Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome

Hopkins, Ramona O.; Key, Colin W.; Suchyta, Mary R.; Weaver, Lindell K.; Orme, James F.

doi:10.1016/j.genhosppsych.2009.11.003

« Previous Next »General Hospital Psychiatry
Volume 32, Issue 2 , Pages 147-155, March 2010

Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome

Ramona O. Hopkins, Ph.D.
- Pulmonary and Critical Care Division, Department of Medicine, LDS Hospital, Salt Lake City, UT 84107, USA
- Pulmonary and Critical Care Division, Department of Medicine, Intermountain Medical Center, Murray, UT 84107, USA
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
- Neuroscience Center, Brigham Young University, Provo, UT 84602, USA
- Corresponding author. Critical Care Medicine, Intermountain Medical Center, SLC, UT 84107, USA. Tel.: +1 801 507 4569; fax: +1 801 507 5578.
Colin W. Key, Ph.D.
- Psychology Department, Brigham Young University, Provo, UT 84602, USA
Mary R. Suchyta, D.O.
- Pulmonary and Critical Care Division, Department of Medicine, LDS Hospital, Salt Lake City, UT 84107, USA
- Pulmonary and Critical Care Division, Department of Medicine, Intermountain Medical Center, Murray, UT 84107, USA
Lindell K. Weaver, M.D.
- Pulmonary and Critical Care Division, Department of Medicine, LDS Hospital, Salt Lake City, UT 84107, USA
- Pulmonary and Critical Care Division, Department of Medicine, Intermountain Medical Center, Murray, UT 84107, USA
- Pulmonary and Critical Care Divisions, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
James F. Orme Jr., M.D.
- Pulmonary and Critical Care Division, Department of Medicine, LDS Hospital, Salt Lake City, UT 84107, USA
- Pulmonary and Critical Care Division, Department of Medicine, Intermountain Medical Center, Murray, UT 84107, USA
- Pulmonary and Critical Care Divisions, University of Utah School of Medicine, Salt Lake City, UT 84132, USA

Received 28 August 2009; accepted 9 November 2009. published online 14 December 2009.

Abstract

Objective

Depression and anxiety are common morbidities of critical illness. We assessed risk factors of depression and anxiety in Acute Respiratory Distress Syndrome (ARDS) survivors at 1 and 2 years post-hospital discharge.

Method

Risk factors for depression and anxiety at 1 and 2 years were assessed using stepwise multiple regression analyses, with and without 1-year outcomes.

Results

ARDS survivors had depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. Predictors of depression at 1 year were alcohol dependence, female gender and younger age (P=.006). Predictors of anxiety were ratio of arterial oxygen tension to inspired oxygen fraction and duration of mechanical ventilation (P<.005). Predictors of depression at 2 years were depression at 1 year and the presence of cognitive sequelae (P<.0001). Predictors of anxiety at 2 years was anxiety at 1 year (P<.0001).

Conclusions

Medical variables that predicted depression or anxiety at 1 year no longer predicted depression and anxiety at 2 years. Medical variables appear to have a short-term effect on psychiatric outcomes. At 2 years lifestyle behaviors including history of smoking along with cognitive sequelae, depression and anxiety at 1 year predict depression and anxiety.

Keywords: Psychiatric disorders, Depression, Anxiety, Critical illness, ARDS