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Prevalence of Depression, Anxiety and Stress among Patients Discharged from Critical Care Units

Mohammad Saeidi
Mohammad Saeidi
, 
Alireza Safaei
Alireza Safaei
, 
Zohreh Sadat
Zohreh Sadat
, 
Parisa Abbasi
Parisa Abbasi
, 
Masoumeh Sadat Mousavi Sarcheshmeh
Masoumeh Sadat Mousavi Sarcheshmeh
, 
Fariba Dehghani
Fariba Dehghani
, 
Mehran Tahrekhani
Mehran Tahrekhani
 and 
Mohammad Abdi
Mohammad Abdi
   | May 12, 2021
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Article Category: Research Article
Published Online: May 12, 2021
Page range: 113 - 122
Received: May 30, 2020
Accepted: Apr 08, 2021
DOI: https://doi.org/10.2478/jccm-2021-0012
Keywords
© 2021 Mohammad Saeidi, Alireza Safaei, Zohreh Sadat, Parisa Abbasi, Masoumeh Sadat Mousavi Sarcheshmeh, Fariba Dehghani, Mehran Tahrekhani, Mohammad Abdi, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1

A flow diagram of participants through the study.
A flow diagram of participants through the study.

The prevalence and mean (SD) severity scores for depression, anxiety, and stress.

Mental symptoms Severity N (%) M (SD)
Depression Normal 166 (53.5) 2.18 (2.27)
N (%) 144 (46.5%) Mild 10 (3.2) 8.10 (0.31)
Moderate 53 (17.1) 11.92 (1.43)
M(SD) 16.15(1.40) Severe 66 (21.3) 16.96 (1.32)
Very severe 15(4.9) 20.53 (0.51)
Anxiety
Normal 144 (46.4) 2.13 (2.52)
N (%) 166 (53.6%) Mild 13 (4.2) 8.23 (0.43)
Moderate 47 (15.2) 12.40 (1.31)
M(SD) 18.57(1.46) Severe 89 (28.7) 17.25 (1.15)
Very severe 17 (5.5) 20.29 (0.58)
Stress
Normal 131 (42.2) 2.00 (2.30)
N (%) 179(57.8%) Mild 16 (5.2) 8.50 (0.51)
Moderate 38 (12.3) 11.68 (1.27)
M(SD) 19.69 (1.48) Severe 95 (30.6) 16.85 (1.45)
Very severe 30 (9.7) 20.30 (0.53)

Risk factors related to anxiety, depression and stress.

Factors N (%) Anxiety
 Depression
 Stress
M SD P M SD P M SD P
Gender Male 181 (58.4) 17.52 14.28 0.154* 15.41 13.76 0.215* 18.99 14.42 0.056*
Female 129 (41.6) 20.04 15.16 17.19 14.33 20.66 15.51
Age Less than 60 years 184 (59.4) 14.80 14.85 0.001** 12.71 13.41 0.001** 15.57 14.81 0.001**
60 years and more 126 (40.6) 24.07 12.59 21.17 13.38 25.69 13.86
Occupation Simple worker and technical 102 (32.9) 21.03 14.41 18.33 13.95 22.49 14.31
Governmental employee 89 (28.7) 6.24 9.38 0.001*** 6.28 9.90 0.001*** 7.78 10.76 0.001***
Abandoned and housewife 91 (29.3) 26.65 11.79 22.46 12.31 27.12 11.93
Retired 26 (8.38) 23.76 12.80 20.07 14.32 24.38 14.48
Marital status Single 20 (6.5) 22.50 11.23 0.001* 20.40 13.05 0.157* 19.46 14.99 0.001*
Married 290 (93.5) 18.30 14.87 15.86 14.05 22.90 13.17
Number of M SD children Less than five 206 (66.5) 24.82 11.79 0.001* 21.59 12.64 0.001* 16.21 14.79 0.001*
3.7 2.28 More than five 104 (33.5) 15.41 15.00 13.40 13.89 26.57 12.54
Elementary or higher education level No 153 (49.3) 27.98 11.16 24.82 12.71 28.51 11.41
Yes 157 (50.6) 9.70 11.81 0.001* 7.94 9.58 0.001* 11.40 12.89 0.001*
Hospital LOS (days) Up to 5 138 (44.5) 11.04 14.37 10.01 13.58 11.57 14.69
5-10 99 (31.9) 22.78 12.45 0.001*** 21.9 12.48 0.001*** 24.64 11.27 0.001***
10-15 45 (14.5) 26.88 10.56 23.51 12.43 29.33 9.82
More than 15 28 (9.08) 27.42 11.12 16.78 10.79 26.64 13.83
Hospitalization ward ICU 138 (44.5) 19.77 14.26 0.029* 18.41 15.02 0.001* 18.42 14.63 0.001*
CCU 172 (55.5) 17.07 14.94 13.33 12.11 20.70 15.05
Hospitalization due to trauma Yes 20 (6.45) 24.61 14.52 0.345* 18.00 14.00 0.564* 26.15 13.96 0.313*
No 290 (93.5) 24.61 14.52 16.07 14.03 19.40 14.88
Mechanical ventilation Yes 109 (35.2) 24.18 11.82 0.001* 19.03 11.34 0.001* 25.83 11.46 0.001*
No 201 (64.8) 15.53 15.20 14.59 15.06 16.35 15.48
Drug abuse Yes 39 (12.6) 27.53 10.53 0.001* 22.92 10.53 0.001* 27.58 10.53 0.001*
No 271 (87.4) 17.28 14.76 15.18 14.30 18.55 15.05

