4943) of respondents passed thresholds for one or more condition at 3 or 12 months following discharge. Caseness prevalence was 46%, 40% and 22% for anxiety, depression and PTSD respectively; 18% (870/4943 patients) met the caseness threshold for all three psychological conditions. Patients with symptoms of depression were 47% more likely to die during the first 2 years after discharge from ICU than those without (HR 1.47, CI 1.19–1.80).ConclusionsOver half of those who respond to postal questionnaire following treatment on ICU in the UK reported significant symptoms of anxiety, depression or PTSD. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of one of the other two disorders. Depression following critical illness is associated with an increased mortality risk in the first 2 years following discharge from ICU.Trial registrationISRCTN Registry, ISRCTN69112866. Registered on 2 May 2006.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2223-6) contains supplementary material, which is available to authorized users.

A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors

“…This finding echoes that of previous studies indicating that chronic illness or a self-evaluation of poor health is associated with increased psychological distress [6,16]. A possible explanation for this result is that persons with a history of medical problems who also perceive their health as poor might feel more vulnerable to contracting a new disease [24].…”

“…The DASS-21 obtained high reliabilities in the Italian validation study, with Cronbach's alphas of 0.74, 0.82, and 0.85 for the Anxiety, Depression, and Stress subscales, respectively; Cronbach's alpha for the total scales was 0.90. In the Lovibond and Lovibond version of the DASS-21 [19], the subscales are scored as follows: normal (0-9), mild (10-12), moderate (13)(14)(15)(16)(17)(18)(19)(20), severe (21-27), and extremely severe (28-42) for Depression; normal (0-6), mild (7-9), moderate (10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19), and extremely severe (20-42) for Anxiety; and normal (0-10), mild (11)(12)(13)(14)(15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25)(26), severe (27-34), and extremely severe (35-42) for Stress.…”

Hand- och benstyrka vid intensivvårdsavdelning (IVA)-mottagning, -en retrospektiiv studie

“…Det skall också nämnas att intensivvård även kan ge negativa psykologiska effekter, såsom ångest, depression och posttraumatiskt stressyndrom (Hatch, Young, Barber, Griffiths, Harrison, & Watkinson, 2018). I en studie…”

“…För att motverka riskerna med immobilisering bör patienten få stöd med tidig mobilisering, en aktivering som bör ske inom de första dygnen efter att patienten har skrivits in på IVA (Paton, Lane, & Hodgson, 2018). Det skall dock nämnas att tydliga effekter av tidig mobilisering av kritiskt sjuka patienter på IVA har ifrågasatts i en systematisk litteraturgenomgång, på grund av att tillgängliga studier för detta hade få deltagare, avsaknad av blindade deltagare i studier, varierade interventioner och mätmetoder samt ofullständig beskrivning av given intervention (Doiron, Hoffmann, & Beller, 2018).Det skall också nämnas att intensivvård även kan ge negativa psykologiska effekter, såsom ångest, depression och posttraumatiskt stressyndrom (Hatch, Young, Barber, Griffiths, Harrison, & Watkinson, 2018). I en studie…”

Resilience and Motivation Following Intensive Care Unit Admission: Tools for Survivorship

“…Up to 15% develop post‐traumatic stress disorder (PTSD), resulting from illness severity, prolonged hospitalisation, invasiveness of treatments, and psychological trauma (Long et al ., ). Additionally, discharged patients from ICU suffer from multiple concurrent mental health disorders such as anxiety and depression along with PTSD (Hatch et al ., ). ICU survivors of all ages suffer significant cognitive impairments and loss of physical function, with long‐lasting consequences (Kim et al ., ).…”