TY - JOUR
T1 - Psychiatric symptoms after acute respiratory distress syndrome
T2 - 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.
N1 - Funding Information:
The National Institutes of Health (Acute Lung Injury SCCOR Grant #P050 HL73994 and R01 HL88045) and the Johns Hopkins Institute for Clinical and Translational Research (grant UL1 TR 000424‑06) supported this research. A Mid‑Career Investigator Award in Patient‑Oriented Research (K24 HL88551) supported Dr. Pronovost. The funding bodies had no role in the study design,
Funding Information:
The National Institutes of Health (Acute Lung Injury SCCOR Grant #P050 HL73994 and R01 HL88045) and the Johns Hopkins Institute for Clinical and Translational Research (grant UL1 TR 000424-06) supported this research. A Mid-Career Investigator Award in Patient-Oriented Research (K24 HL88551) supported Dr. Pronovost. The funding bodies had no role in the study design, data collection, analysis, interpretation, writing, or decision to submit the manuscript for publication. We thank all of the patients who participated in the study and the dedicated research staff who assisted with the study, including Nardos Belayneh, Alexander Brown, Jahnavi Chatterjee, Lin Chen, Alexandra Chong, Abdulla Damluji, Elizabeth Baer, Laura Methvin, Mariela Pinedo, Kim Pitner, Faisal Siddiqi, and Jennifer McGrain.
Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM.
PY - 2018/1/1
Y1 - 2018/1/1
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.
AB - 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.
KW - Acute respiratory distress syndrome
KW - Anxiety
KW - Depression
KW - Epidemiology
KW - Patient outcomes
KW - Posttraumatic stress disorder
UR - http://www.scopus.com/inward/record.url?scp=85039062998&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039062998&partnerID=8YFLogxK
U2 - 10.1007/s00134-017-5009-4
DO - 10.1007/s00134-017-5009-4
M3 - Article
C2 - 29279973
AN - SCOPUS:85039062998
SN - 0342-4642
VL - 44
SP - 38
EP - 47
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 1
ER -