Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study

O. Joseph Bienvenu, Lisa Aronson Friedman, Elizabeth Colantuoni, Victor D. Dinglas, Kristin A. Sepulveda, Pedro Mendez-Tellez, Carl Shanholz, Peter J. Pronovost, Dale M. Needham

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


Purpose: We aimed to characterize anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms over 5-year follow-up after acute respiratory distress syndrome (ARDS) and determine risk factors for prolonged psychiatric morbidity. Methods: This prospective cohort study enrolled patients from 13 medical and surgical intensive care units in four hospitals, with follow-up at 3, 6, 12, 24, 36, 48, and 60 months post-ARDS. Trained research staff administered the Hospital Anxiety and Depression Scale (HADS) (scores ≥ 8 on anxiety and depression subscales indicating substantial symptoms) and the Impact of Event Scale-Revised (IES-R, scores ≥ 1.6 indicating substantial PTSD symptoms) at each follow-up visit. Results: Of 196 consenting survivors, 186 (95%) completed HADS and IES-R assessments; 96 (52%) had any continuous or recurring (prolonged) symptoms, and 71 (38%), 59 (32%), and 43 (23%) had prolonged anxiety, depression, and PTSD symptoms, respectively (median total durations 33–39 months, 71–100% of observed follow-up time). Prolonged psychiatric symptoms tended to co-occur across domains; the most common morbidity pattern involved substantial symptoms in all three domains. Worse pre-ARDS mental health, including prior depression and psychological distress in the period immediately preceding ARDS, was strongly associated with prolonged post-ARDS psychiatric morbidity across symptom domains. Conclusions: Clinically significant and long-lasting symptoms of anxiety, depression, and PTSD are common in the first 5 years after ARDS. In-hospital screening of psychiatric history, including recent anxiety and depression symptoms, may be useful for long-term mental health treatment planning after ARDS.

Original languageEnglish (US)
Pages (from-to)38-47
Number of pages10
JournalIntensive Care Medicine
Issue number1
StatePublished - Jan 1 2018


  • Acute respiratory distress syndrome
  • Anxiety
  • Depression
  • Epidemiology
  • Patient outcomes
  • Posttraumatic stress disorder

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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