Li HN, Wang JL, Chen W. Neuropsychiatric symptoms in the context of hemodynamic disruption during septic shock. World J Psychiatry 2025; 15(7): 105992 [DOI: 10.5498/wjp.v15.i7.105992]
Corresponding Author of This Article
Wei Chen, Department of Critical Care Medicine, Shenyang Tenth People’s Hospital, No. 11 Beihai Street, Dandong District, Shenyang 110044, Liaoning Province, China. cwei7636@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Jul 19, 2025; 15(7): 105992 Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.105992
Neuropsychiatric symptoms in the context of hemodynamic disruption during septic shock
Hai-Ning Li, Jia-Lin Wang, Wei Chen
Hai-Ning Li, Wei Chen, Department of Critical Care Medicine, Shenyang Tenth People’s Hospital, Shenyang 110044, Liaoning Province, China
Jia-Lin Wang, Department of Emergency Medicine, Bishan Hospital of Chongqing Medical University (Bishan Hospital of Chongqing), Chongqing 402760, China
Co-first authors: Hai-Ning Li and Jia-Lin Wang.
Author contributions: Li HN and Wang JL contributed equally to this work; Li HN and Wang JL were responsible for data collection, patient stratification, and initial drafting of the manuscript; Chen W conceptualized the study, supervised the research process, and critically revised the manuscript; All authors contributed to the interpretation of the data and approved the final version of the manuscript for submission.
Institutional review board statement: This study was approved by the Institutional Review Board of Shenyang Tenth People’s Hospital, China (Approval No. KYXM-2024-068).
Informed consent statement: All procedures were conducted in accordance with the Declaration of Helsinki and relevant ethical guidelines.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Chen, Department of Critical Care Medicine, Shenyang Tenth People’s Hospital, No. 11 Beihai Street, Dandong District, Shenyang 110044, Liaoning Province, China. cwei7636@163.com
Received: March 5, 2025 Revised: April 11, 2025 Accepted: May 19, 2025 Published online: July 19, 2025 Processing time: 126 Days and 20.5 Hours
Abstract
BACKGROUND
Septic shock represents one of the most severe critical illness types, characterized by significant hemodynamic disorders and neuropsychiatric symptoms. This study aimed to investigate the association mechanism between hemodynamic indicators and neuropsychiatric symptoms in patients with septic shock, revealing potential pathophysiological connections.
AIM
To investigate the link between hemodynamic parameters and neuropsychiatric symptoms in septic shock.
METHODS
A retrospective case-control study involving 132 patients with septic shock. Multiple assessment tools were employed, including the Confusion Assessment Method, Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Scale, and Mini-Mental State Examination, systematically evaluating patients’ neuropsychiatric symptoms and hemodynamic indicators.
RESULTS
Patient mean age was 52.4 ± 12.3 years, with 68.5% males. Multivariate analysis revealed significant correlations between neuropsychiatric symptom severity and mean arterial pressure < 65 mmHg [odds ratio (OR) = 2.7], lactate levels > 4 mmol/L (OR = 3.1), and elevated interleukin-6 inflammatory factors (OR = 2.4). Neuropsychiatric symptom incidence rates were: Delirium 37.1%; anxiety 28.8%; depression 24.2%; and posttraumatic stress disorder 19.7%.
CONCLUSION
Hemodynamic disorders in patients with septic shock are closely associated with neuropsychiatric symptoms, influencing central nervous system function through complex inflammatory and neurotransmitter pathways.
Core Tip: Septic shock induces severe hemodynamic disturbances, which are closely linked to neuropsychiatric symptoms such as delirium, anxiety, depression, and posttraumatic stress disorder. This study highlighted the impact of impaired cerebral perfusion, inflammatory cascades, and neurotransmitter imbalances on cognitive function. Key hemodynamic markers, including low cardiac output, elevated lactate, and reduced mean arterial pressure, significantly correlated with neuropsychiatric symptom severity. Early hemodynamic optimization and inflammation control may mitigate these complications and improve patient outcomes. These findings provide insights into the pathophysiological mechanisms underlying neuropsychiatric manifestations in septic shock, emphasizing the need for targeted interventions in patients who are critically ill.
