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[Psychiatric disorders in intensive care units]
J F Ampélas1, F Pochard, S M Consoli
1Equipe Rapide d'Intervention de Crise (ERIC), EPS Charcot, 30, rue Marc Laurent, 78373 Plaisir cedex, France.
L'Encephale
|July 2, 2002
Summary
Psychiatric disorders are common in intensive care unit (ICU) patients, stemming from both organic causes and the ICU environment. Improved management and environmental modifications can significantly aid patient recovery and well-being.
Area of Science:
- Psychiatry
- Intensive Care Medicine
- Psychology
Context:
- Psychiatric disorders in intensive care unit (ICU) patients have been historically overlooked.
- These conditions are now increasingly recognized and managed.
- Manifestations occur during ICU stays, post-transfer, and months after discharge.
Purpose:
- To highlight the prevalence and types of psychiatric disorders in ICU patients.
- To identify causes, including organic factors and the ICU environment.
- To propose management strategies and environmental modifications.
Summary:
- Common disorders include delirium, anxiety, adaptation disorders with depressive mood, and brief psychotic disorders.
- Contributing factors include metabolic disturbances, withdrawal, infection, and the ICU environment (noise, sleep deprivation, sensory issues, pain, witnessing death).
- Management involves environmental changes (noise reduction, normal day-night cycles, human contact), psychotropic drugs, psychotherapy, and family/caregiver support.
Impact:
- Environmental modifications can prevent psychiatric manifestations.
- Collaborative care between psychiatrists and ICU physicians is crucial.
- Psychological support for patients, families, and caregivers improves outcomes and prevents burnout.