psychiatry

New Study Helps to Predict Psychiatric Symptoms Following ARDS

It may be possible to predict which patients will experience anxiety, depression, and post-traumatic stress disorder following acute respiratory distress syndrome (ARDS), according to a recent study.

Although psychiatric morbidity following ARDS is common, the ability to predict the risk of psychiatric symptoms based on patient- and illness-specific factors is currently limited. For this reason, researchers sought to examine the risk of anxiety, depression, and post-traumatic stress disorder in long-term survivors of ARDS, and whether treatment with immune modulatory treatments such as GM-CSF and corticosteroids could affect this risk.
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In a previous randomized, double-blind, placebo-controlled trial, researchers followed 132 participants with ARDS who received either GM-CSF or placebo.1 The participants were given 3 questionnaires (Post-Traumatic Stress Syndrome 10 Questions Inventory, Impact of Event Scale, and Hospital Anxiety and Depression Scale) during a follow-up appointment 6 months after discharge from the hospital. Of the 132 participants, 44 completed the questionnaires.

For the current study, researchers returned to the results of these 3 questionnaires to determine whether GM-CSF could affect psychiatric outcomes, despite having no association with ventilator days and mortality.2

Overall, 36% of patients reported significant psychiatric symptoms on at least 1 of the 3 scales.  Those patients treated with GM-CSF reported more significant post-traumatic stress and depression symptoms than those given placebo. After conducting multiple regression analyses, the researchers found that younger age, female gender, higher severity of illness, shorter duration of corticosteroid treatment, and treatment with GM-CSF were independently associated with more severe psychiatric symptoms on at least 1 of the 3 scales.

“This proved to us that so many factors contribute to emotional vulnerability after a major illness,” the researchers concluded. “In particular, there are some treatments that might affect a patient’s post-traumatic stress later on. We are trying to use results like in this study to make targeted treatments that would protect these patients in the future from psychiatric illness, even if they aren’t exhibiting symptoms now.”3

—Michael Potts

Reference:

  1. Paine R, Standiford TJ, Dechert RE, et al. A randomized trial of recombinant human GM-CSF for patients with acute lung injury. Crit Care Med. 2012;40(1):90–97.
  2. Spencer-Segal JL, Hyzy RC, Iwashyna TJ, Standiford TJ. Psychiatric symptoms in survivors of the acute respiratory distress syndrome: effects of age, sex, and immune modulation [published online March 30, 2017]. Annals ATS. doi:http://dx.doi.org/10.1513/AnnalsATS.201606-468OC.
  3. Predicting—and Preventing—Psychiatric Morbidity After ARDS [press release]. Michigan Health Lab. http://labblog.uofmhealth.org/body-work/predicting-and-preventing-psychiatric-morbidity-after-ards. Published March 31, 2017. Accessed April 4, 2017.