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Patients are considered to have developed chronic critical illness when they experience acute illness requiring prolonged mechanical ventilation or other life-sustaining therapies but neither recover nor die within days to weeks. It is estimated that chronic critical illness affected 380,000 patients in the United States in 2009. Family members of patients in the intensive care unit ( ICU ) experience emotional distress including anxiety, depression, and posttraumatic stress disorder (PTSD). Palliative care specialists are trained to provide emotional support, share information, and engage patients and surrogate decision makers in discussions of patient values and goals of care. Shannon S. Carson, M.D., of the University of North Carolina School of Medicine, Chapel Hill, N.C., Judith E. Nelson, M.D., J.D., of the Memorial Sloan Kettering Cancer Center, New York, and colleagues randomly assigned adult patients requiring 7 days of mechanical ventilation and their family surrogate dec...

A new study in Biological Psychiatry supports this hypothesis, providing evidence that inflammation of the hippocampus, a region of the brain implicated in the genesis and maintenance of depression and in the pathology of multiple sclerosis, alters its function and contributes to symptoms of depression. "This study elegantly links hippocampal inflammation to depression," said Dr. John Krystal, Editor of Biological Psychiatry. The research was a collaboration between King's College London, Imperial College London, and Imanova Center for Imaging Sciences. Led by senior authors Paul Matthews and Eugenii Rabiner, the research team combined two complementary brain imaging techniques to study the relationship between hippocampal immune response, functional connections, and depressive symptoms in 13 patients with multiple sclerosis and 22 healthy control subjects. Positron emission tomography (PET) allowed for quantification of activated microglia , a measure of immune res...