Posttraumatic stress disorder in general intensive care unit survivors: a systematic review

被引:442
作者
Davydow, Dimitry S. [1 ]
Gifford, Jeneen M. [3 ]
Desai, Sanjay V. [2 ]
Needham, Dale M. [4 ]
Bienvenu, O. Joseph [5 ]
机构
[1] Univ Washington, Sch Med, Harborview Med Ctr, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA
[2] Washington Hosp Ctr, Sect Pulm Crit Care & Resp Serv, Washington, DC USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21224 USA
[4] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care Med, Baltimore, MD 21287 USA
[5] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21287 USA
关键词
stress disorder; posttraumatic; critical care; intensive care unit; risk factors; outcome assessment (health care);
D O I
10.1016/j.genhosppsych.2008.05.006
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: 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). Methods: We conducted a systematic literature review using Medline, EMBASE, Cochrane Library, CINAHL, PsycINFO and a hand-search of 13 journals. Results: Fifteen studies were eligible. The median point prevalence of questionnaire-ascertained "clinically significant" PTSD symptoms was 22% (n=1104), and the median point prevalence of clinician-diagnosed PTSD was 19% (n=93). Consistent predictors of post-ICU PTSD included prior psychopathology, greater ICU benzodiazepine administration and post-ICU memories of in-ICU frightening and/or psychotic experiences. Female sex and younger age were less consistent predictors, and severity of critical illness was consistently not a predictor. Post-ICU PTSD was associated with substantially lower HRQOL. Conclusions: The prevalence of PTSD in ICU survivors is high and negatively impacts survivors' HRQOL. Future studies should comprehensively address how patient-specific factors (e.g., pre-ICU psychopathology), ICU management factors (e.g., administration of sedatives) and ICU clinical factors (e.g., in-ICU delirium) relate to one another and to post-ICU PTSD. Clinicians caring for the growing population of ICU survivors should be aware of PTSD risk factors and monitor patients' needs for early intervention. (C) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:421 / 434
页数:14
相关论文
共 46 条
  • [1] Surviving intensive care: a report from the 2002 Brussels Roundtable
    Angus, DC
    Carlet, J
    [J]. INTENSIVE CARE MEDICINE, 2003, 29 (03) : 368 - 377
  • [2] Personality and anxiety disorders: A review
    Bienvenu, OJ
    Stein, MB
    [J]. JOURNAL OF PERSONALITY DISORDERS, 2003, 17 (02) : 139 - 151
  • [3] Factors associated with posttraumatic stress symptoms in a prospective cohort of patients after abdominal sepsis: a nomogram
    Boer, Kimberly R.
    van Ruler, Oddeke
    van Emmerik, Arnold A. P.
    Sprangers, Mirjam A.
    de Rooij, Sophia E.
    Vroom, Margreeth B.
    de Borgie, Corianne A. J. M.
    Boermeester, Marja A.
    Reitsma, Johannes B.
    [J]. INTENSIVE CARE MEDICINE, 2008, 34 (04) : 664 - 674
  • [4] Predeployment personality traits and exposure to trauma as predictors of posttraumatic stress symptoms: A prospective study of former peacekeepers
    Bramsen, I
    Dirkzwager, AJE
    van der Ploeg, HM
    [J]. AMERICAN JOURNAL OF PSYCHIATRY, 2000, 157 (07) : 1115 - 1119
  • [5] Epidemiologic studies of trauma, posttraumatic stress disorder, and other psychiatric disorders
    Breslau, N
    [J]. CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 2002, 47 (10): : 923 - 929
  • [6] Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults
    Brewin, CR
    Andrews, B
    Valentine, JD
    [J]. JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 2000, 68 (05) : 748 - 766
  • [7] Clinical review: Intensive care follow-up - what has it told us?
    Broomhead, LR
    Brett, SJ
    [J]. CRITICAL CARE, 2002, 6 (05): : 411 - 417
  • [8] Anterior cingulate activation and error processing during interferon-alpha treatment
    Capuron, L
    Pagnoni, G
    Demetrashvili, M
    Woolwine, BJ
    Nemeroff, CB
    Berns, GS
    Miller, AH
    [J]. BIOLOGICAL PSYCHIATRY, 2005, 58 (03) : 190 - 196
  • [9] Post-traumatic stress disorder after critical illness requiring general intensive care
    Cuthbertson, BH
    Hull, A
    Strachan, M
    Scott, J
    [J]. INTENSIVE CARE MEDICINE, 2004, 30 (03) : 450 - 455
  • [10] Psychiatric morbidity in survivors of the acute respiratory distress syndrome: A systematic review
    Davydow, Dimitry S.
    Desai, Sanjay V.
    Needham, Dale M.
    Bienvenu, O. Joseph
    [J]. PSYCHOSOMATIC MEDICINE, 2008, 70 (04): : 512 - 519