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The association between intensive care unit admission and subsequent depression in patients with diabetes
Author(s) -
Davydow Dimitry S.,
Hough Catherine L.,
Russo Joan E.,
Von Korff Michael,
Ludman Evette,
Lin Elizabeth H. B.,
Ciechanowski Paul,
Young Bessie,
Oliver Malia,
Katon Wayne J.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2684
Subject(s) - medicine , depression (economics) , intensive care unit , diabetes mellitus , comorbidity , odds ratio , confidence interval , logistic regression , prospective cohort study , emergency medicine , cohort study , intensive care medicine , economics , macroeconomics , endocrinology
Abstract Objective To examine whether intensive care unit (ICU) admission is independently associated with increased risk of major depression in patients with diabetes. Methods This prospective cohort study included 3596 patients with diabetes enrolled in the Pathways Epidemiologic Follow‐Up Study, of whom 193 had at least one ICU admission over a 3‐year period. We controlled for baseline depressive symptoms, demographics, and clinical characteristics. We examined associations between ICU admission and subsequent major depression using logistic regression. Results There were 2624 eligible patients who survived to complete follow‐up; 98 had at least one ICU admission. Follow‐up assessments occurred at a mean of 16.4 months post‐ICU for those who had an ICU admission. At baseline, patients who had an ICU admission tended to be depressed, older, had greater medical comorbidity, and had more diabetic complications. At follow‐up, the point prevalence of probable major depression among patients who had an ICU admission was 14% versus 6% among patients without an ICU admission. After multivariate adjustment, ICU admission was independently associated with subsequent probable major depression (Odds Ratio 2.07, 95% confidence interval (1.06–4.06)). Additionally, baseline probable major depression was significantly associated with post‐ICU probable major depression. Conclusions ICU admission in patients with diabetes is independently associated with subsequent probable major depression. Additional research is needed to identify at‐risk patients and potentially modifiable ICU exposures in order to inform future interventional studies with the goal of decreasing the burden of comorbid depression in older patients with diabetes who survive critical illnesses. Copyright © 2011 John Wiley & Sons, Ltd.