Depression & the ICU
While few would dispute the necessity and benefit of ICU stays, we are seeing more and more the total impact these stays are having on patients. While discharge from the ICU could (and should) be considered a success story, many are realizing that such stays often take an unseen negative toll on patients that is only sometimes detected weeks or months later. MedPageToday featured a nice discussion of a new study from Lancet Respiratory Medicine that evaluated ICU patients for depression 3 months and 12 months post-stay.
The study enrolled 821 patients with a median age of 61 years. Thirty-one percent of the patients died within 3 months of discharge and could not be studied further. The remaining patients were first evaluated for depression using the Beck Depression Inventory II at 3 months post-ICU stay. Thirty-seven percent of 406 patients (those with available data) reported at least mild depression. At 12 months, 33% of 347 patients (again those with available data) reported at least mild depression. Interestingly, the depression was mainly diagnosed due to somatic symptoms –not cognitive-affective symptoms. The most common symptoms included fatigue, insomnia and poor appetite. Even with awareness of depression post-ICU stays, the presence of these particular physical symptoms could prove difficult for future physicians to successfully make the diagnosis of depression in these patients, as many of these symptoms can also be the result of other factors.
The results of this study probably aren’t surprising to many –it’s not to us here at MyMedicalMalpracticeInsurance.com. We recently wrote about another study examining PTSD after ICU stays. (See our article, “Can the ICU Cause PTSD?”) Interestingly, the Lancet study found that depression was 5 times more likely than PTSD in their study sample.
While many people need the ICU, there is no doubt that the impact of such intense care in the weeks and months afterwards isn’t always positive. For more details of this study and to see how disability was present in patients post-stay, and its impact, see the link to the study above.