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Depression in general intensive care unit survivors: a systematic review
Dimitry S Davydow1, Jeneen M Gifford, Sanjay V Desai
1Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Avenue, Box 356896, Seattle, WA 98104, USA. ddavydo1@u.washington.edu
Purpose:
To critically review data on the prevalence of depressive symptoms in general intensive care unit (ICU) survivors, risk factors for these symptoms, and their impact on health-related quality of life (HRQOL).
Methods:
We conducted a systematic review using Medline, EMBASE, Cochrane Library, CINAHL, PsycINFO, and a hand-search of 13 journals.
Results:
Fourteen studies were eligible. The median point prevalence of "clinically significant" depressive symptoms was 28% (total n = 1,213). Neither sex nor age were consistent risk factors for post-ICU depression, and severity of illness at ICU admission was consistently not a risk factor. Early post-ICU depressive symptoms were a strong risk factor for subsequent depressive symptoms. Post-ICU depressive symptoms were associated with substantially lower HRQOL.
Conclusions:
Depressive symptoms are common in general ICU survivors and negatively impact HRQOL. Future studies should address how factors related to individual patients, critical illness and post-ICU recovery are associated with depression in ICU survivors.
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