Long-term mental health change patterns in ICU survivors: a four-year comparative follow-up from the SMAP-HoPe study.

IF 4.7 2区 医学 Q1 CRITICAL CARE MEDICINE
Takeshi Unoki, Tomoki Kuribara, Sakura Uemura, Mayumi Hino, Masako Shirasaka, Yuko Misu, Takumi Nagao, Mio Kitayama, Junpei Haruna, Masahiro Yamane, Keiko Atsumi, Miyuki Sagawa, Yumi Kajiyama, Kazuyuki Okada, Tomomi Nishide, Emiko Higuchi, Hideaki Sakuramoto
{"title":"Long-term mental health change patterns in ICU survivors: a four-year comparative follow-up from the SMAP-HoPe study.","authors":"Takeshi Unoki, Tomoki Kuribara, Sakura Uemura, Mayumi Hino, Masako Shirasaka, Yuko Misu, Takumi Nagao, Mio Kitayama, Junpei Haruna, Masahiro Yamane, Keiko Atsumi, Miyuki Sagawa, Yumi Kajiyama, Kazuyuki Okada, Tomomi Nishide, Emiko Higuchi, Hideaki Sakuramoto","doi":"10.1186/s40560-025-00812-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Post-intensive care syndrome (PICS) encompasses persistent physical, cognitive, and psychological impairments in individuals following intensive care unit (ICU) discharge. The short-term mental health impacts of PICS have been previously examined; however, long-term change pattern remain inadequately understood. In this study, we aimed to determine the prevalence of mental health disorders in individuals at 4 years post-ICU discharge, compare prevalence rates between 1 and 4 years, and identify change patterns and associated factors.</p><p><strong>Methods: </strong>In this 4-year follow-up study of the SMAP-HoPe study (754 ICU survivors from 12 Japanese ICUs were originally examined in the SMAP-HoPe study), we included participants from seven ICUs who completed mental health assessments using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised at both 1- and 4-years post-ICU discharge. Growth mixture modeling was employed to identify distinct change patterns for anxiety, depression, and post-traumatic stress disorder (PTSD).</p><p><strong>Results: </strong>Among the 319 eligible participants, 223 (70.0%) provided responses. The prevalence of depression significantly increased from 24.7% at 1 year to 32.7% at 4 years (p = 0.021), whereas that of anxiety increased from 15.3% to 21.6% (p = 0.049). PTSD prevalence decreased from 5.1% to 2.7% (p = 0.549). Distinct change patterns were observed for anxiety-minimal (scores < 4) and decreasing, mild (scores ≥ 4) and increasing, and moderate (scores ≥ 8) and stable; for depression-minimal (scores < 4) and stable, mild (scores ≥ 4) and increasing, and moderate (scores ≥ 8) and stable; and for PTSD-minimal (scores < 4), mild (scores ≥ 4), and moderate (scores ≥ 10) symptoms that remained stable. Participants with higher education had a lower risk of exhibiting the moderate-stable depression change patterns (adjusted odds ratio: 0.25, 95% confidence interval: 0.09-0.68, p = 0.006).</p><p><strong>Conclusions: </strong>Mental health disorders in ICU survivors persist for a long term, with the prevalence of depression increasing over 4 years. Multiple change patterns were observed for each disorder, suggesting various progression courses. Participants with high education were protected from severe depression and its change patterns. These findings highlighted the importance of extended follow-up care and individualized interventions based on the change patterns and associated predictors.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":"13 1","pages":"41"},"PeriodicalIF":4.7000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302793/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40560-025-00812-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Post-intensive care syndrome (PICS) encompasses persistent physical, cognitive, and psychological impairments in individuals following intensive care unit (ICU) discharge. The short-term mental health impacts of PICS have been previously examined; however, long-term change pattern remain inadequately understood. In this study, we aimed to determine the prevalence of mental health disorders in individuals at 4 years post-ICU discharge, compare prevalence rates between 1 and 4 years, and identify change patterns and associated factors.

Methods: In this 4-year follow-up study of the SMAP-HoPe study (754 ICU survivors from 12 Japanese ICUs were originally examined in the SMAP-HoPe study), we included participants from seven ICUs who completed mental health assessments using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised at both 1- and 4-years post-ICU discharge. Growth mixture modeling was employed to identify distinct change patterns for anxiety, depression, and post-traumatic stress disorder (PTSD).

Results: Among the 319 eligible participants, 223 (70.0%) provided responses. The prevalence of depression significantly increased from 24.7% at 1 year to 32.7% at 4 years (p = 0.021), whereas that of anxiety increased from 15.3% to 21.6% (p = 0.049). PTSD prevalence decreased from 5.1% to 2.7% (p = 0.549). Distinct change patterns were observed for anxiety-minimal (scores < 4) and decreasing, mild (scores ≥ 4) and increasing, and moderate (scores ≥ 8) and stable; for depression-minimal (scores < 4) and stable, mild (scores ≥ 4) and increasing, and moderate (scores ≥ 8) and stable; and for PTSD-minimal (scores < 4), mild (scores ≥ 4), and moderate (scores ≥ 10) symptoms that remained stable. Participants with higher education had a lower risk of exhibiting the moderate-stable depression change patterns (adjusted odds ratio: 0.25, 95% confidence interval: 0.09-0.68, p = 0.006).

Conclusions: Mental health disorders in ICU survivors persist for a long term, with the prevalence of depression increasing over 4 years. Multiple change patterns were observed for each disorder, suggesting various progression courses. Participants with high education were protected from severe depression and its change patterns. These findings highlighted the importance of extended follow-up care and individualized interventions based on the change patterns and associated predictors.

Abstract Image

Abstract Image

Abstract Image

ICU幸存者的长期心理健康变化模式:来自SMAP-HoPe研究的四年比较随访
背景:重症监护后综合征(PICS)包括重症监护病房(ICU)出院后个体持续的身体、认知和心理障碍。以前曾研究过囚犯对精神健康的短期影响;然而,长期变化模式仍未得到充分认识。在本研究中,我们旨在确定icu出院后4年个体精神健康障碍的患病率,比较1年和4年的患病率,并确定变化模式和相关因素。方法:在这项SMAP-HoPe研究的4年随访研究中(来自12个日本ICU的754名ICU幸存者最初在SMAP-HoPe研究中进行了检查),我们纳入了来自7个ICU的参与者,他们在ICU出院后1年和4年使用医院焦虑和抑郁量表和事件影响量表(修订)完成了心理健康评估。生长混合模型用于识别焦虑、抑郁和创伤后应激障碍(PTSD)的不同变化模式。结果:在319名符合条件的参与者中,223名(70.0%)提供了回复。抑郁的患病率从1年的24.7%上升到4年的32.7% (p = 0.021),而焦虑的患病率从15.3%上升到21.6% (p = 0.049)。PTSD患病率从5.1%降至2.7% (p = 0.549)。结论:ICU幸存者的精神健康障碍长期存在,抑郁症的患病率在4年以上增加。观察到每种疾病的多种变化模式,提示不同的进展过程。受过高等教育的参与者不受严重抑郁症及其变化模式的影响。这些发现强调了基于变化模式和相关预测因素的延长随访护理和个性化干预的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Intensive Care
Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
11.90
自引率
1.40%
发文量
51
审稿时长
15 weeks
期刊介绍: "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信