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Published in: Critical Care 1/2018

Open Access 01-12-2018 | Research

Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study

Authors: Robert Hatch, Duncan Young, Vicki Barber, John Griffiths, David A. Harrison, Peter Watkinson

Published in: Critical Care | Issue 1/2018

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Abstract

Background

Survivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multicentre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU).

Methods

Design: prospective multicentre follow-up study of survivors of ICU in the UK.
Setting: patients from 26 ICUs in the UK.
Inclusion criteria: patients who had received at least 24 h of level 3 ICU care and were 16 years of age or older.
Interventions: postal follow up: Hospital Anxiety and Depression Score (HADS) and the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian (PCL-C) at 3 and 12 months following discharge from ICU.
Main outcome measure: caseness of anxiety, depression and PTSD, 2-year survival.

Results

In total, 21,633 patients admitted to ICU were included in the study. Postal questionnaires were sent to 13,155 survivors; of these 38% (4943/13155) responded and 55% (2731/4943) of respondents passed thresholds for one or more condition at 3 or 12 months following discharge. Caseness prevalence was 46%, 40% and 22% for anxiety, depression and PTSD respectively; 18% (870/4943 patients) met the caseness threshold for all three psychological conditions. Patients with symptoms of depression were 47% more likely to die during the first 2 years after discharge from ICU than those without (HR 1.47, CI 1.19–1.80).

Conclusions

Over half of those who respond to postal questionnaire following treatment on ICU in the UK reported significant symptoms of anxiety, depression or PTSD. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of one of the other two disorders. Depression following critical illness is associated with an increased mortality risk in the first 2 years following discharge from ICU.

Trial registration

ISRCTN Registry, ISRCTN69112866. Registered on 2 May 2006.
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Literature
3.
go back to reference Nikayin S, Rabiee A, Hashem MD, et al. Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2016;43:23–9.CrossRef Nikayin S, Rabiee A, Hashem MD, et al. Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2016;43:23–9.CrossRef
7.
17.
go back to reference Intensive Care Society. A Guide for critical care settings standards for critical incident reporting in critical care; 2005. p. 37. Intensive Care Society. A Guide for critical care settings standards for critical incident reporting in critical care; 2005. p. 37.
19.
go back to reference Snaith RP, Zigmond AS (1994) The Hospital Anxiey and Depression Scale with the Irritability-depression-anxiety Scale and the Leeds Situational Anxiety Scale: manual. Snaith RP, Zigmond AS (1994) The Hospital Anxiey and Depression Scale with the Irritability-depression-anxiety Scale and the Leeds Situational Anxiety Scale: manual.
21.
go back to reference Harrison DA, Brady AR, Rowan K. Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database. Crit Care. 2004;9(S1). https://doi.org/10.1186/cc3745.CrossRef Harrison DA, Brady AR, Rowan K. Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database. Crit Care. 2004;9(S1). https://​doi.​org/​10.​1186/​cc3745.CrossRef
23.
go back to reference R core team. R: A language and environment for statistical computing. Vienna: R Found. Stat. Comput; 2017. R core team. R: A language and environment for statistical computing. Vienna: R Found. Stat. Comput; 2017.
27.
go back to reference Breslau N, Davis GC, Andreski P, Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults lifetime prevalence of exposure to traumatic events. Arch Gen Psychiatry. 1991;48:216–22.CrossRef Breslau N, Davis GC, Andreski P, Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults lifetime prevalence of exposure to traumatic events. Arch Gen Psychiatry. 1991;48:216–22.CrossRef
34.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52:69–77.CrossRef Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52:69–77.CrossRef
Metadata
Title
Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study
Authors
Robert Hatch
Duncan Young
Vicki Barber
John Griffiths
David A. Harrison
Peter Watkinson
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-018-2223-6

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