title: Post-traumatic stress disorder after weaning from prolonged mechanical ventilation.
abstract: OBJECTIVE
  Weaning from prolonged mechanical ventilation may be associated with mental discomfort. It is not known whether such discomfort is linked with the development of post-traumatic stress disorder (PTSD). Accordingly, we investigated whether PTSD occurs in patients after weaning from prolonged ventilation. We also determined whether administering a questionnaire would identify patients at risk for developing PTSD.
  
  
  METHODS
  A prospective longitudinal study of patients transferred to a long-term acute-care hospital for weaning from prolonged ventilation was undertaken: 72 patients were studied 1 week after weaning, and 41 patients were studied again 3 months later. An experienced psychologist conducted a structured clinical interview 3 months after weaning to establish a diagnosis of PTSD. To assess for the presence of PTSD-related symptoms, the post-traumatic stress syndrome (PTSS-10) questionnaire was administered 1 week after weaning and 3 months later.
  
  
  RESULTS
  The psychologist diagnosed PTSD in 12% of patients 3 months after ventilator weaning. Patients who developed PTSD were more likely to have a previous history of psychiatric disorders (P < 0.02). A PTSS-10 score >20 one week after weaning reliably identified patients who were diagnosed with PTSD 3 months later: sensitivity 1.0; specificity 0.76; area under the receiver-operating characteristic curve 0.91.
  
  
  CONCLUSIONS
  PTSD was diagnosed in 12% of patients who were weaned from prolonged ventilation. A PTSS-10 score >20 one week after weaning identified patients diagnosed with PTSD 3 months later. This finding suggests that a simple questionnaire administered before hospital discharge can identify patients at risk for developing PTSD.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Affairs Hospital, Hines IL and Loyola University of Chicago Stritch School of Medicine, Maywood, IL, USA. ajubran@lumc.edu
authors.forename: Amal
authors.initials: A
authors.lastname: Jubran
authors.forename: Gerald
authors.initials: G
authors.lastname: Lawm
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Duffner
authors.forename: Eileen G
authors.initials: EG
authors.lastname: Collins
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Lanuza
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Hoffman
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Tobin
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D013997:Time Factors; D015300:Ventilator Weaning