Cited by 434Intensive Care Unit Cognitive DisordersFamily and Patient Care in Intensive Care UnitsMental Health Treatment and Access

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Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis

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Rabiee, Anahita, Nikayin, Sina, Hashem, Mohamed D., Huang, Minxuan, Dinglas, Victor D., Bienvenu, O. Joseph, Turnbull, Alison E., Needham, Dale M.·2016·Critical Care Medicine

DOI 10.1097/ccm.0000000000001811PMC PMC7418220

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Abstract

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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Self-citation

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: Rabiee, Anahita
Nikayin, Sina
Hashem, Mohamed D.
Huang, Minxuan
Dinglas, Victor D.
Bienvenu, O. Joseph
Turnbull, Alison E.
Needham, Dale M.
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2016-09
Volume: 44
Issue: 9
Pages: 1744-1753
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/ccm.0000000000001811
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 › Medicine › Critical Care and Intensive Care Medicine › Family and Patient Care in Intensive Care Units
Health Sciences › Medicine › Psychiatry and Mental health › 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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Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis

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