title: Posttraumatic stress disorder in general intensive care unit survivors: a systematic review.
abstract: OBJECTIVE
  Our objective was to summarize and critically review data on the prevalence of posttraumatic stress disorder (PTSD) in general intensive care unit (ICU) survivors, risk factors for post-ICU PTSD and the impact of post-ICU PTSD on health-related quality of life (HRQOL).
  
  
  METHODS
  We conducted a systematic literature review using Medline, EMBASE, Cochrane Library, CINAHL, PsycINFO and a hand-search of 13 journals.
  
  
  RESULTS
  Fifteen studies were eligible. The median point prevalence of questionnaire-ascertained "clinically significant" PTSD symptoms was 22% (n=1,104), and the median point prevalence of clinician-diagnosed PTSD was 19% (n=93). Consistent predictors of post-ICU PTSD included prior psychopathology, greater ICU benzodiazepine administration and post-ICU memories of in-ICU frightening and/or psychotic experiences. Female sex and younger age were less consistent predictors, and severity of critical illness was consistently not a predictor. Post-ICU PTSD was associated with substantially lower HRQOL.
  
  
  CONCLUSIONS
  The prevalence of PTSD in ICU survivors is high and negatively impacts survivors' HRQOL. Future studies should comprehensively address how patient-specific factors (e.g., pre-ICU psychopathology), ICU management factors (e.g., administration of sedatives) and ICU clinical factors (e.g., in-ICU delirium) relate to one another and to post-ICU PTSD. Clinicians caring for the growing population of ICU survivors should be aware of PTSD risk factors and monitor patients' needs for early intervention.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington School of Medicine, Box 356896, Seattle, WA 98104, USA. ddavydo1@u.washington.edu
authors.forename: Dimitry S
authors.initials: DS
authors.lastname: Davydow
authors.forename: Jeneen M
authors.initials: JM
authors.lastname: Gifford
authors.forename: Sanjay V
authors.initials: SV
authors.lastname: Desai
authors.forename: Dale M
authors.initials: DM
authors.lastname: Needham
authors.forename: O Joseph
authors.initials: OJ
authors.lastname: Bienvenu
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
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