TY - JOUR
T1 - The 5-Year Incidence of Mental Disorders in a Population-Based ICU Survivor Cohort
AU - Sareen, Jitender
AU - Olafson, Kendiss
AU - Kredentser, Maia S.
AU - Bienvenu, O. Joseph
AU - Blouw, Marcus
AU - Bolton, James M.
AU - Logsetty, Sarvesh
AU - Chateau, Dan
AU - Nie, Yao
AU - Bernstein, Charles N.
AU - Afifi, Tracie O.
AU - Stein, Murray B.
AU - Leslie, William D.
AU - Katz, Laurence Y.
AU - Mota, Natalie
AU - El-Gabalawy, Reneé
AU - Sweatman, Sophia
AU - Marrie, Ruth Ann
N1 - Funding Information:
Supported, in part, by a Canadian Institutes of Health Research Foundation Grant (#333252). Dr. Sareen received funding from UptoDate, and he is a consultant for UpToDate. Dr. Kredentser received funding from Canadian Institutes of Health Research (CIHR) and UpToDate. Dr. Bernstein’s institution received funding from Abbvie, Janssen, Pfizer, Takeda, and Shire, and he received funding from Abbvie, Janssen, Pfizer, Takeda, Medtronic, Shire, Ferring, and Mylan Pharmaceutical. Dr. Stein received funding from UptoDate, Elsevier (Biological Psychiatry deputy editor), and Wiley (Depression and Anxiety). Dr. El-Gabalawy received University of Manitoba Start-Up Funding. Drs. Olafson and Marrie’s institution received funding from CIHR. The remaining authors have disclosed that they do not have any potential conflicts of interest.
Publisher Copyright:
© 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Objective: To estimate incidence of newly diagnosed mental disorders among ICU patients. Design: Retrospective-matched cohort study using a population-based administrative database. Setting: Manitoba, Canada. Participants: A total of 49,439 ICU patients admitted between 2000 and 2012 were compared with two control groups (hospitalized: N = 146,968 and general population: N = 141,937), matched on age (± 2 yr), sex, region of residence, and hospitalization year. Intervention: None. Measurements and Main Results: Incident mental disorders (mood, anxiety, substance use, personality, posttraumatic stress disorder, schizophrenia, and psychotic disorders) not diagnosed during the 5-year period before the index ICU or hospital admission date (including matched general population group), but diagnosed during the subsequent 5-year period. Multivariable survival models adjusted for sociodemographic variables, Charlson comorbidity index, admission diagnostic category, and number of ICU and non-ICU exposures. ICU cohort had a 14.5% (95% CI, 14.0-15.0) and 42.7% (95% CI, 42.0-43.5) age- A nd sex-standardized incidence of any diagnosed mental disorder at 1 and 5 years post-ICU exposure, respectively. In multivariable analysis, ICU cohort had increased risk of any diagnosed mental disorder at all time points versus the hospitalized cohort (year 5: Adjusted hazard ratio, 2.00; 95% CI, 1.80-2.23) and the general population cohort (year 5: Adjusted hazard ratio, 3.52; 95% CI, 3.23-3.83). A newly diagnosed mental disorder was associated with younger age, female sex, more recent admitting years, presence of preexisting comorbidities, and repeat ICU admission. Conclusions: ICU admission is associated with an increased incidence of mood, anxiety, substance use, and personality disorders over a 5-year period.
AB - Objective: To estimate incidence of newly diagnosed mental disorders among ICU patients. Design: Retrospective-matched cohort study using a population-based administrative database. Setting: Manitoba, Canada. Participants: A total of 49,439 ICU patients admitted between 2000 and 2012 were compared with two control groups (hospitalized: N = 146,968 and general population: N = 141,937), matched on age (± 2 yr), sex, region of residence, and hospitalization year. Intervention: None. Measurements and Main Results: Incident mental disorders (mood, anxiety, substance use, personality, posttraumatic stress disorder, schizophrenia, and psychotic disorders) not diagnosed during the 5-year period before the index ICU or hospital admission date (including matched general population group), but diagnosed during the subsequent 5-year period. Multivariable survival models adjusted for sociodemographic variables, Charlson comorbidity index, admission diagnostic category, and number of ICU and non-ICU exposures. ICU cohort had a 14.5% (95% CI, 14.0-15.0) and 42.7% (95% CI, 42.0-43.5) age- A nd sex-standardized incidence of any diagnosed mental disorder at 1 and 5 years post-ICU exposure, respectively. In multivariable analysis, ICU cohort had increased risk of any diagnosed mental disorder at all time points versus the hospitalized cohort (year 5: Adjusted hazard ratio, 2.00; 95% CI, 1.80-2.23) and the general population cohort (year 5: Adjusted hazard ratio, 3.52; 95% CI, 3.23-3.83). A newly diagnosed mental disorder was associated with younger age, female sex, more recent admitting years, presence of preexisting comorbidities, and repeat ICU admission. Conclusions: ICU admission is associated with an increased incidence of mood, anxiety, substance use, and personality disorders over a 5-year period.
KW - anxiety
KW - critical illness
KW - depression
KW - postintensive care syndrome
KW - posttraumatic stress disorder
UR - http://www.scopus.com/inward/record.url?scp=85088459436&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088459436&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000004413
DO - 10.1097/CCM.0000000000004413
M3 - Article
C2 - 32541566
AN - SCOPUS:85088459436
SN - 0090-3493
VL - 48
SP - E775-E783
JO - Critical care medicine
JF - Critical care medicine
IS - 8
ER -