Screening instruments for post-intensive care unit emotional impairment
| Screening tool | Number of questions | Interpretation of results | Further information |
|---|---|---|---|
| Depression | |||
| Hospital Anxiety and Depression Scale (HADS) | 14 total, 7 focusing on depression symptoms | 0-7 Normal 8-10 Borderline abnormal (borderline case) 11-21 Abnormal | Validated in ICU population |
| Hamilton Depression Rating Scale (HAM-D) | 21 items, scoring based on first 17 items | 10-13 Mild 14-17 Mild to moderate > 17 Moderate to severe | |
| Beck Depression Inventory-II | 21 items (13-item short-form available) | 0-14 Minimal 14-19 Mild 20-28 Moderate > 29 Severe | |
| Patient Health Questionnaire-9 (PHQ-9) | 9 | 1-4 Minimal 5-9 Mild 10-14 Moderate 15-19 Moderately severe 20-27 Severe | |
| Anxiety | |||
| Hospital Anxiety and Depression Scale (HADS) | 14 total, 7 focusing on depression symptoms | 0-7 Normal 8-10 Borderline abnormal 11-21 Abnormal | Validated in ICU population |
| Hamilton Anxiety Rating Scale (HAM-A) | 14 | 0-13 Minimal 14-17 Mild 18-24 Moderate 25-30 Severe | |
| Generalized Anxiety Disorder 7-item (GAD-7) | 7 | 0-4 Minimal 5-9 Mild 10-14 Moderate 15-21 Severe | |
| PTSD | |||
| Impact Event Scale-Revised (IES-R) | 22 | 24-32 Clinical concern for PTSD 33-38 Clinical cutoff for probable PTSD diagnosis > 39 Significant enough symptoms to suppress immune system (even 10 years after impact event) | Validated in ICU population |
| Impact Event Scale-6 (IES-6) (abbreviated IES-R) | 6 | Calculated as mean of 6 questions with higher scores representing more-severe PTSD symptoms | Validated in ARDS survivors47 |
| Posttraumatic Symptom Scale, 10 items (PTSS-10) | 10 | Cutoff score > 35 predicts PTSD (PTSS-High) | Validated in ICU population Good reliability Detects PTSD symptoms but does not diagnose PTSD |
| PTSD Checklist for DSM-5 (PCL-5) | 20 | Total score of 31-33 or higher suggests patient may benefit from PTSD treatment | |
| Abbreviated Posttraumatic Checklist (PCL-C) | 6 | > 14 suggestive of difficulties with posttraumatic stress | |
ARDS = acute respiratory distress syndrome; DSM = Diagnostic and Statistical Manual of Mental Disorders; ICU = intensive care unit; PTSD = posttraumatic stress disorder
Based on information in references 5, 40, and 45–47.