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Delirium, depression, and long-term cognition.

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Summary
This summary is machine-generated.

A history of depression before intensive care unit (ICU) admission was linked to increased depression severity one year later. However, it did not affect delirium/coma-free days or cognitive function post-ICU.

Keywords:
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Area of Science:

  • Critical Care Medicine
  • Psychiatry
  • Neuroscience

Background:

  • Preadmission history of depression is common among intensive care unit (ICU) patients.
  • The impact of preadmission depression on post-ICU outcomes, including delirium, depression severity, and cognitive function, requires further investigation.

Purpose of the Study:

  • To investigate the association between preadmission history of depression and delirium/coma-free (DCF) days.
  • To examine the effect of preadmission depression history on depression symptom severity at 3 and 12 months post-ICU.
  • To assess the relationship between preadmission depression history and cognitive performance at 3 and 12 months post-ICU.

Main Methods:

  • A health proxy reported preadmission history of depression in eligible medical/surgical ICU patients.
  • Outcomes assessed included DCF days, Beck Depression Inventory-II (BDI-II) scores at 3 and 12 months, and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) global scores at 3 and 12 months.
  • Statistical models were used to analyze the associations, adjusting for relevant covariates.

Main Results:

  • Preadmission depression history was not significantly associated with fewer DCF days (p=0.077).
  • A prior history of depression was significantly associated with higher BDI-II scores at 3 months (p<0.001) and 12 months (p=0.003).
  • No significant association was found between preadmission depression history and cognitive performance at 3 or 12 months (p=0.97 and p=0.28, respectively).

Conclusions:

  • Patients with a preadmission history of depression experience greater depressive symptom severity in the year following ICU hospitalization.
  • Preadmission depression history does not appear to impact delirium/coma-free days or cognitive function in the post-ICU period.
  • These findings highlight the importance of addressing pre-existing depression in ICU survivors to manage long-term mental health outcomes.