Magazine article Clinical Psychiatry News

Depression Plagues Acute Lung Injury Survivors

Magazine article Clinical Psychiatry News

Depression Plagues Acute Lung Injury Survivors

Article excerpt

FROM THE AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE

Survivors of acute lung injury are likely to experience de-pression and physical impairment for up to 2 years after leaving the intensive care unit.

In a prospective study, 40% of patients had new-onset depression and 66% had new physical impairment after discharge.

The findings seem inextricably linked on both psychological and physiological levels, Dr. Oscar J. Bi-envenu and his colleagues wrote. "Depressive symptoms may decrease motivation for and reward from the physical activities necessary for recovery of maintenance of functioning ... [they] can also amplify symptoms of general medical illnesses, and an increased physical symptom load could negatively affect functioning."

In addition, there may be less-understood links between depression and physical functioning, wrote Dr. Bienvenu of Johns Hopkins University, Baltimore, and his coauthors.

"Depressive symptoms could affect functioning through direct neurobi-ologic pathways, including neuroendocrine and inflammatory mechanisms."

The study comprised 2-year follow-up data on 186 patients who were mechanically ventilated for acute lung injury (ALI). Baseline depression was present in 21% and baseline physical impairment in 40% (Am. J. Respir. Crit. Care Med. 2011 Dec. 8[doi:10.1164/rccm.201103-05030C]).

The patients' mean age was 49 years; 56% were male. The mean length of stay in the ICU was 19 days. Patients were assessed for depression and physical function at 3, 6, 12, and 14 months after discharge. During the entire follow-up period, 40% of the patients experienced new-onset depression and 66% had new-onset physical impairment. Remission occurred in 39% of those with depression and 54% of those with physical impairment, but there was recurrence in 20% and 14%, respectively. …

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