scholarly journals Trajectories of depression in sepsis survivors: an observational cohort study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Monique Boede ◽  
Jochen S. Gensichen ◽  
James C. Jackson ◽  
Fiene Eißler ◽  
Thomas Lehmann ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Critical Illness ◽  
Posttraumatic Stress ◽  
Symptom Trajectories ◽  
Sum Score ◽  
Icu Discharge ◽  
Sepsis Survivors

Abstract Background Advances in critical care medicine have led to a growing number of critical illness survivors. A considerable part of them suffers from long-term sequelae, also known as post-intensive care syndrome. Among these, depressive symptoms are frequently observed. Depressive symptom trajectories and associated factors of critical illness survivors have rarely been investigated. Study objective was to explore and compare different trajectories of depressive symptoms in sepsis survivors over 1 year after discharge from ICU. Methods Data of a randomized controlled trial on long-term post-sepsis care were analyzed post hoc. Depressive symptoms were collected at 1, 6 and 12 months post-ICU discharge using the Major Depression Inventory (MDI), among others. Statistical analyses comprised descriptive analysis, univariate and multivariate, linear and logistic regression models and Growth Mixture Modeling. Results A total of 224 patients were included into this analysis. We identified three latent classes of depressive symptom trajectories: Over the course of 1 year, 152 patients recovered from mild symptoms, 27 patients showed severe persistent symptoms, and 45 patients recovered from severe symptoms. MDI sum scores significantly differed between the three classes of depressive symptom trajectories at 1 and 6 months after ICU discharge (p < 0.024 and p < 0.001, respectively). Compared with other classes, patients with the mild recovered trajectory showed lower levels of chronic pain (median sum score of 43.3 vs. 60.0/53.3 on the Graded Chronic Pain Scale, p < 0.010) and posttraumatic stress (4.6% with a sum score of ≥ 35 on the Posttraumatic Stress Scale 10 vs. 48.1%/33.3%, p < 0.003); and higher levels of health-related quality of life (HRQOL) using the Short Form-36 scale within 1 month after ICU discharge (p < 0.035). Conclusions In the first year after discharge from ICU, sepsis survivors showed three different trajectories of depressive symptoms. Course and severity of depressive symptoms were associated with chronic pain, posttraumatic stress and reduced HRQOL at discharge from ICU. Regular screening of sepsis survivors on symptoms of depression, chronic pain and posttraumatic stress within 1 year after ICU may be considered. Trial registration ISRCTN, ISRCTN 61744782. Registered April 19, 2011—Retrospectively registered, http://www.isrctn.com/ISRCTN61744782.

scholarly journals The Impact of Academic Achievement and Parental Practices on Depressive Symptom Trajectories Among Chinese Adolescents

2021 ◽  
Author(s):  
Xingna Qin ◽  
Tessa Kaufman ◽  
Lydia Laninga-Wijnen ◽  
Ping Ren ◽  
Yunyun Zhang ◽  
...  
Keyword(s):  
Academic Achievement ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Autonomy Support ◽  
Psychological Control ◽  
Chinese Adolescents ◽  
Parental Practices ◽  
Symptom Trajectories ◽  
Symptom Profile ◽  
The Impact

AbstractThough depressive symptoms tend to increase in early adolescence, the trajectories of these symptoms may vary strongly. This longitudinal study investigated the extent to which the distinct developmental trajectories of depressive symptoms were predicted by adolescents' academic achievement and perceived parental practices in a sample of Chinese young adolescents (N = 2,576). The results showed four trajectory profiles of depressive symptoms: low-stable (75%), low-increasing (11%), high-stable (9%), and high-decreasing (5%). Adolescents with high academic achievement were more likely to be classified into the low-stable, low-increasing, and high-decreasing profiles than into the high-stable depressive symptom profile. Moreover, students who perceived greater parental autonomy support were more likely to be in the low-stable and low-increasing profiles than the high-stable profile, whereas adolescents perceiving more parental psychological control had higher odds of being in the low-increasing rather than the low-stable profile. Parental educational involvement was unrelated to students' depressive symptom trajectories. In sum, Chinese adolescents with higher academic achievement and who perceived more parental autonomy support, and less psychological control, were at lower risk of experiencing depressive symptoms.

