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Pre-Existing Psych Diagnoses Higher in Critically Ill Patients

Risk of new psychiatric diagnoses higher post-critical illness even without psychiatric history

WEDNESDAY, March 19, 2014 (HealthDay News) -- Existing psychiatric diagnoses are more common in critically ill patients compared to other hospitalized patients and the general population, according to a study published in the March 19 issue of the Journal of the American Medical Association.

Hannah Wunsch, M.D., from Columbia University in New York City, and colleagues assessed critically ill patients (intensive care unit admission with mechanical ventilation; 24,179 patients) from 2006 to 2008 for psychiatrist-diagnosed psychiatric illnesses and prescriptions for psychoactive medications in the five years before critical illness.

The researchers found that 6.2 percent of critically ill patients had one or more psychiatric diagnoses in the prior five years, compared to 5.4 percent for hospitalized patients (adjusted prevalence ratio [aPR], 1.31; P < 0.001) and 2.4 percent for the general population (aPR, 2.57; P < 0.001). Preadmission psychoactive prescription rates were similar to hospitalized patients (aPR, 0.97; P < 0.001), but higher than the general population (aPR, 1.40; P < 0.001). The absolute risk of new psychiatric diagnoses among the critical illness survivors with no psychiatric history was low but higher than hospitalized patients over the first three months (adjusted hazard ratio [aHR], 3.42; P < 0.001) and higher than the general population cohort (aHR, 21.77; P < 0.001). By 9 to 12 months after discharge, these differences were largely resolved.

"Prior psychiatric diagnoses are more common in critically ill patients than in hospital and general population cohorts," the authors write.

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