Early Intra-Intensive Care Unit Psychological Intervention Promotes Recovery from Post Traumatic Stress Disorders, Anxiety and Depression Symptoms in Critically Ill Patients

Adriano Peris, Dario Iozzelli, Maria Luisa Migliaccio, Giovanni Zagli, Alberto Bacchereti, Marta Debolini, Manuela Bonizzoli, Elisetta Vannini, Massimo Solaro, Ilaria Balzi,Elisa Bendon, Ilaria Bacchi, Laura Belloni, Valtere Giovannini

Critical Care 2011, 15:R41

Introduction: critically ill patients who required 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 post traumatic stress disorder (PTSD) after 12 months from ICU discharge.

Methods: an observational study included critical patients admitted before clinical psychologist intervention (control group), and patients that were involved in a clinical psychologists program (intervention group). Hospital anxiety and depression scale (HADS) and impact of event scalerevised (IESr) questionnaires were used to assess the level of posttraumatic stress, anxiety and depression symptoms.

Results: control and intervention groups showed similar demographic and clinical characteristics. Patients of the intervention group showed a lower rate of anxiety (8.9% vs 17.4%) and depression (6.5% vs 12.8%) on the HADS scale than the control group, even if not statistically significant. High risk for PTSD was significantly lower in patients receiving early clinical psychologist support than control group patients (21.1% vs 57%; P<0.0001). Percentage of patients needing psychiatric medications at 12 months was significantly higher in control group (41.7% vs 8.1%; P<0.0001). Conclusions: Our results suggest that that an early intra-ICU clinical psychologist program may help critically ill trauma patients recover from this stressful experience.

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