ICU Stays Increase Risk of ARDS Patients Developing Psychiatric Symptoms

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Staying in the ICU after surviving a life-threatening illness may put some patients at high risk for psychiatric symptoms.
Staying in the ICU after surviving a life-threatening illness may put some patients at high risk for psychiatric symptoms.

Staying in the intensive care unit (ICU) after surviving a life-threatening illness may put some patients at high risk for psychiatric symptoms.

"We need to pay more attention to the psychiatric vulnerability of ICU patients in recovery who are women, younger and unemployed prior to hospitalization, not just look at traditional measures of risk, such as greater illness severity and longer length of stay," Dale Needham, MD, professor of medicine at the Johns Hopkins University School of Medicine, said in a statement. 

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A study's findings revealed that 66% of study participants who survived a condition called acute respiratory distress syndrome (ARDS) and stayed in the ICU experienced symptoms of at least one of the following psychiatric disorders: depression, anxiety and post-traumatic stress disorder (PTSD). Nearly 34% of patients with at least 1 psychiatric symptom said they experienced all 3 at the same time.

The investigators found that based on self-reporting at 6 months, 36% of participants showed signs of depression, 42% showed signs of anxiety and 24% showed signs of PTSD. Prevelance of these symptoms was nearly at the same at 12 months, 36%, 42% and 23%, respectively.

Johns Hopkins University researchers examined data from Johns Hopkins and 40 other hospitals across the United States, recruiting a total of 698 participants. At the 6-month follow-up, the investigators conducted phone-based assessments with a total of 645 survivors. Similar follow-ups were completed at 1 year. 

A total of 613 individuals finished at least one psychiatric measures at 6 months by using Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised (IES-R) surveys. After a year, 576 participants completed at least 1 psychiatric self-assessment.

Additionally researchers learned that patients who were unemployed prior to hospitalization were 26% to 40% more likely to have psychiatric symptoms after hospital discharge.

"Given the high co-occurrence of psychiatric symptoms, ARDS survivors should be simultaneously evaluated for a full spectrum of psychiatric consequences to maximize recovery,” Dr Needham said. "We must pay heed to those who are not as severely ill as others when monitoring — and considering ways to improve — a person's life after an ICU."

Reference

Huang M, Parker A, Bienvenu O et al. Psychiatric Symptoms in Acute Respiratory Distress Syndrome Survivors. Crit. Care Med. 2016:1. doi:10.1097/ccm.0000000000001621.

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