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The role of psychosomatic medicine in intensive care units

Bedeutung der psychosomatischen Medizin auf Intensivstationen

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Summary

Critically ill patients, their relatives, and intensive care staff are consistently exposed to stress. The principal elements of this exceptional burden are confrontation with a life-threatening disease, specific environmental conditions at the intensive care unit, and the social characteristics of intensive care medicine. The short- and long-term consequences of these stressors include a feeling of helplessness, distress, anxiety, depression, and even posttraumatic stress disorders. Not only the patients, but also their relatives and intensive care staff are at risk of developing such psychopathologies. The integration of psychosomatic medicine into the general concept of intensive care medicine is an essential step for the early identification of fear and anxiety and for understanding biopsychosocial coherence in critically ill patients. Preventive measures such as the improvement of individual coping strategies and enhancing the individual’s resistance to stress are crucial aspects of improving wellbeing, as well as the overall outcome of disease. Additional stress-reducing measures reported in the published literature, such as hearing music, the use of earplugs and eye-masks, or basal stimulation, have been successful to a greater or lesser extent.

Zusammenfassung

Kritisch kranke Patienten sowie deren Angehörige und das betreuende medizinische Personal sind andauernden Stresssituationen ausgesetzt, die hauptsächlich mit der schweren Erkrankung selbst, der speziellen Umgebung der Intensivstation sowie den sozialen Interaktionen, welche die Intensivmedizin mit sich bringt, in Zusammenhang stehen. Gefühle von Hilflosigkeit, Verzweiflung, Angst, Depression und sogar posttraumatische Stressreaktionen können dabei als kurz- oder langfristige Folgen auftreten. Die Integration psychosomatischer Medizin ist bei Intensivpatienten ein wichtiger Schritt für das Erkennen von biopsychosozialen Zusammenhängen und deren Auswirkungen auf das Entstehen, den Verlauf und den Ausgang der Erkrankung. Präventive Maßnahmen, wie die frühzeitige Diagnose von Ängsten und Depressionen, die Förderung von Bewältigungsstrategien und die Stärkung der Resilienz können die Entwicklung von Psychopathologien bei gefährdeten Gruppen minimieren. Andere stressreduzierende Strategien, wie der Einsatz von basaler Stimulation, die Anwendung von Musik oder die Nutzung von Ohrstöpseln und Augenmasken haben sich als mehr oder weniger effizient herausgestellt.

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  1. Department of Internal Medicine, Otto Wagner Hospital, Baumgartner Höhe 1, 1140, Vienna, Austria

    Heidemarie Abrahamian & Diana Lebherz-Eichinger

  2. Department of Anesthesia, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Diana Lebherz-Eichinger

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Correspondence to Heidemarie Abrahamian.

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H. Abrahamian and D. Lebherz-Eichinger declare that they have no competing interests.

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Abrahamian, H., Lebherz-Eichinger, D. The role of psychosomatic medicine in intensive care units. Wien Med Wochenschr 168, 67–75 (2018). https://doi.org/10.1007/s10354-017-0575-1

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