http://www.mdlinx.com/internal-medicine/medical-news-article/2016/04/22/6638062/?
Johns Hopkins Medicine, 04/22/2016
Results
of a multi–institutional national study of nearly 700 people who
survived life–threatening illness with a stay in an intensive care unit
(ICU) suggest that a substantial majority of them are at high risk for
persistent depression, anxiety and post–traumatic stress disorder –
especially if they are female, young and unemployed. The study, led by
Johns Hopkins University researchers, found that two–thirds of study
participants who survived a condition called acute respiratory distress
syndrome (ARDS) and spent time in the ICU self–reported symptoms of at
least one of these psychiatric disorders, and one–third of those
patients with at least one psychiatric symptom said they experienced all
three at the same time. Contrary to the common risk factors associated
with post–ARDS physical impairments and mortality, such as severity of
illness and length of ICU stay, this study demonstrated that none of
these risk factors had positive association with psychiatric symptoms.
In a report on the study, published in the May issue of the journal
Critical Care Medicine, the investigators point out that women, younger
people, and those who were unemployed or who misused alcohol prior to
hospitalization and survived ARDS were at increased risk for psychiatric
symptoms. Based on their self–reporting at six months, 36 percent of
participants showed signs of depression, 42 percent showed signs of
anxiety and 24 percent showed signs of PTSD. At 12 months, prevalence of
these symptoms was nearly the same — 36, 42 and 23 percent,
respectively. Of the patients who experienced symptoms of depression,
anxiety or PTSD at six months, more than one–half — 57 to 66 percent —
still had the same symptoms at 12 months, indicating the persistence of
the symptoms. Of the patients at six months without substantial symptoms
of depression, anxiety or PTSD, less than 15 percent later developed
symptoms by the one–year mark. Most important, the researchers say, the
majority of survivors — 63 percent — with any psychiatric illness
experienced two or more symptoms at the same time at both six and 12
months. Needham and Huang say they plan to investigate preventive and
therapeutic measures that might help such patients. They also plan to
look further into the complex role of in–ICU opioid administration and
dosages.
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