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- Title
Predictors of Major Depressive Disorder following Intensive Care of Chronically Critically Ill Patients.
- Authors
Wintermann, Gloria-Beatrice; Rosendahl, Jenny; Weidner, Kerstin; Strauß, Bernhard; Petrowski, Katja
- Abstract
<bold>Objective: </bold>Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long-term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients.<bold>Materials and Methods: </bold>In a prospective cohort study, patients with long-term mechanical ventilation requirements (n=131) were assessed with respect to a diagnosis of MDD, using the Structured Clinical Interview for DSM-IV, three and six months after the transfer from acute ICU to post-acute ICU. Sociodemographic, psychological, and clinical risk factors with p values ≤ 0.1 were identified in a univariate logistic regression analysis and entered in a multivariable logistic regression model. A mediator analysis was run using the bootstrapping method, testing the mediating effect of perceived helplessness during the ICU stay, between the recalled traumatic experience from the ICU and a post-ICU MDD.<bold>Results: </bold>17.6% (n=23) of the patients showed a full- or subsyndromal MDD. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD. In a mediator analysis, perceived helplessness could be proved as a mediator.<bold>Conclusions: </bold>Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD.
- Subjects
MENTAL depression; CRITICAL care medicine; CRITICALLY ill patient care; INTENSIVE care patients; ARTIFICIAL respiration; DIAGNOSIS of post-traumatic stress disorder
- Publication
Critical Care Research & Practice, 2018, p1
- ISSN
2090-1305
- Publication type
journal article
- DOI
10.1155/2018/1586736