PTSD and ICU (Intensive Care Unit) treatment do not seem to have much in common. When people think of post-traumatic stress disorder, they don’t often associate it with patients who were treated and survived an illness or injury requiring an ICU stay. PTSD is often associated with military personnel, surviving wartime, natural disasters, and physical or sexual assault. However, a recent study1 found that approximately 25% of those who survived life threatening medical treatment in an ICU suffered from PTSD thereafter. Since one of the criteria for PTSD is related to exposure to actual or threatened death or serious injury, it is easy to see how someone in the ICU could be at risk for developing PTSD.
As PTSD has wide ranging effects such as significant impact on the sufferer’s ability to connect and communicate with those around them, it can significantly interfere with their ability to live happy lives. Findings of the study may have use in the discovery of ways to prevent PTSD related to treatment undergone in an intensive care unit.
This particular study was able to provide more data in comparison to similar studies which had been conducted in the past and may provide researchers with a larger set of data to study issues related to PTSD and ICU survival. The study sample included patients of varying ages, illnesses, severity of illnesses, durations of admission, and diagnoses.
The review systemically looked at 40 studies that included 36 patient cohorts which were unique and consisted of a patient count of over 3,000 all of which had experienced an ICU in relation to their critical illness. Patients who had suffered trauma-related injury such as those in car crashes, brain injuries, or other health conditions which affected psychological or cognitive outcomes were excluded as the injuries themselves could potentially create or mask PTSD symptoms. The outcome was that 10 to 60 percent of patients, depending on the study, experienced PTSD and ICU associated outcomes. That is, 10 – 60 % of patients who critically ill and required ICU treatment experienced PTSD.
A meta-analysis of the 40 studies looked at subsets of the studies in order to find a more definitive prevalence estimate. Six studies were chosen, for a total of 450 patients, and the Impact Event Scale was used as a measurement tool during a one to six month post-ICU discharge.
After further reviewing the data, it was discovered that patients suffered from the symptoms of PTSD and ICU discharge in one of every four cases. The same process was used to examine the period 12 months post-discharge and it was revealed that PTSD was present in one of every five cases. These rates are similar to those seen in sexual assault victims or those who have been in combat. This indicates that health care practitioners and patients should be aware that the prevalence of PTSD and ICU discharge is high.
When common risk factors were identified, it was discovered that those diagnosed with depression or anxiety prior to their admission were at increased risk for PTSD. Patients whose treatment involved sedation medications in higher amounts and those who indicated they had experienced memories which were frightening about their stay in the ICU were also at higher risk.
The study also looked at PTSD and ICU prevention during ICU stays and found that daily journal writing of patient treatment course or experience by family members and health care providers was an effective solution. This was found to assist patients with memory creation and helped them to process their experiences of PTSD and ICU treatment more accurately.
Finding a viable solution to this issue would provide a PTSD prevention plan which would prove useful as annual stays in the ICU number at more than 5 million. In addition, as many as 750,000 patients in the US require use of mechanical ventilators annually and a prevention program for those receiving lifesaving treatments in ICUs would have long-lasting impacts on their quality of life post discharge. As innovation and quality of medical critical care has resulted in an increased number of ICU survivors, the results of this study indicate the need for preventive measures is ever-growing.
Because our treatment for depression and anxiety programs rely on evidence based practices, our Intensive Outpatient Program shares many common methods with other successful treatment methods. The foundation of our treatment program for relies on the principles of the stages of change, cognitive behavioral therapy, solution focused treatment, skills training and identifying repetitive dysfunctional behavioral relationship patterns to promote recovery from depression and other mental health disorders. In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of these disorders in six peer reviewed treatment outcome studies. Furthermore, less half of all individuals with any psychiatric condition in Tennessee will receive mental health treatment. Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. It is also important to keep in mind that women and men often experience PTSD and ICU experiences differently and therefore the presence of PTSD may also appear differently based on gender. If you or a loved one is showing signs of depression or anxiety, including PTSD and ICU experiences, they should be assessed by a trained mental health professional who can help design a treatment plan for PTSD that can result in recovery. Treatment for depression and anxiety can be highly successful. People who have completed our program have provide very high consumer satisfaction scores and reviews. Call us at 901-682-6136 to schedule an appointment.
1) Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM. Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Crit Care Med. 43(5):1121-9. doi: 10.1097/CCM.0000000000000882.