Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis
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Objectives: To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivors. Data Sources: PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and Cochrane Controlled Trials Registry (1970–2015). Study Selection: Studies measuring depression after hospital discharge using a validated instrument in more than 20 adults from non-specialty ICUs. Data Extraction: Duplicate independent review and data abstraction. Data Synthesis: The search identified 27,334 titles, with 42 eligible articles on 38 unique studies (n = 4,113). The Hospital Anxiety and Depression Scale-Depression subscale was used most commonly (58%). The pooled Hospital Anxiety and Depression Scale-Depression subscale prevalence (95% CI) of depressive symptoms at a threshold score greater than or equal to 8 was 29% (22–36%) at 2–3 months (12 studies; n = 1,078), 34% (24–43%) at 6 months (seven studies; n = 760), and 29% (23–34%) at 12–14 months (six studies; n = 1,041). The prevalence of suprathreshold depressive symptoms (compatible with Hospital Anxiety and Depression Scale-Depression subscale, ≥ 8) across all studies, using all instruments, was between 29% and 30% at all three time points. The pooled change in prevalence (95% CI) from 2–3 to 6 months (four studies; n = 387) was 5% (–1% to +12%), and from 6 to 12 months (three studies; n = 412) was 1% (–6% to +7%). Risk factors included pre-ICU psychologic morbidity and presence of in-ICU psychologic distress symptoms. We did not identify any post-ICU intervention with strong evidence of improvement in depressive symptoms. Conclusions: Clinically important depressive symptoms occurred in approximately one-third of ICU survivors and were persistent through 12-month follow-up. Greater research into treatment is needed for this common and persistent post-ICU morbidity.
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As many as 66% of acute respiratory distress syndrome survivors report clinically important depression, anxiety, and PTSD symptoms at 1 year post-discharge.
“As many as 66% of acute respiratory distress syndrome (ARDS) survivors report clinically important symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) at 1 year post-discharge.5–8”
From Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: A pilot randomised clinical trial (2019) · cites this paper as [7]
The Discussion reports clinically important depressive symptoms in about 30% of general ICU survivors during the first 12 months after discharge, and the Results report correlations with anxiety and PTSD symptoms. Neither passage establishes the claimed 66% prevalence for ARDS survivors at one year; the paper cites an ARDS-specific study in its References but does not report that figure here. (LLM, conf=0.85)
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Intensivtagebücher senken Risiko für psychische Folgestörungen
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- Authors
- Rabiee, A., Nikayin, S., Hashem, M. D., Huang, M., Dinglas, V. D., Bienvenu, O. J., Turnbull, A. E., & Needham, D. M.
- Affiliations
- Johns Hopkins University (US)
- ORCID
- Venue
- Critical Care Medicine
- Published
- 2016-09
- Volume
- 44
- Issue
- 9
- Pages
- 1744-1753
- ISSN
- 0090-3493 (ISSN-L)
- PMC
- PMC7418220
- OpenAlex
- W2364261361
- Cited by
- 434
- References
- 77
- Citations by year
- 2026: 41 · 2025: 36 · 2024: 46 · 2023: 49 · 2022: 56 · 2021: 76 · 2020: 45 · 2019: 31 · 2018: 25 · 2017: 26 · 2016: 3
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R24HL111895)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depressive symptoms, critical illness, intensive care unit survivors, prevalence, natural history (disease), risk factors, Hospital Anxiety and Depression Scale
- MeSH terms
- Adult, Critical Care, Depression, Humans, Risk Factors, Prevalence, Critical Illness
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