For Some ICU Patients, Depression Could Manifest With Physical Symptoms

For Some ICU Patients, Depression Could Manifest With Physical Symptoms

Intensive care unit (ICU) patients -- those in the hospital with the most severe or life-threatening injuries/illnesses -- have a higher risk of depression, according to a new study.

And among ICU patients who do develop depression, one-third of them experience physical symptoms of depression, such as fatigue, weakness and change in appetite, researchers found.

"We need to pay more attention to preventing and treating the physical rather than psychological symptoms of depression in ICU survivors," study researcher Dr. James Jackson, a psychologist and assistant professor of medicine at Vanderbilt University Medical Center, said in a statement. "The physical symptoms of depression are often resistant to standard treatment with antidepressant drugs and we need to determine how best to enhance recovery with a new focus on physical and occupational rehabilitation."

The findings of the study, published in the journal The Lancet Respiratory Medicine, included 821 patients who were admitted to a surgical ICU in Nashville with either respiratory failure or severe sepsis. Researchers tested depression, PTSD, functional disability and quality of life after three months for 448 of the patients, and after 12 months for 382 of the patients.

Researchers found that about one-third of the patients evaluated three months later, as well as one-third of the patients evaluated 12 months later, reported having symptoms of at least mild depression; "depression was mainly due to somatic rather than cognitive—affective symptoms," they wrote in the study.

Depressive symptoms were seen in both people with a history of the condition, and without a history of the condition. Among those without a history, the symptoms were observed in 30 percent of the patients evaluated after three months, and in 29 percent of patients evaluated after 12 months.

Symptoms of post-traumatic stress disorder were low, compared with depression -- just 7 percent of patients said they had PTSD symptoms, researchers found.

"Substantial time and energy has been invested in addressing PTSD in survivors of critical illness, but our findings suggest that it is less pervasive than depression," Jackson said in the statement. "Patients of all ages are at risk of developing post-ICU mental health and functional disabilities and more needs to be done to ensure that these impairments don't become permanent."