The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review

Objective: To determine the prevalence of post traumatic stress disorder in survivors of intensive care treatment. Design: Systematic literature review including Medline, Embase, CINAHL, PsycINFO and references from identified papers. Study selection: Studies determining the prevalence of PTSD in adult patients who had at least 24 h treatment on an intensive care unit. Independent duplicate data extraction. Study quality was evaluated in terms of study design and method and timing of PTSD assessment. Data synthesis and results: Of the 1472 citations identified, 30 studies meeting the selection criteria were reviewed. PTSD was diagnosed by standardised clinical interview alone in 2 studies. A self- report measure alone was used in 19 studies to measure PTSD symptomatology. The remaining 9 studies applied both standardised clinical interview and a self- report measure. The reported prevalence of PTSD was 0 - 64% when diagnosed by standardised clinical interview and 5 - 64% by self- report measure. PTSD assessments occurred 7 days to 8 years after intensive care discharge. Conclusion: The true prevalence of PTSD and the timing and method of PTSD assessment have not yet been determined in intensive care unit survivors. Deficiencies in design, methodology and reporting make interpretation and comparison of quoted prevalence rates difficult, and rigorous longitudinal studies are needed.