title: Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients.
abstract: BACKGROUND
  Critically ill patients who require intensive care unit (ICU) treatment may experience psychological distress with increasing development of psychological disorders and related morbidity. Our aim was to determine whether intra-ICU clinical psychologist interventions decrease the prevalence of anxiety, depression and posttraumatic stress disorder (PTSD) after 12 months from ICU discharge.
  
  
  METHODS
  Our observational study included critical patients admitted before clinical psychologist intervention (control group) and patients who were involved in a clinical psychologist program (intervention group). The Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised questionnaires were used to assess the level of posttraumatic stress, anxiety and depression symptoms.
  
  
  RESULTS
  The control and intervention groups showed similar demographic and clinical characteristics. Patients in the intervention group showed lower rates of anxiety (8.9% vs. 17.4%) and depression (6.5% vs. 12.8%) than the control group on the basis of HADS scores, even if the differences were not statistically significant. High risk for PTSD was significantly lower in patients receiving early clinical psychologist support than in the control group (21.1% vs. 57%; P < 0.0001). The percentage of patients who needed psychiatric medications at 12 months was significantly higher in the control group than in the patient group (41.7% vs. 8.1%; P < 0.0001).
  
  
  CONCLUSIONS
  Our results suggest that that early intra-ICU clinical psychologist intervention may help critically ill trauma patients recover from this stressful experience.
authors.affiliation: Anaesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital, Largo Brambilla 3, I-50139 Florence, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Peris
authors.forename: Manuela
authors.initials: M
authors.lastname: Bonizzoli
authors.forename: Dario
authors.initials: D
authors.lastname: Iozzelli
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Migliaccio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zagli
authors.forename: Alberto
authors.initials: A
authors.lastname: Bacchereti
authors.forename: Marta
authors.initials: M
authors.lastname: Debolini
authors.forename: Elisetta
authors.initials: E
authors.lastname: Vannini
authors.forename: Massimo
authors.initials: M
authors.lastname: Solaro
authors.forename: Ilaria
authors.initials: I
authors.lastname: Balzi
authors.forename: Elisa
authors.initials: E
authors.lastname: Bendoni
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bacchi
authors.forename: Monica
authors.initials: M
authors.lastname: Trevisan
authors.forename: Valtere
authors.initials: V
authors.lastname: Giovannini
authors.forename: Laura
authors.initials: L
authors.lastname: Belloni
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy*; D016022:Case-Control Studies; D003422:Critical Care / Q000379:methods* / Q000523:psychology; D016638:Critical Illness; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D015995:Prevalence; D011613:Psychotherapy; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D013315:Stress, Psychological / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome