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Commentary: Jackson JC et al . (2007). Post‐traumatic stress disorder and post‐traumatic stress symptoms following critical illness in medical intensive care unit patients: assessing the magnitude of the problem
Author(s) -
Rattray Janice
Publication year - 2008
Publication title -
nursing in critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.689
H-Index - 43
eISSN - 1478-5153
pISSN - 1362-1017
DOI - 10.1111/j.1478-5153.2008.00284.x
Subject(s) - medicine , psychiatry , intensive care unit , critical illness , stressor , traumatic stress , population , intensive care , medline , severity of illness , clinical psychology , intensive care medicine , critically ill , environmental health , political science , law
Post‐traumatic stress disorder (PTSD) is a potentially serious psychiatric disorder that has traditionally been associated with traumatic stressors such as participation in combat, violent assault and survival of natural disasters. Recently, investigators have reported that the experience of critical illness can also lead to PTSD, although details of the association between critical illness and PTSD remain unclear. We conducted keyword searches of MEDLINE and Psych Info and investigations of secondary references for all articles pertaining to PTSD in medical intensive care unit (ICU) survivors. From 78 screened papers, 16 studies (representing 15 cohorts) and approximately 920 medical ICU patients met the inclusion criteria. A total of 10 investigations used brief PTSD screening tools exclusively as opposed to more comprehensive diagnostic methods. Reported PTSD prevalence rates varied from 5% to 63%, with the three highest prevalence estimates occurring in studies with fewer than 30 patients. Loss to follow‐up rates ranged from 10% to 70%, with average loss to follow‐up rates exceeding 30%. Exact PTSD prevalence rates cannot be determined because of methodological limitations such as selection bias, loss to follow‐up and the wide use of screening (as opposed to diagnostic) instruments. In general, the high prevalence rates reported in the literature are likely to be overestimates because of the limitations of the investigations conducted to date. Although PTSD may be a serious problem in some survivors of critical illness, data on the whole population are inconclusive. Because the magnitude of the problem posed by PTSD in survivors of critical illness is unknown, there remains a pressing need for larger and more methodologically rigorous investigations of PTSD in ICU survivors. Abstract reprinted from the Critical Care, volume 11, Jackson JC et al., ‘Post‐traumatic stress disorder and post‐traumatic stress symptoms following critical illness in medical intensive care unit patients: assessing the magnitude of the problem.’, page R27. © 2007, reproduced with permission from BioMed Central Ltd.