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Objective <p>In this study, we sought to conduct a systematic review and meta-analysis of mental health outcomes in survivors of neurocritical illness.</p> Methods <p>Literature databases [PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo] were searched for terms relating to critical illness, intensive care, and outcomes from January 1970 to June 2024. English-language studies of adults with critically illness with a primary neurological diagnosis were included if they reported on mental health outcomes [specifically, depression, anxiety, post-traumatic stress (PTS), or general mental health]. Data extraction was performed, in duplicate, for prespecified variables related to study outcomes. Random effects meta-analyses were conducted to estimate pooled prevalence and symptom severity.</p> Results <p>Of more than 33,000 abstracts screened, 24 publications reported on mental health outcomes: 19 reported on depression outcomes, 11 on anxiety, 7 on PTS, and 8 on general mental health. The median [interquartile range (IQR)] time to first depression, anxiety, and/or PTS assessment was 3 (1.75, 12), 4.5 (1.1, 7.5), and 3 (0, 3) months, respectively. The most common assessment tools were the Hospital Anxiety and Depression Scale, Depression Subscale (HADS-D; <i>n</i> = 8) and the Hospital Anxiety and Depression Scale, Anxiety Subscale HADS-A (<i>n</i> = 8), and Post-traumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5)/Post-traumatic Stress Disorder Checklist, Civilian Version (PCL-C) for PTS (<i>n</i> = 4). General mental health outcomes were studied using seven unique tools at a median (IQR) follow-up time of 3 (0.5, 6) months. Pooled depression prevalence [95% confidence interval (CI)] was 24% (20–29%) among publications using HADS-D and 26% (16–38%) in publications using any assessment tool. Pooled anxiety prevalence was 37% (21–56%) using HADS-A and was 32% (18–51%) using any assessment tool. PTS prevalence was 14% (8–21%). Heterogeneity of assessment tools precluded a pooled analysis of general mental health.</p> Conclusions <p>These findings highlight the burden of mental health symptoms following neurocritical care illness, with prevalences higher than the general population. These findings were impacted by substantial between-study heterogeneity—particularly in assessment tools and timing of evaluations—limiting precise prevalence estimation.</p>

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Mental Health Outcomes After Neurocritical Care: A Systematic Review and Meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Jamie Nicole LaBuzetta,
  • Henry G. Chen,
  • Nicholas Ibrahim,
  • Onyekachi Ezeokeke,
  • Sanil Gandhi,
  • Atul Malhotra,
  • Victor D. Dinglas,
  • Dale M. Needham,
  • Biren B. Kamdar

摘要

Objective

In this study, we sought to conduct a systematic review and meta-analysis of mental health outcomes in survivors of neurocritical illness.

Methods

Literature databases [PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo] were searched for terms relating to critical illness, intensive care, and outcomes from January 1970 to June 2024. English-language studies of adults with critically illness with a primary neurological diagnosis were included if they reported on mental health outcomes [specifically, depression, anxiety, post-traumatic stress (PTS), or general mental health]. Data extraction was performed, in duplicate, for prespecified variables related to study outcomes. Random effects meta-analyses were conducted to estimate pooled prevalence and symptom severity.

Results

Of more than 33,000 abstracts screened, 24 publications reported on mental health outcomes: 19 reported on depression outcomes, 11 on anxiety, 7 on PTS, and 8 on general mental health. The median [interquartile range (IQR)] time to first depression, anxiety, and/or PTS assessment was 3 (1.75, 12), 4.5 (1.1, 7.5), and 3 (0, 3) months, respectively. The most common assessment tools were the Hospital Anxiety and Depression Scale, Depression Subscale (HADS-D; n = 8) and the Hospital Anxiety and Depression Scale, Anxiety Subscale HADS-A (n = 8), and Post-traumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5)/Post-traumatic Stress Disorder Checklist, Civilian Version (PCL-C) for PTS (n = 4). General mental health outcomes were studied using seven unique tools at a median (IQR) follow-up time of 3 (0.5, 6) months. Pooled depression prevalence [95% confidence interval (CI)] was 24% (20–29%) among publications using HADS-D and 26% (16–38%) in publications using any assessment tool. Pooled anxiety prevalence was 37% (21–56%) using HADS-A and was 32% (18–51%) using any assessment tool. PTS prevalence was 14% (8–21%). Heterogeneity of assessment tools precluded a pooled analysis of general mental health.

Conclusions

These findings highlight the burden of mental health symptoms following neurocritical care illness, with prevalences higher than the general population. These findings were impacted by substantial between-study heterogeneity—particularly in assessment tools and timing of evaluations—limiting precise prevalence estimation.