scholarly journals Prevalence of and risk factors for post-intensive care syndrome: Multicenter study of patients living at home after treatment in 12 Japanese intensive care units, SMAP-HoPe study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252167
Author(s):  
Takeshi Unoki ◽  
Hideaki Sakuramoto ◽  
Sakura Uemura ◽  
Takahiro Tsujimoto ◽  
Takako Yamaguchi ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Depressive Symptoms ◽  
Unplanned Admission ◽  
Event Scale ◽  
Icu Discharge ◽  
One Year ◽  
The Impact ◽  
Post Intensive Care Syndrome ◽  
At Home

Few studies have examined the epidemiology of post-intensive care syndrome in Japan. This study investigated the mental health and quality of life of patients living at home in Japan after intensive care unit (ICU) discharge. Additionally, we examined whether unplanned admission to the ICU was associated with more severe post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms. An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of Event Scale—Revised (IER-S), the Hospital Anxiety Depression Scale (HADS), and the EuroQOL—5 Dimension (EQ-5D-L) questionnaires. Patients’ characteristics, delirium and coma status, drugs used, and ICU and hospital length of stay were assessed from medical records. Descriptive statistics and multilevel linear regression modeling were used to examine our hypothesis. Among 7,030 discharged patients, 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The median IES-R score was 3 (interquartile range [IQR] = 1‒9), and the prevalence of suspected PTSD was 6.0%. The median HADS anxiety score was 4.00 (IQR = 1.17‒6.00), and the prevalence of anxiety was 16.6%. The median HADS depression score was 5 (IQR = 2‒8), and the prevalence of depression was 28.1%. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the general ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.

scholarly journals Post-Intensive Care Syndrome Associated With Coronavirus Disease: A Single Institutional Study In Tokyo

2021 ◽  
Author(s):  
Aya Banno ◽  
Toru Hifumi ◽  
Yuta Takahashi ◽  
Mitsuhito Soh ◽  
Ayako Sakaguchi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Comprehensive Evaluation ◽  
Invasive Mechanical Ventilation ◽  
Depression Scale ◽  
High Rate ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Icu Discharge ◽  
The Impact ◽  
Post Intensive Care Syndrome

Abstract Background: The occurrence of post-intensive care syndrome (PICS) in critically ill patients with coronavirus disease (COVID-19) remains unclear. This study aimed to investigate the physical, mental, and cognitive components of PICS in intensive care unit (ICU)-treated COVID-19 survivors.Methods: This prospective cohort study enrolled patients with COVID-19 who were treated in the ICU of a single institution between March 19, 2020 and April 30, 2020. A survey was sent by postal mail at 4 and 6 months after ICU discharge. The questionnaire comprised the post-COVID-19 functional status (PCFS) scale and the modified medical research council dyspnea scale (mMRC) for assessing physical PICS; the impact of event scale-revised (IES-R) and the hospital anxiety and depression scale (HADS) for assessing mental PICS; and self-assessment questions for concentration, memory, and forgetfulness for assessing cognitive PICS. Physical PICS was defined by a PCFS or mMRC score ≥1. Mental PICS was defined by an IES-R score ≥25 or if the HADS score for anxiety or depression components was ≥8. Cognitive PICS was defined according to patient complaints of deterioration in concentration, memory, or forgetfulness. The primary outcome was PICS occurrence at 4 months. Moreover, we assessed the co-occurrence of the three PICS components.Results: Twenty patients consented to participate in the study and responded to the survey. The median age was 57.5 years, and 80% of the patients were male; moreover, 50%, 55%, and 80% lived alone, were married, and were employed/self-employed before hospitalization, respectively. During ICU stay, 80%, 75%, and 25% received invasive mechanical ventilation, systemic steroids, and continuous benzodiazepine, respectively. Delirium occurred in 40% of patients. The median days of ICU and hospital stay were 6 and 21, respectively. Physical, mental, and cognitive PICS occurred in 14 (78%), 9 (45%), and 11 (55%) patients, respectively. There were 16 (80%) and 8 (40%) patients with at least one and all PICS components, respectively.Conclusions: Our findings revealed a high rate of PICS in COVID-19 survivors. Long-term and comprehensive evaluation of all three PICS components is crucial for providing appropriate care to these patients.

scholarly journals Design and conduct of a multicenter randomized clinical trial on the impact of a post-intensive care unit multidisciplinary follow-up on the quality of life (suivi-rea) (Preprint)

2021 ◽  
Author(s):  
Friedman Diane ◽  
Lamiae Grimaldi ◽  
Alain Cariou ◽  
Philippe Aegerter ◽  
Stéphane Gaudry ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Controlled Trial ◽  
Social Evaluation ◽  
Double Blind ◽  
Icu Discharge ◽  
One Year ◽  
The Impact

