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Posttraumatic stress disorder in general intensive care unit survivors: a systematic review Davydow DS; Gifford JM; Desai SV; Needham DM; Bienvenu OJGen Hosp Psychiatry 2008[Sep]; 30 (5): 421-34OBJECTIVE: 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=1,104), 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.|*Intensive Care Units/statistics & numerical data[MESH]|Comorbidity[MESH]|Cross-Sectional Studies[MESH]|Humans[MESH]|Outcome Assessment, Health Care[MESH]|Risk Factors[MESH]|Stress Disorders, Post-Traumatic/*diagnosis/epidemiology/psychology[MESH]|Survivors/*psychology/statistics & numerical data[MESH] |
