- April 6, 2014
Science Daily/The Lancet
A third of intensive care patients develop depression that typically manifests as physical, or somatic, symptoms such as weakness, appetite change, and fatigue, rather than psychological symptoms, according to one of the largest studies to investigate the mental health and functional outcomes of survivors of critical care.
The study suggests that intensive care unit (ICU) survivors could be three times more likely to experience depression than the general population, and that depression is four times more common than post-traumatic stress disorder (PTSD) after critical illness.
"Considering that each year, at least 5 million individuals are admitted to ICU in North America alone -- more than are diagnosed with cancer -- and about 80% survive, it's a significant public health issue", explains study leader Dr James Jackson, psychologist and assistant professor of medicine at Vanderbilt University Medical Center in the USA.
"We need to pay more attention to preventing and treating the physical rather than psychological symptoms of depression in ICU survivors," says Dr Jackson. "The physical symptoms of depression are often resistant to standard treatment with antidepressant drugs and we need to determine how best to enhance recovery with a new focus on physical and occupational rehabilitation."
According to Dr Jackson, "Substantial time and energy has been invested in addressing PTSD in survivors of critical illness, but our findings suggest that it is less pervasive than depression. Patients of all ages are at risk of developing post-ICU mental health and functional disabilities and more needs to be done to ensure that these impairments don't become permanent."
"These findings have important implications. When depression manifests as physical symptoms, patients are less likely to receive a diagnosis. If they are diagnosed, they are less likely to respond to treatment…Traditional pharmacological therapies for depression might be less likely to provide significant benefit alone (or at all). Instead, doctors might need to address the many diagnoses that contribute to poor sleep, impaired concentration, weakness, and fatigue."