Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland
Abstract Background Although comorbid medical diseases are important determinants of outcome among the critically ill, the role of psychiatric comorbidity is not well defined. The objective of this study was to determine the occurrence of psychiatric comorbidity and its effect on the outcome of pati...
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2025-02-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06520-0 |
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| author | Dylan Flaws Kyle White Felicity Edwards Stuart Baker Siva Senthuran Mahesh Ramanan Antony G Attokaran Aashish Kumar James McCullough Kiran Shekar Philippa McIlroy Alexis Tabah Stephen Luke Peter Garrett Kevin B Laupland on behalf of the Queensland Critical Care Research Network (QCCRN) |
| author_facet | Dylan Flaws Kyle White Felicity Edwards Stuart Baker Siva Senthuran Mahesh Ramanan Antony G Attokaran Aashish Kumar James McCullough Kiran Shekar Philippa McIlroy Alexis Tabah Stephen Luke Peter Garrett Kevin B Laupland on behalf of the Queensland Critical Care Research Network (QCCRN) |
| author_sort | Dylan Flaws |
| collection | DOAJ |
| description | Abstract Background Although comorbid medical diseases are important determinants of outcome among the critically ill, the role of psychiatric comorbidity is not well defined. The objective of this study was to determine the occurrence of psychiatric comorbidity and its effect on the outcome of patients admitted to adult intensive care units (ICU) in Queensland. Methods Admissions among adults to 12 ICUs in Queensland during 2015–2021 were included and clinical and outcome information was obtained through linkages between the ANZICS Adult Patient Database, the state-wide Queensland Hospital Admitted Patient Data Collection, and death registry. Results A total of 89,123 admissions were included among 74,513 individuals. Overall, 7,178 (8.1%) admissions had psychiatric co-morbidity with 6,270 (7.0%) having one major psychiatric diagnosis and 908 (1%) having two or more. Individual diagnoses of mood, psychotic, anxiety, or affective disorders were present in 1,801 (2.0%), 874 (1.0%), 3,241 (3.6%) and 354 (0.4%) admissions respectively. Significant differences were observed among the main groups (mood, affective, anxiety, psychotic, or multiple disorders) and those without psychiatric comorbidity with respect to main diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) score, sex, age, and medical comorbidity. Crude 30-day case-fatality rates were significantly lower (5.1%) compared to the general ICU population (10.1%) (p < 0.001). After controlling for confounding variables in the logistic regression model, patients with psychiatric comorbidity were at lower odds of death. Conclusions Psychiatric comorbidity is common among ICU presentations and is associated with a lower risk of death. This association is likely to be more complex than being a simple protective factor, and future research needs to further delineate how psychiatric comorbidity informs outcomes of specific ICU presentations. |
| format | Article |
| id | doaj-art-f2ef8b163afb448fbcdabca11b89314d |
| institution | DOAJ |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj-art-f2ef8b163afb448fbcdabca11b89314d2025-08-20T02:48:12ZengBMCBMC Psychiatry1471-244X2025-02-012511810.1186/s12888-025-06520-0Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in QueenslandDylan Flaws0Kyle White1Felicity Edwards2Stuart Baker3Siva Senthuran4Mahesh Ramanan5Antony G Attokaran6Aashish Kumar7James McCullough8Kiran Shekar9Philippa McIlroy10Alexis Tabah11Stephen Luke12Peter Garrett13Kevin B Laupland14on behalf of the Queensland Critical Care Research Network (QCCRN)Department of Mental Health, Metro North Mental Health, Caboolture HospitalQueensland University of Technology (QUT)Queensland University of Technology (QUT)Intensive Care Unit, Redcliffe HospitalCollege of Medicine and Dentistry, James Cook UniversityQueensland University of Technology (QUT)Faculty of Medicine, University of QueenslandIntensive Care Unit, Logan HospitalSchool of Medicine and Dentistry, Griffith UniversityFaculty of Medicine, University of QueenslandIntensive Care Unit, Cairns HospitalQueensland University of Technology (QUT)Intensive Care Services, Mackay Base HospitalSchool of Medicine and Dentistry, Griffith UniversityQueensland University of Technology (QUT)Abstract Background Although comorbid medical diseases are important determinants of outcome among the critically ill, the role of psychiatric comorbidity is not well defined. The objective of this study was to determine the occurrence of psychiatric comorbidity and its effect on the outcome of patients admitted to adult intensive care units (ICU) in Queensland. Methods Admissions among adults to 12 ICUs in Queensland during 2015–2021 were included and clinical and outcome information was obtained through linkages between the ANZICS Adult Patient Database, the state-wide Queensland Hospital Admitted Patient Data Collection, and death registry. Results A total of 89,123 admissions were included among 74,513 individuals. Overall, 7,178 (8.1%) admissions had psychiatric co-morbidity with 6,270 (7.0%) having one major psychiatric diagnosis and 908 (1%) having two or more. Individual diagnoses of mood, psychotic, anxiety, or affective disorders were present in 1,801 (2.0%), 874 (1.0%), 3,241 (3.6%) and 354 (0.4%) admissions respectively. Significant differences were observed among the main groups (mood, affective, anxiety, psychotic, or multiple disorders) and those without psychiatric comorbidity with respect to main diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) score, sex, age, and medical comorbidity. Crude 30-day case-fatality rates were significantly lower (5.1%) compared to the general ICU population (10.1%) (p < 0.001). After controlling for confounding variables in the logistic regression model, patients with psychiatric comorbidity were at lower odds of death. Conclusions Psychiatric comorbidity is common among ICU presentations and is associated with a lower risk of death. This association is likely to be more complex than being a simple protective factor, and future research needs to further delineate how psychiatric comorbidity informs outcomes of specific ICU presentations.https://doi.org/10.1186/s12888-025-06520-0PsychiatryIntensive careCritical illness |
| spellingShingle | Dylan Flaws Kyle White Felicity Edwards Stuart Baker Siva Senthuran Mahesh Ramanan Antony G Attokaran Aashish Kumar James McCullough Kiran Shekar Philippa McIlroy Alexis Tabah Stephen Luke Peter Garrett Kevin B Laupland on behalf of the Queensland Critical Care Research Network (QCCRN) Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland BMC Psychiatry Psychiatry Intensive care Critical illness |
| title | Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland |
| title_full | Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland |
| title_fullStr | Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland |
| title_full_unstemmed | Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland |
| title_short | Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland |
| title_sort | major psychiatric comorbidity among the critically ill a multi centred cohort study in queensland |
| topic | Psychiatry Intensive care Critical illness |
| url | https://doi.org/10.1186/s12888-025-06520-0 |
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