Cognitive Impairment and Psychological Distress at Discharge from Intensive Care Unit
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This study aimed to investigate cognitive impairment and psychological distress of critically ill patients at discharge from intensive care unit (ICU). This study included 30 critically ill patients who had neither pre-existing dementia nor ongoing delirium. At ICU discharge, they performed a screening test for cognitive impairment (Mini-Cog test) and completed questionnaires for depression (Patient Health Questionnaire-2, PHQ-2) and for 4 stressful experiences during ICU stay including nightmares, severe anxiety or panic, severe pain, and trouble to breathe or feeling of suffocation (Post-Traumatic Stress Syndrome 14-Question Inventory, PTSS-14 Part A). Thirteen patients (43.3%) screened positive for cognitive impairment and 18 patients (60.0%) exhibited depressive symptoms. Twenty three patients (76.7%) recollected one or more stressful in-ICU experiences. Female patients (88.9%) was more likely to feel depressed at ICU discharge, compared to male patients (47.6%) (χ2=4.47, p=0.03). To the best of our knowledge, this is the first report on cognitive and psychological outcomes of ICU survivors in Korea. In this study, we observed that a considerable number of critically ill patients had experienced cognitive impairment or psychological distress at ICU discharge.
Abstract
This study aimed to investigate cognitive impairment and psychological distress of critically ill patients at discharge from intensive care unit (ICU). This study included 30 critically ill patients who had neither pre-existing dementia nor ongoing delirium. At ICU discharge, they performed a screening test for cognitive impairment (Mini-Cog test) and completed questionnaires for depression (Patient Health Questionnaire-2, PHQ-2) and for 4 stressful experiences during ICU stay including nightmares, severe anxiety or panic, severe pain, and trouble to breathe or feeling of suffocation (Post-Traumatic Stress Syndrome 14-Question Inventory, PTSS-14 Part A). Thirteen patients (43.3%) screened positive for cognitive impairment and 18 patients (60.0%) exhibited depressive symptoms. Twenty three patients (76.7%) recollected one or more stressful in-ICU experiences. Female patients (88.9%) was more likely to feel depressed at ICU discharge, compared to male patients (47.6%) (χ2=4.47, p=0.03). To the best of our knowledge, this is the first report on cognitive and psychological outcomes of ICU survivors in Korea. In this study, we observed that a considerable number of critically ill patients had experienced cognitive impairment or psychological distress at ICU discharge.
참고문헌 (20)
- Needham DM, "Improving long-term outcomes after discharge from intensive care unit : report from a stakeholders’ conference", Crit Care Med, 40, pp.502~509 (2012)
- Wilcox ME, "Cognitive dysfunction in ICU patients: risk factors, predictors, and rehabilitation interventions", Crit Care Med, 41(9 Suppl 1), pp.S81~S98 (2013)
- Davydow DS, "Depression in general intensive care unit survivors : a systematic review", Intensive Care Med, 35, pp.796~809 (2009)
- Davydow DS, "Posttraumatic stress disorder in general intensive care unit survivors : a systematic review", Gen Hosp Psychiatry, 30, pp.421~434 (2008)
- Davidson JE, "Implementation of the Pain, Agitation, and Delirium Clinical Practice Guidelines and promoting patient mobility to prevent post-intensive care syndrome", Crit Care Med, 41(9 Suppl 1), pp.S136~S145 (2013)
- Peris A, "Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients", Crit Care, 15, pp.R41~ (2011)
- Wade DM, "Detecting acute distress and risk of future psychological morbidity in critically ill patients : validation of the intensive care psychological assessment tool", Crit Care, 18, pp.519~ (2014)
- Brummel NE, "Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients : the Activity and Cognitive Therapy in ICU(ACT-ICU)trial", Intensive Care Med, 40, pp.370~379 (2014)
- Parker A, "Early Rehabilitation in the Intensive Care Unit : Preventing Physical and Mental Health Impairments", Curr Phys Med Rehabil Rep, 1, pp.307~314 (2013)
- Tan T, "Rehabilitation after critical illness: summary of NICE guidance", BMJ, 338, pp.b822~ (2009)
- Ely EW, "Evaluation of delirium in critically ill patients : validation of the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU)", Crit Care Med, 29, pp.1370~1379 (2001)
- Choi SH, "A short form of the Samsung Dementia Questionnaire(S-SDQ) : development and cross-validation", J Korean Neurol Assoc, 17, pp.253~258 (1999)
- Borson S, "The Mini-Cog as a screen for dementia : validation in a population-based sample", J Am Geriatr Soc, 51, pp.1451~1454 (2003)
- 박준현, "치매 선별검사 한국어판 Mini-Cog의 타당도", 노인정신의학, 16(2), pp.111~116 (2012), 대한노인정신의학회
- Kroenke K, "The Patient Health Questionnaire-2 : validity of a two-item depression screener", Med Care, 41, pp.1284~1292 (2003)
- Twigg E, "Use of a screening questionnaire for post-traumatic stress disorder(PTSD)on a sample of UK ICU patients", Acta Anaesthesiol Scand, 52, pp.202~208 (2008)
- Jones C, "Significant cognitive dysfunction in non-delirious patients identified during and persisting following critical illness", Intensive Care Med, 32, pp.923~926 (2006)
- Torgersen J, "Cognitive impairments after critical illness", Acta Anaesthesiol Scand, 55, pp.1044~1051 (2011)
- Robbins TW, "Cambridge Neuropsychological Test Automated Battery(CANTAB) : a factor analytic study of a large sample of normal elderly volunteers", Dementia, 5, pp.266~281 (1994)
- Samuelson KA, "Stressful memories and psychological distress in adult mechanically ventilated intensive care patients-a 2-month follow-up study", Acta Anaesthesiol Scand, 51, pp.671~678 (2007)