• Robert Hatch, Duncan Young, Vicki Barber, John Griffiths, David A Harrison, and Peter Watkinson.
• NIHR Academic Clinical Fellow in Intensive Care Medicine, Oxford Deanery, Oxford, UK.
• Crit Care. 2018 Nov 23; 22 (1): 310.

BackgroundSurvivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multicentre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU).MethodsDesign: prospective multicentre follow-up study of survivors of ICU in the UK.Settingpatients from 26 ICUs in the UK.Inclusion Criteriapatients who had received at least 24 h of level 3 ICU care and were 16 years of age or older.Interventionspostal follow up: Hospital Anxiety and Depression Score (HADS) and the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian (PCL-C) at 3 and 12 months following discharge from ICU.Main Outcome Measurecaseness of anxiety, depression and PTSD, 2-year survival.ResultsIn total, 21,633 patients admitted to ICU were included in the study. Postal questionnaires were sent to 13,155 survivors; of these 38% (4943/13155) responded and 55% (2731/4943) of respondents passed thresholds for one or more condition at 3 or 12 months following discharge. Caseness prevalence was 46%, 40% and 22% for anxiety, depression and PTSD respectively; 18% (870/4943 patients) met the caseness threshold for all three psychological conditions. Patients with symptoms of depression were 47% more likely to die during the first 2 years after discharge from ICU than those without (HR 1.47, CI 1.19-1.80).ConclusionsOver half of those who respond to postal questionnaire following treatment on ICU in the UK reported significant symptoms of anxiety, depression or PTSD. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of one of the other two disorders. Depression following critical illness is associated with an increased mortality risk in the first 2 years following discharge from ICU.Trial RegistrationISRCTN Registry, ISRCTN69112866 . Registered on 2 May 2006.

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