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Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care

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Abstract

Objective

This prospective observational study was designed to explore the relationships between post-traumatic stress disorder (PTSD), patients' memories of the intensive care unit (ICU) and sedation practices.

Design

Prospective multi-centre follow-up study out to 3 months after ICU discharge.

Setting

Two district general hospitals and three teaching hospitals across Europe.

Patients and participants

Two hundred and thirty-eight recovering, post-ventilated ICU patients.

Interventions

None.

Measurements and results

Assessment of patients' memories of ICU was undertaken at 1–2 weeks post ICU discharge. Patients' psychological recovery was assessed by examining the level of PTSD-related symptoms and rate of PTSD by 3 months post ICU. The rate of defined PTSD was 9.2%, ranging from 3.2% to 14.8% in the different study ICUs. Independent of case mix and illness severity, the factors found to be related to the development of PTSD were recall of delusional memories, prolonged sedation, and physical restraint with no sedation.

Conclusion

The development of PTSD following critical illness is associated with a number of different precipitating factors that are in part related to how patients are cared for within intensive care. This study raises the hypothesis that the impact of care within the ICU has an impact on subsequent psychological morbidity and therefore must be assessed in future studies looking at the way patients are sedated in the ICU and how physical restraint is used.

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Acknowledgements

Funding from the Stanley Thomas Johnson Charitable Foundation. We would like to acknowledge the hard work of our data collectors: Tracy Slater, Neven Ivcic, Anne-Khristine Muri, Ulla Löwenmark, Eva Rosell, Wiveka Etemad, Mia Hending.

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Correspondence to C. Jones.

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Jones, C., Bäckman, C., Capuzzo, M. et al. Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care. Intensive Care Med 33, 978–985 (2007). https://doi.org/10.1007/s00134-007-0600-8

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  • DOI: https://doi.org/10.1007/s00134-007-0600-8

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