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PTSD affects 10% of critical care patients a year later

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One in 10 critical care patients is at risk of having new post-traumatic stress disorder related to their experience up to a year after being discharged, according to US researchers.

They assessed levels of PTSD among patients receiving intensive care, including a group of armed forces veterans, from four hospitals.

A total of 181 patients were checked after three months and 160 were assessed again at 12 months.

“The rate of ICU-related PTSD is very comparable to the 8% PTSD rates seen in current and former service members deployed to the recent Iraq and Afghanistan conflicts”

Mayur Patel

The cumulative incidence of PTSD was 6-12% within one year following hospitalisation, according to the study published by the American Journal of Respiratory and Critical Care Medicine.

Approximately two in five ICU survivors developed clinically significant PTSD symptoms of avoidance or hyperarousal, which both occurred twice as frequently as intrusion symptoms, said the researchers.

Lead author Dr Mayur Patel, assistant professor of surgery and neurosurgery at Vanderbilt University Medical Center, said: “Although lower than prior research and public perception suggests, the rate of ICU-related PTSD is very comparable to the 8% PTSD rates seen in current and former service members deployed to the recent Iraq and Afghanistan conflicts.

“It is important to understand more about PTSD following the traumatising events of a critical illness so we can better support the growing number of ICU survivors,” he added.

Pre-existing PTSD has rarely been systematically assessed in previous studies, but this latest work took extra effort to distinguish pre-existing PTSD from new PTSD cases, noted the researchers.

“It is important to understand more about PTSD following the traumatising events of a critical illness so we can better support the growing number of ICU survivors”

Mayur Patel

They found that pre-existing PTSD, as well as prior depression, were strong risk factors associated with ICU-related PTSD at three and 12 months post-discharge.

The authors said: “Pre-existing PTSD and depression are strong markers for ICU-related PTSD risk, and healthcare providers caring for these patients should be cognisant about the possible presence of this condition.”

However, being an armed forces veteran did not increase risk of ICU-related PTSD, nor did duration of delirium, amount of pain medication or amount of sedative.

“Currently, the international psychological aftercare for ICU survivors is not organised proactively – rather, it is largely reactive in response to disabling reports from survivors, caregivers, and primary care providers,” said the study authors.

In comparison, they highlighted that the quality of post-conflict PTSD care given to armed forces veterans was heavily assessed – especially in the US.

“We suggest that the same should apply to the large civilian and veteran populations of critically ill survivors,” said the researchers.

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