Main Category: Depression
Also Included In: Respiratory / Asthma
Article Date: 12 Dec 2011 - 9:00 PST
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A new study from the John Hopkins University School of Medicine published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine, reveals that during the first two years after an acute lung injury (ALI) depressive symptoms and impaired physical function were common and long-lasting, with depressive symptoms being an independent risk factor for impaired physical function.
Leading author O. Joseph Bienvenu, MD, PhD, associate professor of psychiatry and behavioral sciences said:
"Early identification and treatment of depressive states should be evaluated as a potential intervention to improve long-term outcomes in ALI survivors. Depressive symptoms are a potentially modifiable risk factor for later-onset physical impairment in these patients."
The researchers conducted a study on a total of 186 mechanically ventilated patients with ALI, with follow-up at 3, 6, 12 and 24 months after injury. They measured outcomes on the Hospital Anxiety and Depression Scale (HADS), defining depressive symptoms with a score =8, and dependencies in instrumental activities of daily living (IADLs) were as =2 impairments, indicating impaired physical function.
Their findings showed that amongst the 147 patients without baseline depression 40% overall suffered depressive symptoms, whilst they observed a cumulative incidence rate of 66% in impaired physical function in 112 patients who had no impaired physical function at baseline. They noted that incident rates peaked at 3-months follow up and declined afterwards. The most common durations for each outcome was >21 months. They established during a multivariable analysis that =12 years of education was substantially linked to the incident rate of depressive symptoms and that these symptoms were significantly linked to incident impaired physical function at the last follow up at 24 months.
The study had some limitations, for example, instead of depressive symptoms being diagnosed by psychiatrics, patients self-reported their symptoms using a questionnaire. Given that information on baseline depression was obtained from medical records, this may have led to some inaccuracy regarding patients' baseline mood states. The researchers also did not account for possible effects of treatment of depression or impaired physical function, and may have overlooked resolved instances of depressive symptoms or impaired physical function that occurred earlier.
Author Dale M. Needham, MD, PhD, associate professor of pulmonary and critical care medicine commented: "Depressive symptoms are not only persistent in ALI survivors but are a risk factor for subsequent impairment in physical function in ALI survivors. Given our findings, the early identification and treatment of depressive symptoms should be evaluated as part of the comprehensive rehabilitation of these patients, to determine if such an intervention would improve not only mood states but physical functioning."
Written by: Petra Rattue
Copyright: Medical News Today
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MLA
13 Dec. 2011.
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