Understanding posttraumatic stress disorder-related symptoms after critical care: The early illness amnesia hypothesis

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Granja, C (Author) Other; Gornes, E (Author) Other; Amaro, A (Author) Other; Ribeiro, O (Author) Other; Jones, C (Author) Other; Carneiro, A (Author) Other; Costa-Pereira A (Author) FMUP

Journal

Title: Critical Care Medicine

Vol. 36 No. 10

Pages: 2801-2809

ISSN: 0090-3493

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 104 Citations

Scopus - 118 Citations

Pubmed / Medline

Other information

Authenticus ID: P-003-VPX

DOI: 10.1097/ccm.0b013e318186a3e7

Abstract (EN): Objective: To assess the factual and delusional memories reported by intensive care unit survivors and its relationship with the development of Posttraumatic Stress Syndrome (PTSS). Design: Multicenter observational cohort study. Setting: Nine Portuguese intensive care units, as part of a multicenter study. Methods and Patients: Between January and June 2005, 1,174 patients were admitted across the nine intensive care units. Two hundred thirty-nine patients were excluded, 14 with <18 yrs old and 225 with a length of intensive care stay <= 48 hrs. Thus a total of 935 patients were included in the study. One hundred ninety (20%) patients died in the intensive care unit, 90 (12%) patients died on the ward (30% in-hospital mortality rate), and another 56 (9%) died in the next 6 months after intensive care unit discharge. Results: From the 599 survivors at 6 months, 313 patients answered the questionnaires (52% response rate). From the 313 respondents, 58% (n = 183) were men, median age was 59. The median Simplified Acute Physiology Score II was 37, median intensive care unit length of stay was 8 days, 57% (n = 177) of the patients were admitted for medical reasons. Forty percent (n = 116) of the respondents did not remember their admission to hospital, 48% (n = 142) did not remember the time in the hospital before intensive care unit admission, 73% (n = 220) had factual memories and 39% (n = 118) had delusional memories. Twenty-three percent (n = 66) stated that they had had intrusive memories. A higher number of "adverse" experiences were significantly associated with a higher PTSS-14 score. Eighteen percent (n = 54) of patients had a PTSS-14 score >49, indicating a higher risk of developing posttraumatic stress disorder. A PTSS-14 score >49 was significantly associated with not remembering the hospital stay before intensive care unit admission. Conclusion: Amnesia for the early period of critical illness (early amnesia) was positively associated with the level of posttraumatic stress disorder-related symptoms, which may be a proxy for severity of disease at the time of intensive care unit admission.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9