Pre-existing mental health disorders in patients admitted to the intensive care unit: A systematic review and meta-analysis of prevalence.

Pilowsky, JK; Elliott, R; Roche, MA

Pre-existing mental health disorders in patients admitted to the intensive care unit: A systematic review and meta-analysis of prevalence.

Pilowsky, JK Elliott, R

Roche, MA

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Journal of Advanced Nursing, 2021, 77, (5), pp. 2214-2227
Issue Date:: 2021-01-10

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Field	Value	Language
dc.contributor.author	Pilowsky, JK
dc.contributor.author	Elliott, R https://orcid.org/0000-0002-9239-7126
dc.contributor.author	Roche, MA
dc.date.accessioned	2021-12-14T04:00:57Z
dc.date.available	2020-12-10
dc.date.available	2021-12-14T04:00:57Z
dc.date.issued	2021-01-10
dc.identifier.citation	Journal of Advanced Nursing, 2021, 77, (5), pp. 2214-2227
dc.identifier.issn	0309-2402
dc.identifier.issn	1365-2648
dc.identifier.uri	http://hdl.handle.net/10453/152315
dc.description.abstract	Aims To determine the reported prevalence rate of pre-existing mental health disorders in patients admitted to adult ICUs and identify the most commonly occurring types of these disorders. Design Systematic review and meta-analysis. Data sources Five electronic databases were searched from 1 January 2000 -15 April 2020. Google Scholar was used to perform forwards citation searching. Methods This review was conducted in line with the PRISMA guidelines and protocol registered with PROSPERO CRD42020181818. Meta-analyses were performed using the quality effects model to calculate weighted pooled prevalence estimates and heterogeneity was tested using the I2 statistic. Results Seven articles were included in the final review and meta-analysis (143,179 participants). Identified prevalence rates varied considerably, ranging from 6.2–28.0%, reflecting variation in each study's clinical context, as well as different patient selection and identification methodologies. The pooled prevalence rate of all pre-existing mental health disorders was 19.4% (95% CI 8.9–32.6%). Depression was the most common subtype, accounting for an estimated 60.5% (95% CI 54.4–66.5%) of identified mental health disorders. All analyses showed significant heterogeneity with I2 > 95%. Conclusion Approximately 19% of adult ICU patients have a history of a mental health disorder, most commonly depression. Further research is needed to improve the accuracy of this estimate as well as determine the best identification method. Impact This study has demonstrated that patients with pre-existing mental health disorders, particularly depression, constitute a significant subgroup in ICU. Given that the presence of a pre-existing mental health disorder appears to confer an increased mortality risk following ICU discharge, clinicians need to be made aware of this group of patients to provide additional support. Further research is needed to more accurately quantify this vulnerable group and establish methods to enable clinicians to readily identify and refer these patients for appropriate follow-up treatment.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Journal of Advanced Nursing
dc.relation.isbasedon	10.1111/jan.14753
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Hospitalization
dc.subject.mesh	Prevalence
dc.subject.mesh	Mental Health
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Adult
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Adult
dc.subject.mesh	Hospitalization
dc.subject.mesh	Humans
dc.subject.mesh	Intensive Care Units
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Mental Health
dc.subject.mesh	Prevalence
dc.title	Pre-existing mental health disorders in patients admitted to the intensive care unit: A systematic review and meta-analysis of prevalence.
dc.type	Journal Article
utslib.citation.volume	77
utslib.location.activity	England
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2021-12-14T04:00:54Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	77
utslib.citation.issue	5

Abstract:

Aims To determine the reported prevalence rate of pre-existing mental health disorders in patients admitted to adult ICUs and identify the most commonly occurring types of these disorders. Design Systematic review and meta-analysis. Data sources Five electronic databases were searched from 1 January 2000 -15 April 2020. Google Scholar was used to perform forwards citation searching. Methods This review was conducted in line with the PRISMA guidelines and protocol registered with PROSPERO CRD42020181818. Meta-analyses were performed using the quality effects model to calculate weighted pooled prevalence estimates and heterogeneity was tested using the I2 statistic. Results Seven articles were included in the final review and meta-analysis (143,179 participants). Identified prevalence rates varied considerably, ranging from 6.2–28.0%, reflecting variation in each study's clinical context, as well as different patient selection and identification methodologies. The pooled prevalence rate of all pre-existing mental health disorders was 19.4% (95% CI 8.9–32.6%). Depression was the most common subtype, accounting for an estimated 60.5% (95% CI 54.4–66.5%) of identified mental health disorders. All analyses showed significant heterogeneity with I2 > 95%. Conclusion Approximately 19% of adult ICU patients have a history of a mental health disorder, most commonly depression. Further research is needed to improve the accuracy of this estimate as well as determine the best identification method. Impact This study has demonstrated that patients with pre-existing mental health disorders, particularly depression, constitute a significant subgroup in ICU. Given that the presence of a pre-existing mental health disorder appears to confer an increased mortality risk following ICU discharge, clinicians need to be made aware of this group of patients to provide additional support. Further research is needed to more accurately quantify this vulnerable group and establish methods to enable clinicians to readily identify and refer these patients for appropriate follow-up treatment.

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http://hdl.handle.net/10453/152315