posttraumatic stress, anxiety and depression symptoms in patients during the first year post intensive care unit discharge创伤后应激、焦虑和抑郁症状的病人在重症监护室放电后的第一年.pdfVIP

Myhren et al. Critical Care 2010, 14:R14 /content/14/1/R14 RESEARCH Open Access Posttraumatic stress, anxiety and depression symptoms in patients during the first year post intensive care unit discharge 1* 2,3 1 1 1 Hilde Myhren , Øivind Ekeberg , Kirsti Tøien , Susanne Karlsson , Olav Stokland Abstract Introduction: To study the level and predictors of posttraumatic stress, anxiety and depression symptoms in medical, surgical and trauma patients during the first year post intensive care unit (ICU) discharge. Methods: Of 255 patients included, 194 participated at 12 months. Patients completed the Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS), Life Orientation Test (LOT) at 4 to 6 weeks, 3 and 12 months and ICU memory tool at the first assessment (baseline). Case level for posttraumatic stress symptoms with high probability of a posttraumatic stress disorder (PTSD) was ≥ 35. Case level of HADS-Anxiety or Depression was ≥ 11. Memory of pain during ICU stay was measured at baseline on a five-point Likert-scale (0-low to 4-high). Patient demographics and clinical variables were controlled for in logistic regression analyses. Results: Mean IES score one year after ICU treatment was 22.5 (95%CI 20.0 to 25.1) and 27% (48/180) were above case level, IES ≥ 35. No significant differences in the IES mean scores across the three time points were found (P = 0.388). In a subgroup, 27/170 (16%), patients IES score increased from 11 to 32, P 0.001. No differences in posttraumatic stress, anxiety or depression between medical, surgical and trauma patients were found. High educational level (OR 0.4, 95%CI 0.2 to 1.0), personality trait (optimism) OR 0.9, 95%CI 0.8 to 1.0), factual recall (OR 6.6,