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Over half of former intensive care patients suffer from anxiety, PTSD or depression

More than half of patients who survive a critical illness requiring care in an intensive care unit suffer anxiety, PTSD or depression within a year after discharge.

The numbers of patients who suffer psychologically are greater than first thought, revealed an Oxford University study.

And when they suffer symptoms of one psychological condition, there is a 64 per cent chance they will co-occur with symptoms of another.

Those who are depressed are 47 cent more likely to die in the two years following discharge, the study shows.

Scientists said ICU patients should be screened to spot those who may have the psychological disorders.

More than half of former intensive care patients suffer from mental health problems such as PTSD within a year of being discharged from intensive care, an Oxford University study found

New or worsening impairment in physical, cognitive or mental health status following treatment in ICU is known as post-intensive care syndrome (PICS).

Dr Peter Watkinson, Associate Professor of Intensive Care Medicine, said: ‘The psychopathological components of PICS are estimated to occur in up to a third of survivors of ICU treatment.

‘The major psychological conditions described are anxiety, depression and post-traumatic stress disorder (PTSD).’ 

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events.

People with PTSD often suffer nightmares and flashbacks to the traumatic event and can experience insomnia and an inability to concentrate.    

Symptoms are often severe enough to have a serious impact on the person’s day-to-day life, and can emerge straight after the traumatic event or years later. 

PTSD is thought to affect about one in every three people who have a traumatic experience, and was first documented in the First World War in soldiers with shell shock.

People who are worried they have PTSD should visit their GP, who could recommend a course of psychotherapy or anti-depressants, the NHS say. 

Combat Stress operate a 24-hour helpline for veterans, which can be reached on 0800 138 1619.  

The researchers investigated psychological disorders in a cohort of 4,943 former ICU patients between 2006 and 2013.  

They had at least 24 hours at level 3 ICU care and filled in a questionnaire on their symptoms of anxiety, depression and PTSD three months after discharge and again 12 months afterwards. 

Findings, published in the journal Critical Care, show that 46 per cent of patients reported symptoms of anxiety, 40 per cent reported symptoms of depression and 22 per cent reported symptoms of PTSD.

And 18 per cent reported symptoms of all three psychological conditions.

Prof Watkinson said: ‘Psychological problems after being treated for a critical illness in the ICU are very common and often complex when they occur.

‘When symptoms of one psychological disorder are present, there is a 65 per cent chance they will co-occur with symptoms of another psychological disorder.’ 

The study also found that depression is linked to higher mortality rates for common medical conditions such as heart disease, respiratory illness, cerebrovascular disease, accidents, diabetes mellitus and hypertension.

This is the first time an association between despression and an increased rate of mortality has been shown, according to the authors.

Prof Watkinson said: ‘It remains unclear whether clinicians are overlooking the screening and treatment of depression in favour of treating chronic medical conditions or whether there is a biological association between chronic illness and depression.

‘In the post-ICU population, the observed association between depression and mortality could be in part explained by the severity of chronic illness both pre-discharge and post-discharge, factors we did not adjust for in this study. 

Depression could be a factor not previously considered in post-ICU survival.

‘Given the incidence of depression amongst survivors, symptoms of this condition should be detected and managed during the time following ICU in primary care and in ICU follow-up clinics.’ 

There were 271,079 records of adults in an intensive care unit in the year 2015-2016, according to NHS figured. Patients aged 50 years and over accounted for 77 per cent.

He noted because of the observational nature of the study and its reliance of self-reported data mean that it does not allow for conclusions about cause and effect between ICU care and symptoms of psychological disorders.