Experiencing a traumatic event may require a trip to the Intensive Care Unit, but a new study indicates that going to the ICU can be a traumatizing experience in itself, especially for individuals already suffering from a mental illness. Past studies have questioned how a prolonged stay in the ICU, where patients with a serious illness or injury may be restrained or prevented from speaking due to a breathing apparatus, affects mental health. After leaving the ICU, many patients develop post-traumatic stress disorder (PTSD), which affects about 7.7 million American adults. Research indicates that many of these individuals have traumatic memories relating to the treatment they received while in the ICU rather than recollections of the medical problems that landed them there. In one recent study, Dr. Christina Jones from the University of Liverpool in England identified three potential components of a stay in the ICU that are associated with the development of PTSD: prolonged sedation, physical restraint without sedation, and recall of delusional memories.
The researchers observed 238 patients from five ICUs in the United Kingdom, Sweden, Italy, and Norway. They recorded each patient's level and duration of sedation, the drug and dose used for sedation, the presence or absence of delirium after sedation, and wether or not the patient was physically restrained. The researchers administered the Post-traumatic Stress Syndrome 14-Question Inventory (PTSS-14) to the patients two and three months following discharge and found that 9.2% met the criteria for PTSD. Many of the individuals with PTSD displayed delusional memories of their time in the ICU instead of factual traumatic memories. They misunderstood the events going on around them, viewing medical treatments like sedation, restraints, and injections as attempts to harm them. For these delusional individuals, the ICU became a scary and unsafe place. Those who already have diagnosable mental disorders were at an even greater risk for developing PTSD, as they were more likely to be delusional and to be sedated.
Although identifying the specific factors that lead to PTSD can be difficult, researchers continue to question the role that the ICU plays. More research can determine how best to prevent new cases of PTSD, whether by changing the way we treat patients within the ICU or by helping patients after they have left the ICU. Either way, by identifying individuals at risk for PTSD, we can lessen the number of individuals crippled by its effects.
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