UNSTRUCTURED Introduction: Critically ill patients are at risk to develop a Post-Intensive Care Syndrome (PICS), which is characterized by physical, psychological and cognitive impairments and dramatically impacts the quality of life. No intervention has been shown to improve the quality of life (QoL). Because of the interdependency of its domains, we hypothesized that a medical, psychological and social follow-up would improve the QoL by mitigating the PICS. Methods and analysis: We conducted a multicenter, double-blind, randomized controlled trial comparing a multidisciplinary to a standard post-ICU follow-up. In the intervention arm, multidisciplinary follow-up consisted of medical, psychological and social evaluation at ICU discharge and at 3, 6 and 12 months after ICU discharge. In the placebo group, patients were seen only at 12 months by the multidisciplinary team. The baseline characteristics at ICU discharge were collected in all patients. The primary outcome was the quality of life at one year, assessed with help of EuroQoL 5 dimensions (EQ5D). Secondary outcomes were mortality, cognitive, psychological and functional status, the social and professional reintegration as well as the rate of re-hospitalization and outpatient consultations at one year. The first patient was randomized on 20/12/2012 and the last patient on 01/09/2017 out of 546 patients who were enrolled across 11 ICUs. At present, data management is still ongoing, and all parties involved in the trial remain blinded. Ethics and dissemination – Research Ethics Committee of Saint-Germain-en-Laye, France, initial approval received on 08/07/2011. Results will be disseminated via peer-reviewed publication and presentation at international conferences. Trial registration: Clinicaltrials.gov identifier NCT01796509 (registered on 21/02/2013).

scholarly journals COVID-19 and Post-intensive Care Syndrome: Community-Based Care for ICU Survivors

2020 ◽  
pp. 108482232097495
Author(s):  
Ellen M.T. Smith ◽  
Alan Chong W. Lee ◽  
James M. Smith ◽  
Alecia Thiele ◽  
Hallie Zeleznik ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Critical Illness ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Screening Tools ◽  
Care Providers ◽  
Community Based ◽  
The Impact ◽  
Post Intensive Care Syndrome

Survivors of critical illness, including those with COVID-19, are likely to experience post-intensive care syndrome (PICS). PICS involves a constellation of physical, cognitive, and mental health problems that can occur following hospitalization in an intensive care unit (ICU). This focused review describes the impact of PICS on an individual’s function, societal participation, and family. Specific evidence-based screening tools for in-home identification of the deficits associated with PICS are recommended. Recognition of PICS through early screening by home health care providers is crucial in order to assemble the physical rehabilitation, mental health, and community resources needed to mitigate the long-term effects of COVID-19 and other critical illnesses. This review concludes with further PICS resources for community-based providers to enhance their knowledge and expertise and to prepare them for caring for COVID-19 and other critical illness survivors.

Impact of an educative program on dialysis patients’ knowledge and mental health: controlled before and after program

2018 ◽  
Vol 10 (2) ◽  
pp. 20204
Author(s):  
Laetitia Idier ◽  
Aurélie Untas ◽  
Nicole Rascle ◽  
Michèle Koleck ◽  
Maider Aguirrezabal ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Vascular Access ◽  
Educational Program ◽  
Psychological State ◽  
Control Group ◽  
Dialysis Patients ◽  
Emotional Change ◽  
The Impact ◽  
Experimental Group

Introduction:Psychological impact of Therapeutic Patient Education (TPE) for dialysis patients is rarely evaluated since the focus of many studies is on medical variables (i.e., adherence).Objectives:The aims of this study were: 1) to estimate the impact of a TPE program on knowledge, depression and anxiety, 2) to examine change in knowledge as a mediator of the effects of a TPE program on mental health.Method:This study was conducted in three hemodialysis units and comprised two groups: an experimental group with education and a control group with routine care. The program was based of 5 educative sessions. Knowledge, depressive and anxious symptoms were assessed with self-reported outcomes measured before and 3 months after the program.Results:The sample comprised 125 patients. Knowledge about vascular access and nutrition (p < 0.01) and depressive symptoms increased in the experimental group (p < 0.01). Analysis of mediation showed that changes in knowledge about vascular access were a significant mediator of the effects of the program on depressive symptoms (F = 4.90;p = 0.01).Discussion:Knowledge acquired during an educational program could lead to an emotional change. Improving knowledge often leads to an awareness of the risks that can modify the psychological state of patients by reminding them of their vulnerability. This study shows that it is required to be attentive to the way of transmitting knowledge. It’s necessary adapting this transmission to the needs of patients and promoting the acquisition of psychosocial competence too.Conclusion:This study shows that knowledge acquired during an educational program can lead to an emotional change in the short term. A long-term follow-up of the population should be interesting to observe these emotional effects.