Psychological prognosis after newly diagnosed chronic conditions: socio-demographic and clinical correlates

2016 ◽  
Vol 29 (2) ◽  
pp. 281-292 ◽  
Author(s):  
Ching-Ju Chiu ◽  
Yu-Ching Hsu ◽  
Shuo-Ping Tseng
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Chronic Conditions ◽  
Liver Diseases ◽  
Lung Diseases ◽  
Heart Diseases ◽  
Psychological Burden ◽  
Symptom Trajectories ◽  
Physical Limitations ◽  
Over Time

ABSTRACTBackground:This study was aimed toward discerning depressive symptom trajectories associated with different chronic conditions and toward finding modifiable factors associated with those trajectories.Methods:Data were drawn from the 1996–2007 Taiwan Longitudinal Study on Aging. Nine chronic conditions were selected, and mood trajectories were measured with the Center of Epidemiological Studies-Depression scale.Results:Among the nine chronic conditions we examined, four patterns of depressive symptom trajectories were identified: (1) elevated depressive symptoms and worsened over time after diagnosed with heart disease (n= 681), arthritis (n= 850), or hypertension (n= 1,207); (2) elevated depressive symptoms without worsening over time after diagnosed with stroke (n= 160), lung diseases (n= 432), gastric conditions (n= 691), or liver diseases (n= 234); (3) no elevated depressive symptoms after diagnosis but an increase in depressive symptoms over time for participants with diabetes (n= 499); and (4) no significant patterns after diagnosed with cancer (n= 57). Cumulative psychological burden over time was significant for participants with hypertension, diabetes, heart diseases, or arthritis. However, these effects disappeared after controlling for comorbidities and physical limitations. Moreover, psychiatric condition was found to play an important role in baseline depressive symptoms among participants diagnosed with lung diseases, arthritis, or liver diseases.Conclusions:Findings from this study provide information in addressing psychological burden at different times for different conditions. In addition, minimizing the incidence of comorbidities, physical limitations, or psychiatric conditions may have the prospective effect of avoiding the trend of increased depressive symptoms, especially when adults diagnosed with hypertension, diabetes, heart diseases, arthritis, lung diseases, arthritis, or liver diseases.

scholarly journals Psychosocial and health-related risk factors for depressive symptom trajectories among midlife women over 15 years: Study of Women's Health Across the Nation (SWAN)

2018 ◽  
Vol 49 (2) ◽  
pp. 250-259 ◽  
Author(s):  
Joyce T. Bromberger ◽  
Laura L. Schott ◽  
Nancy E. Avis ◽  
Sybil L. Crawford ◽  
Sioban D. Harlow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Midlife Women ◽  
Role Functioning ◽  
Symptom Trajectories ◽  
Related Risk ◽  
Health Related ◽  
Symptom Trajectory

AbstractBackgroundPsychosocial and health-related risk factors for depressive symptoms are known. It is unclear if these are associated with depressive symptom patterns over time. We identified trajectories of depressive symptoms and their risk factors among midlife women followed over 15 years.MethodsParticipants were 3300 multiracial/ethnic women enrolled in a multisite longitudinal menopause and aging study, Study of Women's Health Across the Nation. Biological, psychosocial, and depressive symptom data were collected approximately annually. Group-based trajectory modeling identified women with similar longitudinal patterns of depressive symptoms. Trajectory groups were compared on time-invariant and varying characteristics using multivariable multinomial analyses and pairwise comparisons.ResultsFive symptom trajectories were compared (50% very low; 29% low; 5% increasing; 11% decreasing; 5% high). Relative to whites, blacks were less likely to be in the increasing trajectory and more likely to be in the decreasing symptom trajectory and Hispanics were more likely to have a high symptom trajectory than an increasing trajectory. Psychosocial/health factors varied between groups. A rise in sleep problems was associated with higher odds of having an increasing trajectory and a rise in social support was associated with lower odds. Women with low role functioning for 50% or more visits had three times the odds of being in the increasing symptom group.ConclusionsChanges in psychosocial and health characteristics were related to changing depressive symptom trajectories. Health care providers need to evaluate women's sleep quality, social support, life events, and role functioning repeatedly during midlife to monitor changes in these and depressive symptoms.

