Depression in general intensive care unit survivors: A systematic review

Abstract

Purpose: To critically review data on the prevalence of depressive symptoms in general intensive care unit (ICU) survivors, risk factors for these symptoms, and their impact on health-related quality of life (HRQOL). Methods: We conducted a systematic review using Medline, EMBASE, Cochrane Library, CINAHL, PsycINFO, and a hand-search of 13 journals. Results: Fourteen studies were eligible. The median point prevalence of "clinically significant" depressive symptoms was 28% (total n = 1,213). Neither sex nor age were consistent risk factors for post-ICU depression, and severity of illness at ICU admission was consistently not a risk factor. Early post-ICU depressive symptoms were a strong risk factor for subsequent depressive symptoms. Post-ICU depressive symptoms were associated with substantially lower HRQOL. Conclusions: Depressive symptoms are common in general ICU survivors and negatively impact HRQOL. Future studies should address how factors related to individual patients, critical illness and post-ICU recovery are associated with depression in ICU survivors. © 2009 Springer-Verlag.