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Depression screening predicts lower health-related quality of life in ICU survivorsDepression and anxiety symptoms lower health quality for ICU survivors after leaving the hospital

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Key Takeaway
Note that depression screening identifies ICU survivors with lower health-related quality of life.

This study was a cross-sectional analysis of pre-randomization data from a randomized controlled trial involving 319 intensive care unit survivors. The setting was multicenter primary care-based. The analysis focused on depression, anxiety, and post-traumatic stress symptoms as exposures. The primary outcome was health-related quality of life, measured using the EuroQol Five-Dimension Five-Level index and visual analog scale.

The mean EQ-5D-5L index was 0.71 with a standard deviation of 0.27 and a median of 0.81. The mean visual analog scale score was 60.7 with a standard deviation of 19.4 and a median of 60.0. Screening positive for depression using the PHQ-2 with a score greater than or equal to 3 points was associated with a median reduction of -0.13 in the EQ-5D-5L index. The 95% confidence interval for this reduction was -0.19 to -0.07.

For the visual analog scale, screening positive for depression was associated with a reduction of -12.45 points. The 95% confidence interval for this reduction was -17.93 to -6.96. Safety data, including adverse events and discontinuations, were not reported. Tolerability was not reported. Serious adverse events were not reported.

Key limitations include the cross-sectional nature of the analysis and insufficient understanding of the relative contribution of co-occurring symptoms. The study design prevents causal inference. Practice relevance supports routine brief depression screening in post-intensive care follow up.

This analysis looked at 319 people who survived a stay in the intensive care unit. Researchers checked their mental health right before they were officially assigned to a treatment group in a larger study. They wanted to see how sadness, worry, and trauma affected how patients felt about their daily lives.

Patients who scored high on depression screens had much worse health scores. Their average score was lower than those without these symptoms. The study also found that anxiety and trauma symptoms made things worse for many survivors. These mental health issues are common after a serious illness in the hospital.

The team suggests that doctors should routinely check for sadness and worry when patients return home. Finding these problems early helps doctors plan better support. However, this study only shows a connection, not a cause. More research is needed to fully understand how these feelings affect recovery.

Limitations include looking at data before the main study started. This means we cannot say for sure that the mental health caused the lower scores. Still, the findings support checking on mental health during follow-up visits for all ICU survivors.

What this means for you:
Doctors should check for sadness and worry in ICU survivors to improve their recovery and daily life quality.

Study Details

Study typeRct
EvidenceLevel 2
PublishedMay 2026
View Original Abstract ↓
Survivors of critical illness frequently experience persistent impairments in health-related quality of life (HRQoL), with psychological symptoms contributing substantially to this burden. The relative contribution of co-occurring depression, anxiety, and post traumatic stress symptoms remains insufficiently understood. To address this gap, we conducted a cross-sectional analysis of pre-randomization data from the PICTURE randomized controlled trial, a multicenter study of a brief primary care-based psychological intervention for post-traumatic stress disorder symptoms following critical illness, including 319 intensive care unit survivors. Clinical, demographic, and mental health assessments were obtained after ICU discharge. Latent profile analysis, random forest modeling, and quantile regression were applied to identify determinants of HRQoL measured by the EuroQol Five-Dimension Five-Level (EQ-5D-5L) index and visual analog scale (VAS). The mean EQ-5D-5L index was 0.71 (SD 0.27; median 0.81) and the mean EQ VAS score was 60.7 (SD 19.4; median 60.0), indicating considerable overall impairment. Depression, anxiety, and post-traumatic stress symptoms showed substantial overlap and formed four distinct symptom profiles associated with specific functional impairments. Screening positive for depression on the 2-item Patient Health Questionnaire (PHQ-2) with ≥ 3 points was associated with a median reduction of -0.13 (95% CI -0.19 to -0.07) on the EQ-5D-5L index and -12.45 points (95% CI -17.93 to -6.96) on the EQ VAS, exceeding clinical and demographic predictors. These findings indicate that depressive symptoms are a major determinant of impaired health related quality of life among intensive care survivors with psychological distress and support routine brief depression screening in post-intensive care follow up.Trial registration: ClinTrials.gov: NCT03315390 (Registration date: 2017-10-20); German Clinical Trials Register: DRKS-ID: DRKS00012589 (Registration date: 2017-10-17).
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