Saturday, April 23, 2016

Patients at high risk for psychiatric symptoms after a stay in the intensive care unit

How was your stay in the intensive care unit? Mine was listening to a family screaming at doctors to help the husband/father who had some heart condition. My three days there were marked by zero sleep. I don't recall any psychiatric symptoms. What is your doctor doing to treat this? ANYTHING AT ALL?
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.

No comments:

Post a Comment