title: The association between intensive care unit admission and subsequent depression in patients with diabetes.
abstract: OBJECTIVE
  To examine whether intensive care unit (ICU) admission is independently associated with increased risk of major depression in patients with diabetes.
  
  
  METHODS
  This prospective cohort study included 3596 patients with diabetes enrolled in the Pathways Epidemiologic Follow-Up Study, of whom 193 had at least one ICU admission over a 3-year period. We controlled for baseline depressive symptoms, demographics, and clinical characteristics. We examined associations between ICU admission and subsequent major depression using logistic regression.
  
  
  RESULTS
  There were 2624 eligible patients who survived to complete follow-up; 98 had at least one ICU admission. Follow-up assessments occurred at a mean of 16.4 months post-ICU for those who had an ICU admission. At baseline, patients who had an ICU admission tended to be depressed, older, had greater medical comorbidity, and had more diabetic complications. At follow-up, the point prevalence of probable major depression among patients who had an ICU admission was 14% versus 6% among patients without an ICU admission. After multivariate adjustment, ICU admission was independently associated with subsequent probable major depression (Odds Ratio 2.07, 95% confidence interval (1.06-4.06)). Additionally, baseline probable major depression was significantly associated with post-ICU probable major depression.
  
  
  CONCLUSIONS
  ICU admission in patients with diabetes is independently associated with subsequent probable major depression. Additional research is needed to identify at-risk patients and potentially modifiable ICU exposures in order to inform future interventional studies with the goal of decreasing the burden of comorbid depression in older patients with diabetes who survive critical illnesses.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. ddavydo1@u.washington.edu
authors.forename: Dimitry S
authors.initials: DS
authors.lastname: Davydow
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.forename: Joan E
authors.initials: JE
authors.lastname: Russo
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Evette
authors.initials: E
authors.lastname: Ludman
authors.forename: Elizabeth H B
authors.initials: EH
authors.lastname: Lin
authors.forename: Paul
authors.initials: P
authors.lastname: Ciechanowski
authors.forename: Bessie
authors.initials: B
authors.lastname: Young
authors.forename: Malia
authors.initials: M
authors.lastname: Oliver
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
mesh_terms: D000368:Aged; D003866:Depressive Disorder / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000523:psychology*; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology