Depression screening predicts lower health-related quality of life in ICU survivors

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Scientific reports Published May 26, 2026 Medically reviewed May 26, 2026 Study authors: Kosilek Robert Philipp, Schröder Nora, Sanftenberg Linda, Lindemann Daniela, Beutel Antina, Schmidt … PubMed ↗ NCT03315390 ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

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.

Study Details

Study typeRct

EvidenceLevel 2

PublishedMay 2026

PMID42185352

TrialNCT03315390

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).