ArticleCritical care (London, England)2025
Association between isolation room admission in intensive care units and long-term psychiatric disorders: a nationwide cohort study.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhether admission to a single-bed intensive care unit (ICU) isolation room is associated with subsequent psychiatric morbidity remains uncertain. We investigated the association between ICU isolation and new-onset psychiatric disorders after discharge.
methodsUsing South Korea's National Health Insurance Service database, we conducted a nationwide retrospective cohort study including adults admitted to any ICU between Jan 1 2020 and Dec 31 2022. We excluded patients < 18 years, those who died within 1 year, and those with psychiatric diagnoses in the preceding 12 months. Outcomes were new diagnoses of depression, anxiety disorder, or post-traumatic stress disorder (PTSD) within 1 year after ICU admission. Exposure was any stay in a single-bed ICU isolation room; isolation duration (days) was also analyzed.
resultsAmong 517 917 ICU survivors, 136 172 (26.3%) developed a psychiatric disorder within 1 year (depression 15.6%, anxiety 16.8%, PTSD 0.1%). Admission to an ICU isolation room was modestly associated with any psychiatric disorder (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.06; P = 0.034). This association was primarily driven by depression (OR, 1.06; 95% CI, 1.03-1.10; P < 0.001). There were no significant associations with anxiety disorder (P = 0.64) or PTSD (P = 0.307). When treating the duration of ICU isolation as a continuous variable, each additional day of isolation showed a small incremental association with psychiatric disorder (OR per day, 1.01; 95% CI, 1.01-1.01; P < 0.001) and depression (OR, 1.01; 95% CI, 1.01-1.02; P < 0.001).
conclusionsICU admission to a single-bed isolation room showed a small yet consistent association with post-ICU psychiatric morbidity, mainly depression. Given the minimal absolute difference and observational design, causality cannot be inferred. Nevertheless, isolation represents a potentially modifiable environmental exposure that warrants further confirmatory and mechanistic research, as well as pragmatic evaluation of mitigation strategies such as improved communication, family engagement, and circadian cueing.
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