Psychiatrists and critical care specialists at Johns Hopkins have begun to tease out what there is about a stay in an intensive care unit (ICU) that leads so many patients to report depression after they go home.
In a study reported online April 10 in Critical Care Medicine, the Hopkins researchers say several factors predicted symptoms of depression six months after hospitalization among very sick ICU patients, including a high level of organ failure and being given relatively high doses of a benzodiazepine sedative.
"The hope is that as we learn more about the effect of variations in ICU care, we'll be able to predict which patients are most susceptible to depression, prevent some depression by changing ICU practices, and make sure patients receive adequate mental health monitoring after discharge," says O. Joseph Bienvenu, M.D., Ph.D., an associate professor in the Department of Psychiatry at the Johns Hopkins University School of Medicine.
Bienvenu says doctors have long theorized that a health problem devastating enough to send someone to an ICU might well trigger depression, but because only some patients become depressed, he and his colleagues wondered whether the root causes might be more complex.
"Historically, the only goal for critical care physicians, understandably, was to keep people alive, but now there is interest in longer-term outcomes, such as patients' mental health and well-being," says Bienvenu. "So we asked ourselves, could certain aspects of critical illness and ICU care swing patients toward depression?"
To test the idea, Bienvenu and other Johns Hopkins researchers evaluated patients recently admitted to one of 13 ICUs located at four teaching hospitals in Baltimore, Md., including four ICUs at The Johns Hopkins Hospital.
Each of the patients was treated for acute lung injury (ALI), a respiratory distress syndrome that's considered an archetype of critical illness. Pat
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Johns Hopkins Medical Institutions