title: Posttraumatic stress disorder among survivors of critical illness: creation of a conceptual model addressing identification, prevention, and management.
abstract: Quality of life is frequently impaired among survivors of critical illness, and psychiatric morbidity is an important element contributing to poor quality of life in these patients. Among potential manifestations of psychiatric morbidity following critical illness, symptoms of posttraumatic stress are prevalent and intricately linked to the significant stressors present in the intensive care unit (ICU). As our understanding of the epidemiology of post-ICU posttraumatic stress disorder improves, so must our ability to identify those at highest risk for symptoms in the period of time following critical illness and our ability to implement strategies to prevent symptom development. In addition, a focus on strategies to address clinically apparent psychiatric morbidity will be essential. Much remains to be understood about the identification, prevention, and management of this significant public health problem. This article addresses the importance of uniformity in future epidemiologic studies, proposes framing of risk factors into those likely to be modifiable versus non-modifiable, and provides an assessment of modifiable risk factors in the context of a novel conceptual model that offers insight into potential strategies to attenuate symptoms of posttraumatic stress among survivors of critical illness.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA, USA.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Long
authors.forename: Erin K
authors.initials: EK
authors.lastname: Kross
authors.forename: Dimitry S
authors.initials: DS
authors.lastname: Davydow
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
mesh_terms: D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D008962:Models, Theoretical; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D017741:Survivors