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Post-traumatic stress disorder and post-traumatic stress symptoms following critical illness in medical intensive care unit patients: assessing the magnitude of the problem

机译：重症监护病房患者重症后的创伤后应激障碍和创伤后应激症状：评估问题的严重性

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IntroductionPost-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.MethodsWe 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.ResultsFrom 78 screened papers, 16 studies (representing 15 cohorts) and approximately 920 medical ICU patients met 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%.ConclusionExact PTSD prevalence rates cannot be determined due to 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 due to 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.
机译：简介创伤后应激障碍（PTSD）是一种潜在的严重精神疾病，传统上与​​创伤应激源有关，例如参与战斗，暴力袭击和自然灾害的生存。最近，研究人员报告说，尽管尚不清楚危疾与PTSD之间的关联细节，但危疾的经历也可能导致PTSD。方法我们对MEDLINE和Psych Info进行了关键字搜索，并对与PTSD相关的所有文章进行了二级参考文献的调查。结果从78篇筛选的论文中，有16项研究（代表15个队列）和大约920名医疗ICU患者符合纳入标准。总共10项调查仅使用简短的PTSD筛查工具，而不使用更全面的诊断方法。报告的PTSD患病率从5％到63％不等，其中三个患病率最高的估计发生在少于30名患者的研究中。失访率在10％到70％之间，平均失访率超过30％。结论由于方法学上的局限性，例如选择偏倚，失访和失访，无法确定确切的PTSD患病率。广泛使用筛查（相对于诊断）仪器。通常，由于迄今为止进行的研究的局限性，文献中报道的高患病率可能被高估了。尽管在某些重病幸存者中，PTSD可能是一个严重的问题，但有关总体人群的数据尚无定论。由于PTSD对重症幸存者造成的问题的严重性尚不清楚，因此迫切需要对ICU幸存者进行PTSD的更大且方法更严格的研究。

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