Depression affects more than one out of three survivors of critical illness, according to a Vanderbilt study released in The Lancet Respiratory Medicine, and the majority of patients experience their symptoms physically rather than mentally.
It is one of the largest studies to investigate the mental health and functional outcomes of critical care survivors, according to lead author James Jackson, Psy.D., assistant professor of Medicine, and it highlights a significant public health issue, with roughly 5 million patients admitted to intensive care units (ICUs) in the United States each year.
Weakness, appetite change and fatigue all signs of somatic, or physical, depression were present in two-thirds of the patients, as opposed to cognitive symptoms such as sadness, guilt or pessimism.
"We need to pay more attention to preventing and treating the physical rather than psychological symptoms of depression in ICU survivors," Jackson said. "The physical symptoms of depression are often resistant to standard treatment with antidepressant drugs, so we need to determine how best to enhance recovery with a new focus on physical and occupational rehabilitation."
The BRAIN-ICU study observed 821 critically ill patients ages 18-90 with respiratory failure or severe sepsis (blood poisoning) admitted to medical or surgical ICUs at Vanderbilt University Hospital and Saint Thomas Hospital.
Vanderbilt researchers assessed survivors for depression, PTSD, functional disability and impact on quality of life at three-month and one-year intervals, reporting that 149 of the 407 patients (37 percent) assessed at three months had at least mild depression, while only 7 percent of patients experienced symptoms of PTSD.
"Depression symptoms were significantly more common than symptoms of PTSD," Jackson said. "And they occurred to a large degree across the entire age range. People tend to have a vision of a frail, older pat
|Contact: Craig Boerner|
Vanderbilt University Medical Center