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Risk Factors of Delayed Onset Posttraumatic Stress Disorder in Chronically Critically Ill Patients

Wintermann, Gloria-Beatrice PhD*†; Rosendahl, Jenny PhD†‡; Weidner, Kerstin MD*; Strauß, Bernhard PhD; Petrowski, Katja PhD

Journal of Nervous & Mental Disease: October 2017 - Volume 205 - Issue 10 - p 780–787
doi: 10.1097/NMD.0000000000000714
Original Articles

Abstract: The main aim of this study was to investigate factors associated with a delayed-onset posttraumatic stress disorder (PTSD) after the intensive care unit (ICU) treatment of patients with a chronic critical illness (CCI). Patients (n = 97) with critical illness polyneuropathy or critical illness myopathy were interviewed via the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The diagnosis of the acute stress disorder was assessed within 1 month (t1), the diagnosis of PTSD at 3 (t2) and 6 (t3) months after transfer from the acute care ICU to the post-acute ICU. Patients showing a delayed-onset or persistent course of PTSD were subsumed in one group; 24.7% (n = 24) showed a delayed-onset PTSD. Significant risk factors were as follows: the severity of the medical illness, the perceived fear of dying at the ICU, the number of traumatic memories from the ICU, and the presence of a coronary heart disease. Every fourth patient with CCI showed a delayed-onset PTSD up to 6 months after the ICU treatment. Markers for a delayed-onset PTSD should already be assessed at the time of discharge from the ICU.

*Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; †Center for Sepsis Control and Care, and ‡Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena; and §Department of Workplace Health Promotion, German Sport University Cologne, Cologne, Germany.

Send reprint requests to Gloria-Beatrice Wintermann, PhD, Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden Fetscherstraße 74, 01307 Dresden, Germany. E-mail: Gloria.Wintermann@uniklinikum-dresden.de.

This work was performed at Jena University Hospital, Jena, Germany, and Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Author contributions: G. B. W. wrote the manuscript. J. R. developed the study design and mainly supported the statistical analyses. K. P. proofread the manuscript and systematically contributed to the development of the main concept of the present manuscript. B. S. and K. W. contributed to data assessment and supported the realization of the present study.

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