PTSD After Critical Illness: Current Issues and Future Directions

Abstract

Post-traumatic stress disorder (PTSD) is a condition that is typically described in the context of military trauma, physical and sexual abuse, yet it also commonly occurs in survivors of critical illness. Indeed, rates of PTSD in individuals after intensive care are at least three times as high as in the population at large, although some studies have reported the existence of PTSD in as many as half of ICU survivors. Risk factors for PTSD have been studied extensively, and findings suggest that younger individuals and those with pre-existing mental health problems are at highest risk of developing PTSD in the months and years after critical illness. While PTSD has certain core elements, in survivors of critical illness, marked symptoms of avoidance and preoccupation with health-related concerns predominate the clinical presentation. It may be that existing approaches to treating PTSD are effective in managing such symptoms; alternatively, there may be unique methods to the treatment of PTSD after the ICU. Future investigations of PTSD in ICU survivors should focus on improving preventive strategies and our predictive ability for this disabling condition. Finally, significant efforts should be made to help facilitate post-traumatic growth (PTG) in patients and families after critical illness.