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. 2025 Sep 25;15(1):138.
doi: 10.1186/s13613-025-01545-w.

Mental health outcomes at intensive care unit discharge: prevalence, mediators and risk factors

Maryline Couette  1   2 , Segolene Gendreau  3   4   5 , Marie Charlotte Boishardy  3 , Anne-Fleur Jean Baptiste  3 , Paula Xavier  3 , Keyvan Razazi  3   4   5 , Romain Arrestier  3   4   5 , Guillaume Carteaux  3   4   5 , Nicolas De Prost  3   4   5 , Stephane Mouchabac  6   7 , Florian Ferreri  6   7 , Armand Mekontso Dessap  3   4
Affiliations

Mental health outcomes at intensive care unit discharge: prevalence, mediators and risk factors

Maryline Couette et al. Ann Intensive Care. .

Abstract

Background: Intensive Care Unit (ICU) patients often experience significant discomfort and distress due to both the medical environment and the nature of their stay. While long-term sequelae such as depression, anxiety, and post-traumatic stress are well-documented, few studies have examined psychological disorders present at the time of ICU discharge. Based on the model of Post-Intensive Care Syndrome, specifically the mental component (PICS-M), we defined DICS-M (Discharge Intensive Care Syndrome - Mental component). This study aimed to estimate the prevalence of psychological disorders at ICU discharge and to identify potential mediators and risk factors.

Methods: We conducted a prospective observational study involving 243 patients admitted between January 2023 and April 2024.

Results: The prevalence of DICS-M was 53% [95% CI: 46-59], with acute stress, anxiety, and depression observed in 37%, 36%, and 23% of patients, respectively. The analyses revealed an overlap among these psychological components. Peritraumatic distress acted as the main mediator of DICS-M. Univariate and multivariable analyses identified female gender and a history of psychiatric and cardiac conditions as risk factors of DICS-M.

Conclusion: Psychological disorders are common at ICU discharge, mediated by peritraumatic distress, and associated with identifiable risk factors. These findings may help guide interventions to prevent long-term sequelae of ICU stays.

Keywords: Acute stress disorder; Early psychological assessment; Post intensive care syndrome; Psychological disorders; Trauma.

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Conflict of interest statement

Declarations. Consent for publication: Not applicable. Competing interests: None.

Figures

Fig. 1
Fig. 1
Flow chart *Categories are not mutually exclusive; a single patient may appear in more than one group
Fig. 2
Fig. 2
Euler diagram illustrating psychological outcomes at intensive care unit discharge among 128 patients diagnosed with DICS-M
Fig. 3
Fig. 3
A general linear model was used to examine the relationship between perceived trauma and three psychological outcomes, mediated by two types of traumatic reactions: emotional peritraumatic distress and dissociation. The mediation model indicated that the indirect pathway from perceived trauma to each psychological outcome through emotional distress was statistically significant (p < 0.001). In this figure, are represented in blue and in green respectively the mediators and risk factors influencing the mental health component of discharge-intensive care syndrome
See this image and copyright information in PMC

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