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Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study.
Intensive Care Med. 2018 01; 44(1):38-47.IC

Abstract

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.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St.-Meyer 115, Baltimore, MD, 21287, USA. obienve1@jhmi.edu. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. obienve1@jhmi.edu. Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. obienve1@jhmi.edu.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29279973

Citation

Bienvenu, O Joseph, et al. "Psychiatric Symptoms After Acute Respiratory Distress Syndrome: a 5-year Longitudinal Study." Intensive Care Medicine, vol. 44, no. 1, 2018, pp. 38-47.
Bienvenu OJ, Friedman LA, Colantuoni E, et al. Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study. Intensive Care Med. 2018;44(1):38-47.
Bienvenu, O. J., Friedman, L. A., Colantuoni, E., Dinglas, V. D., Sepulveda, K. A., Mendez-Tellez, P., Shanholz, C., Pronovost, P. J., & Needham, D. M. (2018). Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study. Intensive Care Medicine, 44(1), 38-47. https://doi.org/10.1007/s00134-017-5009-4
Bienvenu OJ, et al. Psychiatric Symptoms After Acute Respiratory Distress Syndrome: a 5-year Longitudinal Study. Intensive Care Med. 2018;44(1):38-47. PubMed PMID: 29279973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study. AU - Bienvenu,O Joseph, AU - Friedman,Lisa Aronson, AU - Colantuoni,Elizabeth, AU - Dinglas,Victor D, AU - Sepulveda,Kristin A, AU - Mendez-Tellez,Pedro, AU - Shanholz,Carl, AU - Pronovost,Peter J, AU - Needham,Dale M, Y1 - 2017/12/26/ PY - 2017/08/12/received PY - 2017/11/27/accepted PY - 2017/12/28/pubmed PY - 2019/2/14/medline PY - 2017/12/28/entrez KW - Acute respiratory distress syndrome KW - Anxiety KW - Depression KW - Epidemiology KW - Patient outcomes KW - Posttraumatic stress disorder SP - 38 EP - 47 JF - Intensive care medicine JO - Intensive Care Med VL - 44 IS - 1 N2 - 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. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/29279973/Psychiatric_symptoms_after_acute_respiratory_distress_syndrome:_a_5_year_longitudinal_study_ L2 - https://dx.doi.org/10.1007/s00134-017-5009-4 DB - PRIME DP - Unbound Medicine ER -