TY - JOUR
T1 - Psychiatric symptoms in acute respiratory distress syndrome survivors
T2 - A 1-year national multicenter study
AU - Huang, Minxuan
AU - Parker, Ann M.
AU - Bienvenu, O. Joseph
AU - Dinglas, Victor D.
AU - Colantuoni, Elizabeth
AU - Hopkins, Ramona O.
AU - Needham, Dale M.
N1 - Funding Information:
National Heart, Lung, and Blood Institute funded this follow-up study (grants N01HR56170, R01HL091760, and 3R01HL091760-02S1) and the Albuterol for the Treatment of ALI and Early vs. Delayed Enteral Nutrition trials (contracts HHSN268200536165C to HHSN268200536175C and HHSN268200536179C) as well as provided support via grant 5T32HL00753432.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Objective: To evaluate prevalence, severity, and co-occurrence of and risk factors for depression, anxiety, and posttraumatic stress disorder symptoms over the first year after acute respiratory distress syndrome. Design: Prospective longitudinal cohort study. Settings: Forty-one Acute Respiratory Distress Syndrome Network hospitals across the United States. Patients: Six hundred ninety-eight acute respiratory distress syndrome survivors. Interventions: None. Measurements and Main Results: Psychiatric symptoms were evaluated by using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised at 6 and 12 months. Adjusted prevalence ratios for substantial symptoms (binary outcome) and severity scores were calculated by using Poisson and linear regression, respectively. During 12 months, a total of 416 of 629 patients (66%) with at least one psychiatric outcome measure had substantial symptoms in at least one domain. There was a high and almost identical prevalence of substantial symptoms (36%, 42%, and 24% for depression, anxiety, and posttraumatic stress disorder) at 6 and 12 months. The most common pattern of co-occurrence was having symptoms of all three psychiatric domains simultaneously. Younger age, female sex, unemployment, alcohol misuse, and greater opioid use in the ICU were significantly associated with psychiatric symptoms, whereas greater severity of illness and ICU length of stay were not associated. Conclusions: Psychiatric symptoms occurred in two thirds of acute respiratory distress syndrome survivors with frequent co-occurrence. Sociodemographic characteristics and in-ICU opioid administration, rather than traditional measures of critical illness severity, should be considered in identifying the patients at highest risk for psychiatric symptoms during recovery. Given high co-occurrence, acute respiratory distress syndrome survivors should be simultaneously evaluated for a full spectrum of psychiatric sequelae to maximize recovery.
AB - Objective: To evaluate prevalence, severity, and co-occurrence of and risk factors for depression, anxiety, and posttraumatic stress disorder symptoms over the first year after acute respiratory distress syndrome. Design: Prospective longitudinal cohort study. Settings: Forty-one Acute Respiratory Distress Syndrome Network hospitals across the United States. Patients: Six hundred ninety-eight acute respiratory distress syndrome survivors. Interventions: None. Measurements and Main Results: Psychiatric symptoms were evaluated by using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised at 6 and 12 months. Adjusted prevalence ratios for substantial symptoms (binary outcome) and severity scores were calculated by using Poisson and linear regression, respectively. During 12 months, a total of 416 of 629 patients (66%) with at least one psychiatric outcome measure had substantial symptoms in at least one domain. There was a high and almost identical prevalence of substantial symptoms (36%, 42%, and 24% for depression, anxiety, and posttraumatic stress disorder) at 6 and 12 months. The most common pattern of co-occurrence was having symptoms of all three psychiatric domains simultaneously. Younger age, female sex, unemployment, alcohol misuse, and greater opioid use in the ICU were significantly associated with psychiatric symptoms, whereas greater severity of illness and ICU length of stay were not associated. Conclusions: Psychiatric symptoms occurred in two thirds of acute respiratory distress syndrome survivors with frequent co-occurrence. Sociodemographic characteristics and in-ICU opioid administration, rather than traditional measures of critical illness severity, should be considered in identifying the patients at highest risk for psychiatric symptoms during recovery. Given high co-occurrence, acute respiratory distress syndrome survivors should be simultaneously evaluated for a full spectrum of psychiatric sequelae to maximize recovery.
KW - anxiety
KW - critical illness
KW - depression
KW - posttraumatic stress disorder
KW - prospective studies
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U2 - 10.1097/CCM.0000000000001621
DO - 10.1097/CCM.0000000000001621
M3 - Article
C2 - 26807686
AN - SCOPUS:84955568783
SN - 0090-3493
VL - 44
SP - 954
EP - 965
JO - Critical care medicine
JF - Critical care medicine
IS - 5
ER -