Association of social support before ICU admission with postdischarge mental health symptoms in ICU patients: a single-centre prospective cohort study in Japan.

ABSTRACT

OBJECTIVES: Mental health problems after discharge from the intensive care unit (ICU) interfere with physical recovery and seriously affect daily life. Social support has been suggested to be associated with mental health but has not been sufficiently characterised. This study aimed to evaluate the association of social support before ICU admission with mental health after ICU discharge. DESIGN: Prospective cohort study. SETTING: Medical-surgical ICU of a hospital in Japan. PARTICIPANTS: Patients admitted to the ICU for more than 48 hours were surveyed on social support prior to ICU admission, and 3 months after discharge from the ICU, mental health questionnaires were mailed to the patient. PRIMARY OUTCOME MEASURES: Post-traumatic stress disorder (PTSD)-related symptoms were measured using the Impact of Event Scale-Revised, and anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale. RESULTS: A total of 153 patients were enrolled; the prevalence of PTSD-related symptoms, anxiety and depressive symptoms 3 months after discharge from the ICU was 11.3%, 14.0% and 24.6%, respectively. Multivariate analysis using linear regression models adjusted for age, sex and years of education for PTSD-related symptoms, anxiety and depressive symptoms revealed that social support (ß=-0.018, 95% CI -0.029 to 0.006, p=0.002) and female sex (ß=0.268, 95% CI 0.005 to 0.531, p=0.046) were independent factors associated with the severity of depressive symptoms. In addition, sex differences were observed in the association between depressive symptoms and social support (p for interaction=0.056). CONCLUSIONS: Higher social support before ICU admission was not associated with PTSD symptoms after ICU discharge, although it may be associated with a lower prevalence depressive symptoms after ICU discharge. Therefore, it is important to provide necessary social support when needed.