Combination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study

Miyamoto, Kyohei; Shibata, Mami; Shima, Nozomu; Nakashima, Tsuyoshi; Kida, Maki; Matsumoto, H.; Oka, Naoki; Yazaki, Akina; Uchigaki, Akiko; Takemoto, Aya; Kato, Seiya

doi:10.1016/j.jcrc.2021.01.007

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…66 Moreover, the combination was also independently associated with the presence of anxiety and PTSD symptoms at 12 months. 66 However, in a relatively large study, 67 up to 45% of critical care survivors showed symptoms of depression, anxiety, and/or PTSD at 1 year, but developing delirium during the ICU stay was not associated with emotional outcomes. Still, a systematic review concluded that delirium might predispose ICU survivors to developing psychiatric symptoms, especially depression.…”

Section: Delirium-related Psychiatric Morbiditymentioning

confidence: 96%

“…In critically ill patients, the combination of delirium and coma during ICU stay increased the risk for the incidence of composite psychiatric symptoms and autonomous functioning at 3 and 12 months after discharge 66 . Moreover, the combination was also independently associated with the presence of anxiety and PTSD symptoms at 12 months 66 . However, in a relatively large study, 67 up to 45% of critical care survivors showed symptoms of depression, anxiety, and/or PTSD at 1 year, but developing delirium during the ICU stay was not associated with emotional outcomes.…”

Section: Delirium‐related Psychiatric Morbiditymentioning

confidence: 99%

“…Indeed, both the occurrence of delirium and the duration of delirium have been inconsistently associated with subsequent psychiatric symptoms 65 . In critically ill patients, the combination of delirium and coma during ICU stay increased the risk for the incidence of composite psychiatric symptoms and autonomous functioning at 3 and 12 months after discharge 66 . Moreover, the combination was also independently associated with the presence of anxiety and PTSD symptoms at 12 months 66 .…”

Section: Delirium‐related Psychiatric Morbiditymentioning

confidence: 99%

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Delirium‐related psychiatric and neurocognitive impairment and the association with post‐intensive care syndrome—A narrative review

Ramnarain

Pouwels

Fernández-Gonzalo

et al. 2023

Acta Psychiatr Scand

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Introduction Delirium is common among patients admitted to the intensive care unit (ICU) and its impact on the neurocognitive and psychiatric state of survivors is of great interest. These new‐onset or worsening conditions, together with physical alterations, are called post‐intensive care syndrome (PICS). Our aim is to update on the latest screening and follow‐up options for psychological and cognitive sequelae of PICS. Method This narrative review discusses the occurrence of delirium in ICU settings and the relatively new concept of PICS. Psychiatric and neurocognitive morbidities that may occur in survivors of critical illness following delirium are addressed. Future perspectives for practice and research are discussed. Results There is no “gold standard” for diagnosing delirium in the ICU, but two extensively validated tools, the confusion assessment method for the ICU and the intensive care delirium screening checklist, are often used. PICS complaints are frequent in ICU survivors who have suffered delirium and have been recognized as an important public health and socio‐economic problem worldwide. Depression, anxiety, post‐traumatic stress disorder, and long‐term cognitive impairment are recurrently exhibited. Screening tools for these deficits are discussed, as well as the suggestion of early assessment after discharge and at 3 and 12 months. Conclusions Delirium is a complex but common phenomenon in the ICU and a risk factor for PICS. Its diagnosis is challenging with potential long‐term adverse outcomes, including psychiatric and cognitive difficulties. The implementation of screening and follow‐up protocols for PICS sequelae is warranted to ensure early detection and appropriate management.

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Section: Delirium-related Psychiatric Morbiditymentioning

confidence: 96%

Section: Delirium‐related Psychiatric Morbiditymentioning

confidence: 99%

Section: Delirium‐related Psychiatric Morbiditymentioning

confidence: 99%

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Delirium‐related psychiatric and neurocognitive impairment and the association with post‐intensive care syndrome—A narrative review

Ramnarain

Pouwels

Fernández-Gonzalo

et al. 2023

Acta Psychiatr Scand

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Prognostic Conversations Between Parents and Physicians in the Pediatric Intensive Care Unit

Rissman

Derrington

Michelson

2023

American Journal of Critical Care

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Background Up to 80% of pediatric intensive care unit (PICU) patients experience new morbidities upon discharge. Patients and families rely on clear communication to prepare for post-PICU morbidities. Methods Surveys were given at PICU discharge to parents and attending physicians of patients who developed multi-organ dysfunction within 24 hours of PICU admission and whose parents completed an initial survey 5 to 10 days after PICU admission. Participants were asked about prognostic conversations regarding PICU mortality; patient post-PICU physical, cognitive, and psychological morbidities; and parent post-PICU psychological morbidities. Parents also indicated whether they wanted more prognostic information. Results Forty-nine parents and 20 PICU attending physicians completed surveys for 49 patients. Thirty parent (61%) and 29 physician (59%) surveys reported participating in any prognostic conversations. Concordance between parents and physicians about prognostic conversations was slight (κ = 0.19). Parent (n = 22; 45%) and physician (n = 23; 47%) surveys most commonly reported prognostic conversations about post-PICU physical morbidities. Parents less commonly reported conversations about post-PICU cognitive morbidities (n = 10; 20%). According to parents, bedside nurses and physicians provided most prognostic information; social workers (54%) most commonly discussed parent psychological morbidities. Twenty-six parents (53%) requested more prognostic information. Conclusions Most parents and physicians reported having prognostic conversations, primarily about post-PICU physical morbidities. More than half of parents wanted more information about potential post-PICU morbidities. More research is needed to understand how and when medical professionals should have prognostic conversations with parents.

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Combination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study

Cited by 2 publications

References 17 publications

Delirium‐related psychiatric and neurocognitive impairment and the association with post‐intensive care syndrome—A narrative review

Delirium‐related psychiatric and neurocognitive impairment and the association with post‐intensive care syndrome—A narrative review

Prognostic Conversations Between Parents and Physicians in the Pediatric Intensive Care Unit

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