scholarly journals Psychosocial health of school-aged children during the initial COVID-19 safer-at-home school mandates in Florida: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah L. McKune ◽  
Daniel Acosta ◽  
Nick Diaz ◽  
Kaitlin Brittain ◽  
Diana Joyce- Beaulieu ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Psychosocial Health ◽  
Cross Sectional Study ◽  
Home School ◽  
Sectional Study ◽  
Cross Sectional ◽  
School Aged Children ◽  
K 12 ◽  
At Home

Abstract Background Given the emerging literature regarding the impacts of lockdown measures on mental health, this study aims to describe the psychosocial health of school-aged children and adolescents during the COVID-19 Safer-at-Home School mandates. Methods A cross-sectional study was conducted in April 2020 (n = 280) among K-12 students at a research school in North Central Florida. Bivariate analysis and logistic and multinomial logistic regression models were used to examine socio-demographic and knowledge, attitude, and practice (KAP) predictors of indicators of anxiety-related, depressive, and obsessive-compulsive disorder(OCD)-related symptoms. Outcomes (anxiety, OCD, and depressive related symptoms) were measured by indices generated based on reported symptoms associated with each psychosocial outcome. Results Loss of household income was associated with increased risk for all three index-based outcomes: depressive symptoms [aOR = 3.130, 95% CI = (1.41–6.97)], anxiety-related symptoms [aOR = 2.531, 95%CI = (1.154–5.551)], and OCD-related symptoms [aOR = 2.90, 95%CI = (1.32–6.36)]. Being female was associated with being at higher risk for depressive symptoms [aOR = 1.72, 95% CI = (1.02–2.93)], anxiety-related symptoms [aOR = 1.75, 95% CI = (1.04–2.97)], and OCD-related symptoms [aOR = 1.764, 95%CI = (1.027–3.028)]. Parental practices protective against COVID-19 were associated with children being at higher risk of depressive symptoms [aOR = 1.55, 95% CI = (1.04–2.31)]. Lower school level was associated with children being at higher risk of anxiety-related and OCD-related symptoms. Conclusions As the COVID-19 pandemic continues, schools should prioritize mental health interventions that target younger, female students, and children of families with income loss. Limiting the spread of COVID-19 through school closure may exacerbate negative psychosocial health outcomes in children, thus school administrators should move quickly to target those at greatest risk.

scholarly journals Longitudinal Associations between Internalizing Symptoms, Dispositional Mindfulness, Rumination and Impulsivity in Adolescents

2021 ◽  
Author(s):  
Estíbaliz Royuela-Colomer ◽  
Liria Fernández-González ◽  
Izaskun Orue
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Internalizing Symptoms ◽  
Protective Factor ◽  
Negative Association ◽  
Dispositional Mindfulness ◽  
Vulnerability Factors ◽  
Time Points ◽  
Longitudinal Associations ◽  
One Year

AbstractMindfulness has been associated with fewer negative mental health symptoms during adolescence, but fewer studies have examined longitudinal associations between mindfulness and symptoms in conjunction with two vulnerability factors for psychopathology with mindfulness: rumination and impulsivity. This study examined longitudinal associations between internalizing symptoms (depression, anxiety, stress), mindfulness, rumination, and impulsivity over a one-year period among 352 Spanish adolescents (57.4% girls; M = 14.47, SD = 1.34). Participants completed self-reported measures of symptoms, mindfulness, rumination, and impulsivity at two time points. Mindfulness negatively predicted stress and depressive symptoms, and a bidirectional negative association was found between mindfulness and impulsivity. Impulsivity positively predicted stress, and anxiety positively predicted depressive symptoms, stress, and rumination. This study highlights the importance of mindfulness as a protective factor and impulsivity and anxiety as risk factors for internalizing symptoms throughout adolescence. These findings build on previous studies that examined longitudinal associations between mindfulness and symptoms by including rumination and impulsivity’s roles.

scholarly journals Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2093
Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Perceived Stress ◽  
Depression Scale ◽  
Family Physicians ◽  
Knowledge Score ◽  
Well Being ◽  
Anxiety And Depression ◽  
Event Scale ◽  
The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

scholarly journals Post-intensive care syndrome after a critical COVID-19: cohort study from a Belgian follow-up clinic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anne-Françoise Rousseau ◽  
Pauline Minguet ◽  
Camille Colson ◽  
Isabelle Kellens ◽  
Sourour Chaabane ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Inpatient Rehabilitation ◽  
Quadriceps Strength ◽  
Biological Parameters ◽  
Icu Stay ◽  
Icu Discharge ◽  
Prolonged Icu Stay ◽  
Post Intensive Care Syndrome

Abstract Purpose Many patients with coronavirus disease 2019 (COVID-19) required critical care. Mid-term outcomes of the survivors need to be assessed. The objective of this single-center cohort study was to describe their physical, cognitive, psychological, and biological outcomes at 3 months following intensive care unit (ICU)-discharge (M3). Patients and methods All COVID-19 adults who survived an ICU stay ≥ 7 days and attended the M3 consultation at our multidisciplinary follow-up clinic were involved. They benefited from a standardized assessment, addressing health-related quality of life (EQ-5D-3L), sleep disorders (PSQI), and the three principal components of post-intensive care syndrome (PICS): physical status (Barthel index, handgrip and quadriceps strength), mental health disorders (HADS and IES-R), and cognitive impairment (MoCA). Biological parameters referred to C-reactive protein and creatinine. Results Among the 92 patients admitted to our ICU for COVID-19, 42 survived a prolonged ICU stay and 32 (80%) attended the M3 follow-up visit. Their median age was 62 [49–68] years, 72% were male, and nearly half received inpatient rehabilitation following ICU discharge. At M3, 87.5% (28/32) had not regained their baseline level of daily activities. Only 6.2% (2/32) fully recovered, and had normal scores for the three MoCA, IES-R and Barthel scores. The main observed disorders were PSQI > 5 (75%, 24/32), MoCA < 26 (44%, 14/32), Barthel < 100 (31%, 10/32) and IES-R ≥ 33 (28%, 9/32). Combined disorders were observed in 13/32 (40.6%) of the patients. The EQ-5D-3L visual scale was rated at 71 [61–80]. A quarter of patients (8/32) demonstrated a persistent inflammation based on CRP blood level (9.3 [6.8–17.7] mg/L). Conclusion The burden of severe COVID-19 and prolonged ICU stay was considerable in the present cohort after 3 months, affecting both functional status and biological parameters. These data are an argument on the need for closed follow-up for critically ill COVID-19 survivors.

scholarly journals SEPARATED KIN: RURAL-URBAN MIGRATION AND MENTAL HEALTH TRAJECTORIES OF OLDER ADULTS LEFT BEHIND IN RURAL CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S880-S880
Author(s):  
Zhiyong Lin
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Rural China ◽  
Well Being ◽  
Migrant Children ◽  
Urban Migration ◽  
Left Behind ◽  
Rate Of Increase ◽  
The Impact

Abstract As the processes of urbanization and globalization have intensified across the world, a burgeoning literature has documented the impact of emigration on the health of family members left behind in emigrant communities. Although the association between children’s migration and parental well-being is well documented, few have examined the health implications of children’s migration in the milieu of multiple children and further differentiated between children’s short-term and long-term migration. Therefore, I argue that it is not the geographic locality of a single child but the composition of all children’s location that matters. I further suggest that the impact of children’s migration on parental wellbeing is conditioned on the duration of children’s migration. Using a six waves longitudinal data (2001-2015) collected in rural China, this paper compares mental health (measured as depressive symptoms) trajectories of old adults (aged 60 and older) across different compositions of local and migrant children over a 14-year span. Results from growth curve models show that parents having more migrant children relative to local children experience a more rapid increase in depressive symptoms. In addition, older adults who have their most children migrate away for three or more waves of data have experienced the steepest rate of increase in depressive symptoms. These findings provide new evidence to support the life course processes of mental health disparities among older adults from the perspective of intergenerational proximity.

scholarly journals When Words Hurt: Affective Word Use in Daily News Coverage Impacts Mental Health

2018 ◽  
Vol 9 ◽  
Author(s):  
Jolie B. Wormwood ◽  
Madeleine Devlin ◽  
Yu-Ru Lin ◽  
Lisa Feldman Barrett ◽  
Karen S. Quigley
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Computational Linguistics ◽  
News Coverage ◽  
Physical Symptoms ◽  
Physiological Reactivity ◽  
Data Set ◽  
Affective Content ◽  
Aversive Stimuli ◽  
The Impact

Media exposure influences mental health symptomology in response to salient aversive events, like terrorist attacks, but little has been done to explore the impact of news coverage that varies more subtly in affective content. Here, we utilized an existing data set in which participants self-reported physical symptoms, depressive symptoms, and anxiety symptoms, and completed a potentiated startle task assessing their physiological reactivity to aversive stimuli at three time points (waves) over a 9-month period. Using a computational linguistics approach, we then calculated an average ratio of words with positive vs. negative affective connotations for only articles from news sources to which each participant self-reported being exposed over the prior 2 weeks at each wave of data collection. As hypothesized, individuals exposed to news coverage with more negative affective tone over the prior 2 weeks reported significantly greater physical and depressive symptoms, and had significantly greater physiological reactivity to aversive stimuli.

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