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Post-traumatic stress disorder after critical illness requiring general intensive care
Brian H Cuthbertson1, Alastair Hull, Mary Strachan
1Anaesthesia and Intensive Care, Medicine and Therapeutics, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK. b.h.cuthbertson@abdn.ac.uk
Objective:
To determine the incidence and severity of symptoms related to the diagnosis of post-traumatic stress disorder (PTSD) in a cohort of general ICU patients.
Design:
A prospective cohort study 3 months after general ICU discharge.
Setting:
A general ICU in a teaching hospital in northern Scotland.
Patients And Participants:
Seventy-eight ICU survivors of general ICU.
Interventions:
Patients were contacted 3 months after ICU discharge and asked to complete a telephone assessment of the Davidson Trauma Scale.
Measurements And Results:
The median score was 8, with 22% recording a score of at least 27 and 14% meeting the full diagnostic criteria for PTSD. The overall score was not correlated with sex, ICU length of stay, or APACHE II score but was inversely correlated with age and directly correlated with length of mechanical ventilation. The overall score was also related to the patient reporting having visited a GP or a mental health professional for psychological distress previous to ICU.
Conclusions:
We found a high incidence of symptoms consistent with PTSD 3 months after ICU discharge in this general ICU cohort. This was associated with younger patients and those who visited their GP or a mental health professional complaining of psychological symptoms. Further research and a greater liaison between ICU staff and family practitioners and mental health practitioners is required to better identify individuals at risk and reduce psychological morbidity in this group.