scholarly journals Trajectories of maternal depressive symptoms over her child's life span: Relation to adrenocortical, cardiovascular, and emotional functioning in children

2009 ◽  
Vol 21 (1) ◽  
pp. 207-225 ◽  
Author(s):  
Brooks B. Gump ◽  
Jacki Reihman ◽  
Paul Stewart ◽  
Ed Lonky ◽  
Tom Darvill ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Life Span ◽  
Acute Stress ◽  
Depression Scale ◽  
Cardiovascular Responses ◽  
Epidemiological Studies ◽  
Maternal Depressive Symptoms ◽  
Symptom Trajectories ◽  
Maternal Depressive Symptom

AbstractMaternal depression has a number of adverse effects on children. In the present study, maternal depressive symptoms were assessed (using the Center for Epidemiological Studies Depression Scale) when their child was 3 months, 6 months, 1 year, 2 years, 4.25 years, 6 years, 7 years, 8 years, and 10 years of age. At 9.5 years of age, children's (94 females, 82 males) depressive symptoms as well as cardiovascular and cortisol levels during baseline and two psychologically stressful tasks were measured. Using multilevel modeling, maternal depressive symptom trajectories were considered in relation to their child's adrenocortical and cardiovascular responses to acute stress. Our goal was to determine maternal depressive symptom trajectories for children with elevated cardiovascular and cortisol reactivity to acute stress and elevated depressive symptoms. In general, those mothers with chronically elevated depressive symptoms over their child's life span had children with lower initial cortisol, higher cardiac output and stroke volume in response to acute stress, lower vascular resistance during acute stress tasks, and significantly more depressive symptoms at 9.5 years of age. These results are discussed in the context of established associations among hypothalamic–pituitary–adrenal axis dysregulation, depression, and cardiovascular disease.

scholarly journals Adolescents’ Depressive Symptom Experience Mediates the Impact of Long-Term Exposure to Maternal Depression Symptoms on Adolescents’ Body Mass Index

2020 ◽  
Vol 54 (7) ◽  
pp. 510-517
Author(s):  
Amber R Cordola Hsu ◽  
Zhongzheng Niu ◽  
Xiaomeng Lei ◽  
Emily Kiresich ◽  
Yawen Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Body Mass ◽  
Depression Symptoms ◽  
Maternal Depressive Symptoms ◽  
Z Score ◽  
Symptom Experience ◽  
The Impact

Abstract Background Obesity is a cardiovascular disease risk factor and affects approximately 13.7 million U.S. children and adolescents between the ages 2 and 19 years old in 2015–2016. Purpose To determine the relationship between children’s average long-term exposure to maternal depressive symptoms age 1 month to Grade 6 and adolescents’ body mass index (BMI) z-score at age 15 mediated by the adolescents’ depressive symptom experience. Methods A total of 1,364 infants and their families from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were recruited. Results Mediation analyses revealed a significant relationship between children’s average long-term exposure to maternal depressive symptoms from age 1 month to Grade 6 and adolescents’ BMI z-score at age 15 (total effect = 0.015, p = .013, 95% confidence interval (CI): 0.0032, 0.027). The adolescents’ experience of depressive symptoms significantly mediated this relationship (indirect effect = 0.0021, bias-corrected bootstrapped 95% CI: 0.0004, 0.0044), with this mediated relationship more pronounced in girls. Conclusions Findings indicate the possible existence of a mediating role of adolescents’ depressive symptoms experience in the pathway from average long-term exposure to maternal depressive symptoms during children’s early life to adolescents’ elevated BMI.

scholarly journals Enhanced Recovery after Intensive Care (ERIC): study protocol for a German stepped wedge cluster randomised controlled trial to evaluate the effectiveness of a critical care telehealth program on process quality and functional outcomes

