The relationship between executive dysfunction, depression, and mental health-related quality of life in survivors of critical illness: Results from the BRAIN-ICU investigation.
The relationship between executive dysfunction, depression, and mental health-related quality of life in survivors of critical illness: Results from the BRAIN-ICU investigation.
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DOI：
10.1016/j.jcrc.2016.08.023
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发表时间：
2017-02
影响因子：
3.7
通讯作者：
Jackson JC
中科院分区：
文献类型：
--
作者：
Duggan MC;Wang L;Wilson JE;Dittus RS;Ely EW;Jackson JC
虽然执行功能障碍和抑郁症在ICU幸存者中很常见，但在这一人群中尚未评估它们之间的关系。我们试图确定1）执行功能障碍是否与ICU幸存者的抑郁症状严重程度或更差的心理健康相关生活质量（HRQOL）独立相关，以及2）年龄是否改变这些相关性。在一个前瞻性队列中（n=136），我们测量了执行功能的行为评定量表成人执行功能，抑郁症的贝克抑郁症量表II，精神HRQOL的简表36（SF-36）。我们使用多元线性回归模型，调整潜在的混杂因素。我们将年龄作为交互作用项，以检验效应修正。ICU后3个月执行功能障碍与ICU后12个月更多的抑郁症状和更差的精神HRQOL独立相关[执行功能第25百分位数与第75百分位数在抑郁量表上评分差4.3分（95% CI =1.3-7.4，p=0.015），SF-36评分差5分（95% CI=1.7-8.3，p=0.006）]。年龄并没有改变这些关联（抑郁症p=0.12;精神HRQOL p=0.80）。无论年龄大小，执行功能障碍与随后抑郁症状的严重程度和精神HRQOL的恶化独立相关。执行功能障碍可能在抑郁症的发展中起关键作用。
Although executive dysfunction and depression are common among ICU survivors, their relationship has not been evaluated in this population. We sought to determine 1) if executive dysfunction is independently associated with severity of depressive symptoms or worse mental health-related quality of life (HRQOL) in ICU survivors, and 2) if age modifies these associations. In a prospective cohort (n=136), we measured executive dysfunction by the Behavior Rating Inventory of Executive Function-Adult, depression by the Beck Depression Inventory-II, and mental HRQOL by the Short-Form 36 (SF-36). We used multiple linear regression models, adjusting for potential confounders. We included age as an interaction term to test for effect modification. Executive dysfunction 3 months post-ICU was independently associated with more depressive symptoms and worse mental HRQOL 12 months post-ICU [25th vs 75th percentile of executive functioning scored 4.3 points worse on the depression scale (95% CI =1.3–7.4, p=0.015) and 5 points worse on the SF-36 (95% CI=1.7–8.3, p=0.006)]. Age did not modify these associations (depression p=0.12; mental HRQOL p=0.80). Regardless of age, executive dysfunction was independently associated with subsequent worse severity of depressive symptoms and worse mental HRQOL. Executive dysfunction may have a key role in the development of depression.