Posttraumatic Stress Disorder in General Intensive Care Unit
Survivors: A Systematic Review

Author(s)

Dimitry S. Davydow, M.D.,* Jeneen M. Gifford, M.D., Sanjay V. Desai, M.D., Dale M. Needham, M.D., Ph.D., and O. Joseph Bienvenu, M.D., Ph.D.

Type of Media

COVID-19 Related

Medical Journal

No

Description

Our objective was to summarize and critically review data on the prevalence of posttraumatic stress disorder (PTSD) in general intensive care unit (ICU) survivors, risk factors for post-ICU PTSD, and the impact of post-ICU PTSD on health-related quality of life (HRQOL).

Post-traumatic stress disorder in ICU survivors

Author(s)

Christina Jones, Dr

Type of Media

COVID-19 Related

Medical Journal

No

Description

Post-traumatic stress disorder (PTSD) may develop after exposure to a life-threatening event or serious injury. Symptoms include recurring and intrusive memories, such as flashbacks, avoidance of reminders and persistent symptoms of anxiety or physiological arousal. Many factors are associated with the development of PTSD in intensive care unit (ICU) patients, including increased length of stay, and greater levels and longer duration of sedation. Patient-related factors associated with a higher risk of PTSD include younger age, female gender,previous psychological problems and recall of delusional memories from ICU. In contrast, the formation of even fragmented factual memories may reduce the risk of PTSD. Optimum, analgesia-based sedation may help patients to form factual memories of ICU, so possibly reducing the risk of PTSD. Patient diaries, written by health professionals and family members and close friends, may also support patients in coming to terms with traumatic, delusional memories, and so reduce their emotional and psychological symptoms. Following ICU discharge, validated screening tools such as ICU Memory and Post-traumatic Stress Syndrome 14-Questions Inventory can be used as part of routine follow-up to identify patients who may need referral for more specialist assessment of possible PTSD symptoms.

Post-Traumatic Stress Disorder in ICU Survivors

Author(s)

Jones, C.

Type of Media

COVID-19 Related

Medical Journal

No

Description

Post-traumatic stress disorder (PTSD) may develop after exposure to a life-threatening event or serious injury. Symptoms include recurring and intrusive memories, such as flashbacks, avoidance of reminders and persistent symptoms of anxiety or physiological arousal. Many factors are associated with the development of PTSD in intensive care unit (ICU) patients, including increased length of stay, and greater levels and longer duration of sedation. Patient-related factors associated with a higher risk of PTSD include younger age, female gender, previous psychological problems and recall of delusional memories from ICU. In contrast, the formation of even fragmented factual memories may reduce the risk of PTSD. Optimum, analgesia-based sedation may help patients to form factual memories of ICU, so possibly reducing the risk of PTSD. Patient diaries, written by health professionals and family members and close friends, may also support patients in coming to terms with traumatic, delusional memories, and so reduce their emotional and psychological symptoms. Following ICU discharge, validated screening tools such as ICU Memory and Post-traumatic Stress Syndrome 14-Questions Inventory can be used as part of routine follow-up to identify patients who may need referral for more specialist assessment of possible PTSD symptoms.

Post-traumatic stress in the intensive care unit

Author(s)

Talha Khan Burki

Type of Media

COVID-19 Related

Medical Journal

No

Description

A stay in the intensive care unit (ICU) can be traumatic. Patients are confronted with their own mortality. They are rolled in and hooked up to machines. Perhaps they are ventilated or catheterised. They might drift in and out of consciousness, seeing a different set of faces each time they wake. Confusion, sedation, and delirium make it difficult to communicate; intubation makes it impossible. Mysterious alarms ring at strange times. If the stay is long enough, there is likely to be a death, perhaps more than one, elsewhere in the ward. Hallucinations are common, some of which sound like a scene from a horror movie. “I have had patients talk about seeing blood dripping down the walls, or children with no faces”, said Joseph Bienvenu (Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA).
Symptoms of post-traumatic stress disorder (PTSD) vary from person to person, but typically include a combination of flashbacks and nightmares, avoiding reminders of the traumatic event, emotional numbing, and hyperarousal. Symptoms generally develop within a month, but some patients experience delayed onset. Around 60% of patients recover naturally within 5 years.