Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial

Christina Jones, Carl Bäckman, Maurizia Capuzzo, Ingrid Egerod, Hans Flaatten, Cristina Granja, Christian Rylander, Richard D Griffiths, RACHEL group, D Christensen, I Bogø, R Hansen, H Kjerrumgård, L Mathiasen, C Hyldested, C Toft, C Bagger, M B Larsen, L Frank de Jong, A S Ågård, K Knudsen, T Hinzel, A Scaramuzza, S Bertacchini, J Schou Landmark, A Salomonsen, K Tøien, S Walther, A K Muri, E Neutel, E Gomes, T Cardoso, R Ferreira, C Machado, C Santos, S Pinto, A Amaro, E Morujão, A Jerónimo, T Rodrigues, F Carvalho, A Silva, A Morais, W Etemad, E Rosell, A Wirbrand Holmquist, E Åkerman, A Ersson, C Tobin, Christina Jones, Carl Bäckman, Maurizia Capuzzo, Ingrid Egerod, Hans Flaatten, Cristina Granja, Christian Rylander, Richard D Griffiths, RACHEL group, D Christensen, I Bogø, R Hansen, H Kjerrumgård, L Mathiasen, C Hyldested, C Toft, C Bagger, M B Larsen, L Frank de Jong, A S Ågård, K Knudsen, T Hinzel, A Scaramuzza, S Bertacchini, J Schou Landmark, A Salomonsen, K Tøien, S Walther, A K Muri, E Neutel, E Gomes, T Cardoso, R Ferreira, C Machado, C Santos, S Pinto, A Amaro, E Morujão, A Jerónimo, T Rodrigues, F Carvalho, A Silva, A Morais, W Etemad, E Rosell, A Wirbrand Holmquist, E Åkerman, A Ersson, C Tobin

Abstract

Introduction: Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD.

Methods: Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months.

Results: 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02).

Conclusions: The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.

Trial registration: NCT00912613.

Figures

Figure 1
Figure 1
CONSORT diagram of recruitment and follow-up.
Figure 2
Figure 2
Change in PTSS-14 scores between one and three months by study group and PTSS-14 of 45 or more at one month. Patients in the intervention group with a post-traumatic stress syndrome (PTSS)-14 score above the cut-off of 45 at one month had a significant reduction in the PTSS-14 symptom score at three months (Fisher's exact test P = 0.04).

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Source: PubMed

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