j.jccm-2021-0012.tab.005

1 I found it hard to wind down 0 1 2 3
2 I was aware of dryness of my mouth 0 1 2 3
3 I did not experience any positive feeling at all 0 1 2 3
4 I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion) 0 1 2 3
5 I found it difficult to work up the initiative to do things 0 1 2 3
6 I tended to over-react to situations 0 1 2 3
7 I experienced trembling (e.g. in the hands) 0 1 2 3
8 I felt that I was using a lot of nervous energy 0 1 2 3
9 I was worried about situations in which I might panic and make a fool of myself 0 1 2 3
10 I felt that I had nothing to look forward to 0 1 2 3
11 I found myself getting agitated 0 1 2 3
12 I found it difficult to relax 0 1 2 3
13 I felt down-hearted and blue 0 1 2 3
14 I was intolerant of anything that kept me from getting on with what I was doing 0 1 2 3
15 I felt I was close to panic 0 1 2 3
16 I was unable to become enthusiastic about anything 0 1 2 3
17 I felt I wasn’t worth much as a person 0 1 2 3
18 I felt that I was rather touchy 0 1 2 3
19 I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat) 0 1 2 3
20 I felt scared without any good reason 0 1 2 3
21 I felt that life was meaningless 0 1 2 3

The score of each subscale.

Severity Depression Stress Anxiety
Normal 0-9 0-14 0-7
Mild 10-13 15-18 8-9
Moderate 14-20 19-25 10-14
Severe 21-27 26-33 15-19
Highly severe Up to 28 Up to 33 Up to 20

Association between demographic and clinical characteristics with anxiety, depression and stress based on multivariate analysis.

Anxiety Depression Stress
Predictors S.E. β P S.E. β P S.E. β P
Gender .046 .035 .434 .054 .009 .866 .052 .028 .581
Age .049 .076 .111 .058 .006 .914 .055 .050 .353
Occupation .023 .005 .917 .027 .124 .020 .026 -.033 .508
Number of children .051 .117 .015 .060 .046 .427 .057 .106 .053
Marital status .083 .060 .145 .099 .058 .237 .095 .008 .860
Elementary or higher education level .051 -.374 .000 .060 -.429 .000 .057 -.333 .000
Hospital LOS (days) .025 .167 .001 .030 .000 .999 .029 .135 .016
Type of unit .053 .118 .025 .062 .108 .086 .060 .188 .002
Hospitalization due to trauma .100 .067 .097 .119 -.037 .446 .113 .011 .805
Mechanical ventilation .055 -.272 .000 .066 -.097 .125 .063 -.240 .000
Drug abuse .066 -.191 .000 .078 -.210 .000 .075 -.188 .000
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Language:
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Medicine, Clinical Medicine, Internal Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine
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