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036096 ◽  
Author(s):  
Christine Adrion ◽  
Bjoern Weiss ◽  
Nicolas Paul ◽  
Elke Berger ◽  
Reinhard Busse ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Stepped Wedge ◽  
Link Type ◽  
Cluster Randomised ◽  
Icu Discharge ◽  
Randomised Controlled ◽  
The Impact

IntroductionSurvival after critical illness has noticeably improved over the last decades due to advances in critical care medicine. Besides, there is an increasing number of elderly patients with chronic diseases being treated in the intensive care unit (ICU). More than half of the survivors of critical illness suffer from medium-term or long-term cognitive, psychological and/or physical impairments after ICU discharge, which is recognised as post-intensive care syndrome (PICS). There are evidence-based and consensus-based quality indicators (QIs) in intensive care medicine, which have a positive influence on patients’ long-term outcomes if adhered to.Methods and analysisThe protocol of a multicentre, pragmatic, stepped wedge cluster randomised controlled, quality improvement trial is presented. During 3 predefined steps, 12 academic hospitals in Berlin and Brandenburg, Germany, are randomly selected to move in a one-way crossover from the control to the intervention condition. After a multifactorial training programme on QIs and clinical outcomes for site personnel, ICUs will receive an adapted, interprofessional protocol for a complex telehealth intervention comprising of daily telemedical rounds at ICU. The targeted sample size is 1431 patients. The primary objective of this trial is to evaluate the effectiveness of the intervention on the adherence to eight QIs daily measured during the patient’s ICU stay, compared with standard of care. Furthermore, the impact on long-term recovery such as PICS-related, patient-centred outcomes including health-related quality of life, mental health, clinical assessments of cognition and physical function, all-cause mortality and cost-effectiveness 3 and 6 months after ICU discharge will be evaluated.Ethics and disseminationThis protocol was approved by the ethics committee of the Charité—Universitätsmedizin, Berlin, Germany (EA1/006/18). The results will be published in a peer-reviewed scientific journal and presented at international conferences. Study findings will also be disseminated via the website (www.eric-projekt.net).Trial registration numberClinicalTrials.gov Registry (NCT03671447).

scholarly journals Symptoms of Posttraumatic Stress after Intensive Care Delirium

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Helle Svenningsen ◽  
Ingrid Egerod ◽  
Doris Christensen ◽  
Else Kirstine Tønnesen ◽  
Morten Frydenberg ◽  
...  
Keyword(s):  
Posttraumatic Stress ◽  
Anxiety And Depression ◽  
Ptsd Symptoms ◽  
Psychological Consequences ◽  
Post Discharge ◽  
Telephone Interviews ◽  
Icu Discharge ◽  
Observational Cohort ◽  
Icu Delirium

Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort.Methods.A prospective observational cohort study assessing the incidence of delirium in the ICU. Psychometrics were screened by validated tools in structured telephone interviews after 2 months (n=297) and 6 months (n=248) after ICU-discharge.Results. Delirium was detected in 54% of patients in the ICU and symptoms of PTSD in 8% (2 months) and 6% (6 months) after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months. Remaining associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use of antipsychotics and sedation in the ICU.Conclusion.ICU-delirium did not increase the risk of PTSD-symptoms at 2 and 6 months after ICU discharge.

scholarly journals Mid-German Sepsis Cohort (MSC): a prospective observational study of sepsis survivorship

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043352
Author(s):  
Carolin Fleischmann-Struzek ◽  
Miriam Kesselmeier ◽  
Dominique Ouart ◽  
Christiane S. Hartog ◽  
Michael Bauer ◽  
...  
Keyword(s):  
Informed Consent ◽  
Healthcare Utilisation ◽  
Mortality And Morbidity ◽  
Icu Discharge ◽  
Related Quality ◽  
Registration Number ◽  
Health Related ◽  
Sepsis Survivors

