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:10/13/2017)... LEXINGTON, Ky. (PRWEB) , ... October 13, 2017 , ... ... MD, MPH to become its next President and Chief Executive Officer, succeeding Dr. James ... and CEO Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end ...
(Date:10/13/2017)... ... ... Apple Rehab Shelton Lakes , which specializes in the delivery of sub-acute ... of a disaster drill on October 3rd. , Apple Rehab participated with the Shelton ... well as the Connecticut Long Term Care Mutual Aid Plan (LTC-MAP). The LTC-MAP ...
(Date:10/13/2017)... ... October 13, 2017 , ... Yisrayl Hawkins, Pastor and Overseer at ... of the most popular and least understood books in the Holy Scriptures, Revelation. The ... that have baffled scholars for centuries. Many have tossed it off as mere rubbish, ...
(Date:10/12/2017)... WILMINGTON, Del. (PRWEB) , ... October 12, 2017 ... ... technology and advisory services for healthcare compliance program management, will showcase a range ... and National Association for Assisted Living (NCAL) Convention and Expo to be held ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of ... Carol Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, ... In honor of Morris F. Collen, a pioneer in the field of medical informatics, ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... their devotion to personalized service, SMP Pharmacy Solutions announces their ... South Florida Business Journal,s 50 Fastest-Growing Companies, and listed for ... specialty pharmacy has found its niche.  To that end, the ... by SFBJ as the 2017 Power Leader in Health Care. ... award in October, Bardisa said of the three achievements, "It,s ...
(Date:9/22/2017)... 2017  As the latest Obamacare repeal effort moves ... (R-LA) and Lindsey Graham (R-SC) medical ... device industry is in an odd place.  The industry ... excise tax on medical device sales passed along with ... patients, increased visits and hospital customers with the funding ...
(Date:9/18/2017)... Sept. 18, 2017 EpiVax, Inc. ... bioinformatics and immune engineering, today announced a ... A (H7N9) vaccine. ... seasonal influenza and presents a challenge for ... exposure to be effective. Using state-of-the-art bioinformatics and ...
Breaking Medicine Technology: