Risk of Psychiatric Diagnosis Increases for ICU Patients on Ventilation Devices, Study Finds

Though more people are surviving critical illness due to advances in medicine, severely ill patients are often exposed to respiratory distress and delirium, which may negatively impact their mental health. Hannah Wunsch, M.D., M.Sc., of Columbia University College of Physicians and Surgeons and colleagues assessed the prevalence of psychiatric diagnoses and medication prescriptions given before and after critical illness to patients who were connected to a mechanical ventilation device while in the intensive care unit (ICU).

The analysis, published in the Journal of the American Medical Association, showed that among the 24,179 critically ill patients in the study, 6.2% had one or more psychiatric diagnoses within the five years prior to the severe illness, compared with 2.4% of people in the general population. Critically ill patients were also more likely to have prescriptions for a psychoactive medication than were those in the general population (48.7% vs. 33.2%.). Previous ICU patients with no history of psychiatric disorders were 25 times more likely to receive a psychiatric diagnosis after hospitalization than the general population and 18 times more likely to be given a prescription for psychoactive drugs within three months after ICU release. The differences in psychoactive prescriptions between former ICU admittees and the general population decreased after one year.

“Our data suggest both a possible role of psychiatric disease in predisposing patients to critical illness and an increased but transient risk of new psychiatric diagnoses and treatment after critical illness,” said the authors. They concluded that psychiatric history and management of psychiatric symptoms post-ICU may be an important focus for interventions concerning mental health among critically ill patients.

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