Mental health outcomes at intensive care unit discharge: prevalence, mediators and risk factors.

Abstract

Background: Intensive Care Unit (ICU) patients often experience significant discomfort and distress due to both the medical environment and the nature of their stay. While long-term sequelae such as depression, anxiety, and post-traumatic stress are well-documented, few studies have examined psychological disorders present at the time of ICU discharge. Based on the model of Post-Intensive Care Syndrome, specifically the mental component (PICS-M), we defined DICS-M (Discharge Intensive Care Syndrome - Mental component). This study aimed to estimate the prevalence of psychological disorders at ICU discharge and to identify potential mediators and risk factors.

Methods: We conducted a prospective observational study involving 243 patients admitted between January 2023 and April 2024.

Results: The prevalence of DICS-M was 53% [95% CI: 46-59], with acute stress, anxiety, and depression observed in 37%, 36%, and 23% of patients, respectively. The analyses revealed an overlap among these psychological components. Peritraumatic distress acted as the main mediator of DICS-M. Univariate and multivariable analyses identified female gender and a history of psychiatric and cardiac conditions as risk factors of DICS-M.

Conclusion: Psychological disorders are common at ICU discharge, mediated by peritraumatic distress, and associated with identifiable risk factors. These findings may help guide interventions to prevent long-term sequelae of ICU stays.