Post-intensive Care Syndrome: Primer for the General Psychiatrist

As advances in critical care medicine improve survival outcomes, attention has been increasingly directed toward long-term management of patients recovering from critical illness. In 2010, the term "post-intensive care syndrome" (PICS) was proposed at a meeting of stakeholders at the Society of Critical Care Medicine's headquarters to highlight the physical, psychological, cognitive, and social impairments faced by many survivors of critical illness. PICS offers a holistic conceptualization of the long and challenging recovery process these patients may face in the months following a course of intensive care. In particular, psychiatric morbidity following critical illness is associated with worsened physical functioning, increased mortality, and lower quality of life. Thus, psychiatrists occupy a key role in the multidisciplinary management of PICS. This article provides a narrative review of the literature encompassing PICS, with a focus on post-intensive care psychiatric morbidity, to assist general psychiatrists and primary care clinicians in providing well-informed, comprehensive care to this patient population. Core aspects of psychiatric evaluation and management are reviewed, including the components of a comprehensive medical history, the use of screening instruments, pharmacologic and nonpharmacologic interventions, and the importance of a multidisciplinary, coordinated approach to care.