PurposeThe Mid-German Sepsis Cohort (MSC) aims to investigate mid-term and long-term functional disabilities in sepsis survivors from intensive care unit (ICU) discharge until 1 year after. Secondary, post-acute mortality and morbidity, health-related quality of life and healthcare utilisation will be investigated.ParticipantsThe MSC comprises adult (aged ≥18 years) patients who were treated for (severe) sepsis or septic shock on ICU. The participants were recruited between 15 April 2016 and 30 November 2018 from five German centres. Three thousand two hundred and ten patients with sepsis were identified, of which 1968 survived their ICU stay and were eligible for enrolment in the follow-up cohort. Informed consent for follow-up assessment was provided by 907 patients (46.1% of eligible patients).Findings to dateThe recruitment of the participants for follow-up assessments and the baseline data collection is completed. Incidence of sepsis was 116.7 patients per 1000 ICU patients. In this cohort profile, we provide an overview of the demographics and the clinical characteristics of both the overall sepsis cohort and the ICU survivors who provided informed consent for follow-up assessment (907 out of 1968 ICU survivors (46.1%)).Future plansThe follow-ups are conducted 3, 6 and 12 months after ICU discharge. Another yearly follow-up up to 5 years after ICU discharge is pursued. Several cooperation and satellite projects were initiated. This prospective cohort offers a unique resource for research on long-term sequelae of sepsis survivors.Trial registration numberGerman Clinical Trials Registry (DRKS00010050).

scholarly journals Dysregulated Immunity and Immunotherapy after Sepsis

2021 ◽  
Vol 10 (8) ◽  
pp. 1742
Author(s):  
Dijoia B. Darden ◽  
Lauren S. Kelly ◽  
Brittany P. Fenner ◽  
Lyle L. Moldawer ◽  
Alicia M. Mohr ◽  
...  
Keyword(s):  
Immune System ◽  
Critical Illness ◽  
The Elderly ◽  
Long Term Outcomes ◽  
Diagnosis And Management ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Initial Hospitalization ◽  
Sepsis Survivors

Implementation of protocolized surveillance, diagnosis, and management of septic patients, and of surgical sepsis patients in particular, is shown to result in significantly increased numbers of patients surviving their initial hospitalization. Currently, most surgical sepsis patients will rapidly recover from sepsis; however, many patients will not rapidly recover, but instead will go on to develop chronic critical illness (CCI) and experience dismal long-term outcomes. The elderly and comorbid patient is highly susceptible to death or CCI after sepsis. Here, we review aspects of the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS) endotype to explain the underlying pathobiology of a dysregulated immune system in sepsis survivors who develop CCI; then, we explore targets for immunomodulatory therapy.

scholarly journals Trajectories of Depressive Symptoms in Community-Dwelling Korean Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 171-171
Author(s):  
Jinhee Shin ◽  
Eunhee Cho
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Growth Analysis ◽  
Latent Class ◽  
Community Dwelling ◽  
Latent Class Growth Analysis ◽  
Symptom Trajectories ◽  
Symptom Trajectory ◽  
Latent Class Growth

Abstract Objectives This study aimed to identify trajectories of depressive symptoms and investigate predictive variables of latent class in Korean community-dwelling older adults. Methods Study participants comprised 2,016 community-dwelling Korean adults aged over 65 years, using data from the Korean Longitudinal Study of Aging (KLoSA) from 2006–2016. The KLoSA, a nationally representative panel survey, has been conducted biannually since 2006. We used latent class growth analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms. Results Five depressive symptom trajectory groups were identified: Class 1, no depressive symptom (13.8%); Class 2, low depressive symptom (32.8%); Class 3, decreasing depressive symptom (10.6%); Class 4, increasing depressive symptoms (24.0%); and Class 5, persistent depressive symptoms (18.8%). We found that older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, gender, current employment, contact with children, and social activity were associated with a higher risk of these trajectories. Conclusions Depressive symptoms are associated with social networks as cognitive function scores increase and number of chronic diseases decrease. Interventions to strengthening existing social networks and developing relationships should be tailored to target specific needs for each trajectory, and chronic disease management, including cognitive function, may be beneficial in preventing depressive symptoms among older adults. KEYWORDS Older adults, Depressive symptom, Trajectory, Latent class growth analysis, Korean

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