Navigation Links
In the ICU, use of benzodiazepines, other factors may predict severity of post-stay depression
Date:4/10/2009

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. Patients with ALI typically require invasive interventions in the ICU, including use of ventilators. Though better care has greatly reduced mortality rates, ALI still kills about 40 percent of those affected.

Bienvenu and his colleagues followed 160 patients who had survived at least six months after their ALI diagnosis. The researchers took note of a variety of features of each patient's status and care while in the ICU, such as severity of organ failure, their blood sugar levels and other lab work, and the amount and type of sedative they received.

At six months after ALI diagnosis, the researchers administered a questionnaire to patients that measured depressive symptoms ranging from none to possible or probable clinical depression. Of the 160, 26 percent scored above the threshold for possible depression. Compared to other ALI survivors, the depressed patients were more likely to have suffered greater severity of organ failure and to have received 75 mg or more of a benzodiazepine sedative daily.

Bienvenu says that because more severe organ failure may lead to a longer physical recovery period after ICU discharge, patients' depression may be explained, in part, by a slow recovery. However, he and his colleagues aren't sure how to explain the association between depression and ICU benzodiazepine dose.

One possibility could be that the amount of this drug received reflects how agitated patients were in the ICU, with very distressed individuals getting higher doses. However, because this relationship hasn't been seen with other types of sedatives commonly prescribed in the ICU, it's possible that high doses of benzodiazepine alone may somehow cause depressive symptoms. "This is clearly a question that needs further study," says Bienvenu.


'/>"/>

Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Another Reason Not to Smoke While Pregnant: Birth Defects
2. FDA Warns of Codeine Risk for Some Nursing Mothers
3. More than two-thirds of sexually active NYC youth use condoms, but other forms of birth control lag
4. One Species Genome Found Within Another
5. Claim Filed Against the Company and Nine Other Defendants in the Haifa Magistrates Court
6. Family-based treatment more effective than supportive psychotherapy in treating bulimia
7. Mother and Daughter Create Lead-Free/Safe Bibs and Solve Messy Mealtime Problems
8. Mothers Know Best: NFL Moms Team With Eddie George to Showcase a Better Way to a Healthier Lifestyle
9. Eat Seafood, See Weight Loss: Recent Study Finds Another Reason to Eat Seafood for a Fit Lifestyle
10. DTI Medical Corporation Announces Reverse Split and Other Corporate Developments
11. Chemotherapy may be culprit for fatigue in breast cancer survivors
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... "FCPX editors can now reveal their ... Cut Pro X," said Christina Austin - CEO of Pixel Film Studios. , ... Pro X users can now reveal the media of their split screens with ...
(Date:6/27/2016)... (PRWEB) , ... June 27, 2016 , ... TopConsumerReviews.com recently ... of Eyeglasses . , Millions of individuals in the United States and Canada ... become a way to both correct vision and make a fashion statement. Even celebrities ...
(Date:6/26/2016)... ... 2016 , ... PawPaws brand pet supplements owned by Whole Health ... the health of felines. The formula is all-natural and is made from Chinese herbs ... Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract and Rehmannia ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs surgery services, can ... Surgery and to Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey ... cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. ... his M.D from the David Geffen School of Medicine at UCLA. He trained in ... to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 2016  In a startling report released today, National Safety ... lacking a comprehensive, proven plan to eliminate prescription opioid overdoses. ... how states are tackling the worst drug crisis in recorded U.S. ... Kentucky , New Mexico , ... Of the 28 failing states, three – Michigan ...
(Date:6/23/2016)... WAYNE, Pa. , June 23, 2016 ... provider, will launch its next generation clinical outcomes platform, Bracket ... DIA Meeting held on June 26 – 30, 2016 in ... 6.0, the first electronic Clinical Outcome Assessment product of its ... DIA Booth #715. Bracket eCOA 6.0 is a ...
(Date:6/23/2016)... -- Guerbet announced today that it has been named a ... One of 12 suppliers to receive the ... of Premier members through exceptional local customer service and ... lower costs. "We ... customer service from Premier," says Massimo Carrara , ...
Breaking Medicine Technology: