A nationwide cohort study on the association between intensive care treatments and mental distress linked psychiatric disorders.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Critical Care* ; Mental Disorders*/epidemiology ; Mental Disorders*/therapy; Adult ; Humans ; Cohort Studies ; Critical Illness/therapy ; Hospitalization ; Intensive Care Units ; Clinical Trials as Topic

Given the psychic strain patients experience in the intensive care unit (ICU), a potential risk of mental disorders has been suggested. However, the effects of intensive care treatment per se are unknown. We investigated whether the level of intensive care treatments is an independent risk factor for developing long-term mental disorders after intensive care. In a national cohort of adult ICU patients we combined data on diagnoses, treatment, and causes of death. We defined extensive ICU treatment as being treated with invasive ventilation for > 24 h, continuous renal replacement therapy, or both. The primary outcome was incident mental disorder 1 year after ICU admission. Extensive ICU treatment was found to be associated with a decreased risk of developing a mental disorder ≥ 1 year after ICU admission (HR 0.90, 95% CI 0.82-0.99, p = 0.04), and increasing severity of acute illness (HR 1.18, 95% CI 1.06-1.32, p < 0.001) were associated with an increased risk of mental disorders. Because death acted as a competing risk for mental illness, mortality might help explain the apparent protective effect of extensive ICU care.Trial registration Clinical Trials Registry (Identification number NCT05137977). Registered 16 November 2021. As a registry trial the patients were already included at the trial registration i.e. it was retrospectively registered.
(© 2024. The Author(s).)

Crit Care. 2019 Jun 11;23(1):213. (PMID: 31186070)
Intensive Care Med. 2003 Mar;29(3):368-77. (PMID: 12536269)
Am J Epidemiol. 2011 Mar 15;173(6):676-82. (PMID: 21330339)
J Chronic Dis. 1987;40(5):373-83. (PMID: 3558716)
Eur Rev Med Pharmacol Sci. 2013 Feb;17 Suppl 1:65-85. (PMID: 23436669)
Crit Care Med. 1985 Oct;13(10):818-29. (PMID: 3928249)
Lancet Psychiatry. 2017 Jan;4(1):8-9. (PMID: 27856397)
Lancet Respir Med. 2014 May;2(5):369-79. (PMID: 24815803)
Curr Addict Rep. 2021;8(1):89-99. (PMID: 33614395)
Eur Heart J. 2014 Jun 1;35(21):1365-72. (PMID: 24282187)
Am J Psychiatry. 2019 Sep 1;176(9):683-684. (PMID: 31474121)
Biol Psychiatry. 2004 Nov 15;56(10):730-7. (PMID: 15556117)
Arch Phys Med Rehabil. 2016 Feb;97(2 Suppl):S19-25. (PMID: 25944501)
BMC Psychiatry. 2017 Jun 30;17(1):235. (PMID: 28666429)
Intensive Care Med. 2009 May;35(5):796-809. (PMID: 19165464)
Int J Gen Med. 2020 May 14;13:177-183. (PMID: 32523369)
Crit Care Med. 2016 Sep;44(9):1744-53. (PMID: 27153046)
J Behav Med. 2016 Feb;39(1):55-64. (PMID: 26245159)
Epidemiology. 2007 Nov;18(6):805-35. (PMID: 18049195)
Intensive Care Med. 2005 May;31(5):611-20. (PMID: 15803303)
Compr Psychiatry. 2018 Jan;80:155-162. (PMID: 29096206)
Arch Intern Med. 2000 Apr 10;160(7):906-9. (PMID: 10761954)
J Geriatr Cardiol. 2012 Jun;9(2):197-208. (PMID: 22916068)
Curr Psychiatry Rep. 2019 Sep 14;21(10):100. (PMID: 31522306)
BMC Psychiatry. 2014 Oct 17;14:289. (PMID: 25322690)
Intensive Care Med. 2007 Sep;33(9):1506-18. (PMID: 17558490)
Intensive Care Med. 2019 Nov;45(11):1550-1558. (PMID: 31482222)
Crit Care. 2018 Nov 23;22(1):310. (PMID: 30466485)
J Affect Disord. 2013 Dec;151(3):821-30. (PMID: 24091302)
BMJ. 2021 May 5;373:n973. (PMID: 33952509)
J Cardiothorac Vasc Anesth. 2022 May;36(5):1354-1363. (PMID: 34973891)
JAMA. 2022 Nov 8;328(18):1827-1836. (PMID: 36286084)
Intensive Care Med. 2005 Oct;31(10):1336-44. (PMID: 16132893)

Keywords: Critical illness; Epidemiology; Intensive care units; Mental disorders; Risk factors

Date Created: 20240224 Date Completed: 20240226 Latest Revision: 20240307

20240307

PMC10894289

10.1038/s41598-024-55102-9

38402361