The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review
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To determine the prevalence of post traumatic stress disorder in survivors of intensive care treatment.
Systematic literature review including Medline, Embase, CINAHL, PsycINFO and references from identified papers.
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.
The true prevalence of PTSD and the optimum 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.
KeywordsIntensive care Critically ill Post-traumatic stress disorder Systematic review
- 5.American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text revision. American Psychiatric Association, Arlington, VAGoogle Scholar
- 9.Horowitz M, Wilner W, Alvarez W (1979) Impact of Event Scale: A measure of subjective stress. Psychosomat Med 41:209–218Google Scholar
- 10.Weiss DS, Marmar CR (1997) The Impact of Event Scale – revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD. Guilford, New York, pp 399–411Google Scholar
- 11.Stoll C, Kapfhammer HP, Rothenhausler HB, Haller M, Briegel J, Schmidt M, Krauseneck T, Durst K, Schelling G (1999) Sensitivity and specificity of a screening test to document traumatic experiences and to diagnose post-traumatic stress disorder in ARDS patients after intensive care treatment. Intensive Care Med 25:697–704PubMedCrossRefGoogle Scholar
- 16.Schelling G, Stoll C, Kapfhammer HP, Rothenhausler HB, Krauseneck T, Durst K, Haller M, Briegel J (1999) The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health-related quality of life in survivors. Crit Care Med 27:2678–2683PubMedCrossRefGoogle Scholar
- 17.Schelling G, Stoll C, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuss U, Bullinger M, Schuffel W, Peter K (1998) Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 26:651–659PubMedCrossRefGoogle Scholar
- 18.Schelling G, Kilger E, Roozendaal B, de Quervain DJ, Briegel J, Dagge A, Rothenhausler HB, Krauseneck T, Nollert G, Kapfhammer HP (2004) Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study. Biol Psychiatry 55:627–633PubMedCrossRefGoogle Scholar
- 19.Stoll C, Schelling G, Goetz AE, Kilger E, Bayer A, Kapfhammer HP, Rothenhausler HB, Kreuzer E, Reichart B, Peter K (2000) Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment. J Thorac Cardiovasc Surg 120:505–512PubMedCrossRefGoogle Scholar
- 20.Weis F, Kilger E, Roozendaal B, de Quervain DJ, Lamm P, Schmidt M, Schmolz M, Briegel J, Schelling G (2006) Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomized study. J Thorac Cardiovasc Surg 131:277–282PubMedGoogle Scholar
- 21.Schelling G, Richter M, Roozendaal B, Rothenhausler HB, Krauseneck T, Stoll C, Nollert G, Schmidt M, Kapfhammer HP (2003) Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery. Crit Care Med 31:1971–1980PubMedCrossRefGoogle Scholar
- 54.Bennun IS (2004) A critique of the research assessing post traumatic stress disorder in critical care patients. Care Crit Ill 20:102–106Google Scholar