title: Psychiatric outcome after severe cardio-respiratory failure treated with extracorporeal membrane oxygenation: a case-series.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation (ECMO) is increasingly used to save patients with severe cardiopulmonary failure at high risk of dying, but the long-term psychiatric outcome of the treatment has not been studied.
  
  
  METHODS
  Twenty-eight adults who survived ECMO were subjected to psychiatric assessment 5 years after ECMO by means of interviews (MINI-Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale) and psychometrics [Neuroticism and social conformity (EPQ-N+L); General Health Questionnaire (GHQ), Hospital Anxiety Depression Scale; Aggression Questionnaire, Toronto Alexithymia Scale, and Giessener somatic symptom checklist (GBB)].
  
  
  RESULTS
  Fifteen patients (54%) suffered lifetime psychiatric disorders prior to ECMO. After ECMO, 11 subjects (39%) developed new psychiatric disorders, mostly organic mental (18%), obsessive-compulsive disorders (OCD) 15%, and/or post-traumatic stress disorders (PTSD) 11%. These 11 patients reported higher scores on Montgomery-Åsberg Depression Rating Scale (MADRS), GHQ, EPQ-N, and GBB. Disregarding the presence of psychiatric disorders at follow-up, ECMO patients reported high levels of distress, physical aggression, anger, and alexithymic traits.
  
  
  CONCLUSIONS
  Severe life-threatening cardiovascular or pulmonary failure with subsequent ECMO is associated with an increased prevalence of long-term psychiatric disorders and distress. Studies addressing the etiology and prevalence of psychiatric consequences after ECMO are needed.
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, Psychosomatic Medicine, Anaesthesiology, Intensive Care Medicine, Oslo University Hospital-Rikshospitalet, Norway. Electronic address: ivar.risnes@feiringklinikken.no.
authors.forename: Ivar
authors.initials: I
authors.lastname: Risnes
authors.forename: Aasta
authors.initials: A
authors.lastname: Heldal
authors.forename: Kari
authors.initials: K
authors.lastname: Wagner
authors.forename: Birgitte
authors.initials: B
authors.lastname: Boye
authors.forename: Ira
authors.initials: I
authors.lastname: Haraldsen
authors.forename: Siv
authors.initials: S
authors.lastname: Leganger
authors.forename: Kjell
authors.initials: K
authors.lastname: Møkleby
authors.forename: Jan Ludvig
authors.initials: JL
authors.lastname: Svennevig
authors.forename: Ulrik Fredrik
authors.initials: UF
authors.lastname: Malt
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology; D000374:Aggression; D000786:Anger; D003863:Depression / Q000523:psychology; D015199:Extracorporeal Membrane Oxygenation / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D012131:Respiratory Insufficiency / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D055815:Young Adult