TY - JOUR
T1 - The 5-year pre- and post-hospitalization treated prevalence of mental disorders and psychotropic medication use in critically ill patients
T2 - a Canadian population-based study
AU - Olafson, Kendiss
AU - Marrie, Ruth Ann
AU - Bolton, James M.
AU - Bernstein, Charles N.
AU - Bienvenu, O. Joseph
AU - Kredentser, Maia S.
AU - Logsetty, Sarvesh
AU - Chateau, Dan
AU - Nie, Yao
AU - Blouw, Marcus
AU - Afifi, Tracie O.
AU - Stein, Murray B.
AU - Leslie, William D.
AU - Katz, Laurence Y.
AU - Mota, Natalie
AU - El-Gabalawy, Renée
AU - Enns, Murray W.
AU - Leong, Christine
AU - Sweatman, Sophia
AU - Sareen, Jitender
N1 - Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - Purpose: The interplay between critical illness and mental disorders is poorly understood. The purpose of this study is to measure both the treated prevalence of mental disorders and psychotropic medication use before and after hospitalization and the impact of intensive care unit (ICU) admission on these outcomes. Methods: Using a population-based administrative database in Manitoba, Canada, 49,439 ICU patients admitted between 2000 and 2012 were compared to two matched comparison groups (hospitalized; n = 146,968 and general population; n = 141,937). Treated prevalence of mental disorders and psychotropic medication prescriptions were measured in the 5-year periods before and after the hospitalization. Multivariable models compared adjusted prevalence ratios (APRs) between populations. Results: The 5-year treated mental disorder prevalence in the ICU population increased from 41.5% pre-hospitalization to 55.6% post-hospitalization. Compared to non-ICU hospitalized patients, the adjusted treated mental disorder prevalence in ICU patients was lower prior to hospitalization (1-year APR 0.94, 95% CI 0.92–0.97, p < 0.0001; 5-year APR 0.99, 95% CI 0.98–1.00, p = 0.1), but higher following discharge (1-year APR 1.08, 95% CI 1.05–1.11, p < 0.0001, 5-year APR 1.03, 95% CI 1.01–1.05, p < 0.0001). A high proportion of ICU patients received antidepressant, anxiolytic and sedative-hypnotic prescriptions before and after their hospitalization. In multivariable analyses, ICU exposure was associated with an increase in mood, anxiety and psychotic disorders, and sedative-hypnotics use (p < 0.0001 for all Time × Group interactions). Conclusions: During the 5 years after admission to ICU, there is a significant increase in treated prevalence of mental disorders and psychotropic medication use compared to the 5 years prior to ICU and compared to general population and hospital cohorts. Prevention and intervention programs that identify and treat mental disorders among survivors of critical illness warrant further study.
AB - Purpose: The interplay between critical illness and mental disorders is poorly understood. The purpose of this study is to measure both the treated prevalence of mental disorders and psychotropic medication use before and after hospitalization and the impact of intensive care unit (ICU) admission on these outcomes. Methods: Using a population-based administrative database in Manitoba, Canada, 49,439 ICU patients admitted between 2000 and 2012 were compared to two matched comparison groups (hospitalized; n = 146,968 and general population; n = 141,937). Treated prevalence of mental disorders and psychotropic medication prescriptions were measured in the 5-year periods before and after the hospitalization. Multivariable models compared adjusted prevalence ratios (APRs) between populations. Results: The 5-year treated mental disorder prevalence in the ICU population increased from 41.5% pre-hospitalization to 55.6% post-hospitalization. Compared to non-ICU hospitalized patients, the adjusted treated mental disorder prevalence in ICU patients was lower prior to hospitalization (1-year APR 0.94, 95% CI 0.92–0.97, p < 0.0001; 5-year APR 0.99, 95% CI 0.98–1.00, p = 0.1), but higher following discharge (1-year APR 1.08, 95% CI 1.05–1.11, p < 0.0001, 5-year APR 1.03, 95% CI 1.01–1.05, p < 0.0001). A high proportion of ICU patients received antidepressant, anxiolytic and sedative-hypnotic prescriptions before and after their hospitalization. In multivariable analyses, ICU exposure was associated with an increase in mood, anxiety and psychotic disorders, and sedative-hypnotics use (p < 0.0001 for all Time × Group interactions). Conclusions: During the 5 years after admission to ICU, there is a significant increase in treated prevalence of mental disorders and psychotropic medication use compared to the 5 years prior to ICU and compared to general population and hospital cohorts. Prevention and intervention programs that identify and treat mental disorders among survivors of critical illness warrant further study.
KW - Critical illness
KW - Epidemiology
KW - ICU
KW - Mental disorder
KW - Psychotropic medications
KW - Substance use
UR - http://www.scopus.com/inward/record.url?scp=85114614700&partnerID=8YFLogxK
U2 - 10.1007/s00134-021-06513-z
DO - 10.1007/s00134-021-06513-z
M3 - Article
SN - 0342-4642
VL - 47
SP - 1450
EP - 1461
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 12
ER -