title: Late onset and persistence of post-traumatic stress disorder symptoms in survivors of critical care.
abstract: BACKGROUND
  Several recent studies have reported that post-traumatic stress disorder (PTSD) is a frequent occurrence in survivors of an intensive care unit (ICU) admission.
  
  
  OBJECTIVE
  To assess the frequency of PTSD symptoms at three and nine months post-ICU admission and examine possible risk factors that predispose to the development of PTSD symptoms.
  
  
  METHODS
  Using the following scales: Davidson Trauma Scale, Impact of Event Scale and the Post-traumatic Symptom Scale, 69 ICU survivors were assessed for PTSD symptoms at three months post-ICU admission. Of the original 69 patients, 37 completed the same questionnaires at the second follow-up at nine months post-ICU admission. Mean symptom levels for avoidance, intrusive thoughts and hyperarousal were calculated, and risk factors for the development of PTSD symptomatology were examined.
  
  
  RESULTS
  Depending on which scale was used, 16% to 33% of ICU survivors met the criteria for PTSD at either three or nine months. Younger age and the use of a prescription psychoactive medication at time of ICU admission were both independently associated with a higher risk of developing PTSD symptoms. Interestingly, symptoms of hyperarousal worsened during the follow-up interval for female patients, while they remained constant for males.
  
  
  CONCLUSIONS
  The frequency of PTSD symptoms was high in patients who survived an admission to the ICU. Depending on sex, symptoms may present and evolve differently. The adoption of screening tools and a multicentre ICU database in Canada is recommended to identify patients who are most at risk.
authors.forename: Aaron
authors.initials: A
authors.lastname: Khitab
authors.forename: John
authors.initials: J
authors.lastname: Reid
authors.forename: Vern
authors.initials: V
authors.lastname: Bennett
authors.forename: G Camelia
authors.initials: GC
authors.lastname: Adams
authors.forename: Lloyd
authors.initials: L
authors.lastname: Balbuena
mesh_terms: D002908:Chronic Disease; D003422:Critical Care; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012525:Saskatchewan / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors
references.citation: J Intensive Care Med. 2004 Sep-Oct;19(5):285-90
references.pmid: 15358947
references.citation: J Trauma. 2010 Dec;69(6):1552-9
references.pmid: 20664371
references.citation: Intensive Care Med. 1999 Jul;25(7):697-704
references.pmid: 10470573
references.citation: Acta Anaesthesiol Scand. 2007 Jul;51(6):671-8
references.pmid: 17567267
references.citation: J Anxiety Disord. 2008;22(2):187-98
references.pmid: 17369016
references.citation: J Rehabil Res Dev. 2009;46(6):697-702
references.pmid: 20104399
references.citation: BMC Health Serv Res. 2008 Jun 17;8:132
references.pmid: 18559099
references.citation: Psychol Med. 1997 Jan;27(1):153-60
references.pmid: 9122295
references.citation: Crit Care Med. 2000 Jul;28(7):2293-9
references.pmid: 10921555
references.citation: Psychol Assess. 2003 Mar;15(1):101-9
references.pmid: 12674729
references.citation: Crit Care Med. 2012 Jul;40(7):2033-40
references.pmid: 22584757
references.citation: Gen Hosp Psychiatry. 2008 Sep-Oct;30(5):421-34
references.pmid: 18774425
references.citation: Acta Anaesthesiol Scand. 2008 Feb;52(2):202-8
references.pmid: 18005373
references.citation: Anaesthesia. 2005 Nov;60(11):1085-92
references.pmid: 16229693
references.citation: Br J Health Psychol. 2007 Feb;12(Pt 1):65-74
references.pmid: 17288666
references.citation: Crit Care Med. 2012 Feb;40(2):618-24
references.pmid: 22080636
references.citation: Crit Care Med. 2001 Mar;29(3):573-80
references.pmid: 11373423
references.citation: Curr Psychiatry Rep. 2011 Feb;13(1):3-9
references.pmid: 20981585
references.citation: J Consult Clin Psychol. 1998 Jun;66(3):586-90
references.pmid: 9642900
references.citation: Crit Care. 2012 Oct 15;16(5):R192
references.pmid: 23068129
references.citation: J Trauma Stress. 2005 Feb;18(1):53-62
references.pmid: 16281196
references.citation: J Anxiety Disord. 2008 Dec;22(8):1393-402
references.pmid: 18436427
references.citation: Behav Res Ther. 2000 Jun;38(6):619-28
references.pmid: 10846810
references.citation: Chest. 2013 Jul;144(1):24-31
references.pmid: 23699588
references.citation: Intensive Care Med. 2004 Mar;30(3):450-5
references.pmid: 12961065
references.citation: Intensive Crit Care Nurs. 1998 Jun;14(3):108-16
references.pmid: 9814215
references.citation: Crit Care Med. 2003 Oct;31(10):2456-61
references.pmid: 14530751
references.citation: J Trauma. 2010 Sep;69(3):627-32
references.pmid: 20118816
references.citation: Psychosom Med. 1979 May;41(3):209-18
references.pmid: 472086
references.citation: Depress Anxiety. 2002;15(2):75-8
references.pmid: 11891997
references.citation: Crit Care. 2007;11(1):R28
references.pmid: 17316452
references.citation: Crit Care. 2010;14(5):R168
references.pmid: 20843344
references.citation: Am J Psychiatry. 2004 Jan;161(1):45-52
references.pmid: 14702249
references.citation: Nurs Crit Care. 2009 Mar-Apr;14(2):61-7
references.pmid: 19243522
references.citation: Crit Care. 2011;15(2):141
references.pmid: 21542870
references.citation: J Trauma Stress. 2000 Jan;13(1):101-13
references.pmid: 10761177
references.citation: Intensive Crit Care Nurs. 2011 Dec;27(6):338-46
references.pmid: 22055395