Skip to main content
Top
Published in: Critical Care 5/2010

Open Access 01-10-2010 | Research

Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial

Authors: Christina Jones, Carl Bäckman, Maurizia Capuzzo, Ingrid Egerod, Hans Flaatten, Cristina Granja, Christian Rylander, Richard D Griffiths, the RACHEL group

Published in: Critical Care | Issue 5/2010

Login to get access

Abstract

Introduction

Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD.

Methods

Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months.

Results

352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02).

Conclusions

The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.

Trial registration

NCT00912613.
Appendix
Available only for authorised users
Literature
1.
go back to reference American Psychiatric Association: Diagnostic and statistical manual of mental disorders - revised. 4th edition. Washington, DC: American Psychiatric Association; 2000. American Psychiatric Association: Diagnostic and statistical manual of mental disorders - revised. 4th edition. Washington, DC: American Psychiatric Association; 2000.
2.
go back to reference Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ: Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry 2008, 30: 421-434. 10.1016/j.genhosppsych.2008.05.006PubMedCentralCrossRefPubMed Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ: Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry 2008, 30: 421-434. 10.1016/j.genhosppsych.2008.05.006PubMedCentralCrossRefPubMed
3.
go back to reference Jones C, Backman C, Capuzzo M, Flaatten H, Rylander C, Griffiths RD: Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care. Intensive Care Med 2007, 33: 978-985. 10.1007/s00134-007-0600-8CrossRefPubMed Jones C, Backman C, Capuzzo M, Flaatten H, Rylander C, Griffiths RD: Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care. Intensive Care Med 2007, 33: 978-985. 10.1007/s00134-007-0600-8CrossRefPubMed
4.
go back to reference Friedman H, Tucker JS, Schwartz JE: Psychosocial and behavioural predictors of longevity: the aging and death of the "Termites". Am Psychol 1995, 50: 69-78. 10.1037/0003-066X.50.2.69CrossRefPubMed Friedman H, Tucker JS, Schwartz JE: Psychosocial and behavioural predictors of longevity: the aging and death of the "Termites". Am Psychol 1995, 50: 69-78. 10.1037/0003-066X.50.2.69CrossRefPubMed
5.
go back to reference Foa EB, Keane TM, Friedman MJ: Effective treatments for PTSD. New York: Guildford Press; 2000:5. Foa EB, Keane TM, Friedman MJ: Effective treatments for PTSD. New York: Guildford Press; 2000:5.
6.
go back to reference Jones C, Griffiths RD, Humphris G: Disturbed memory and amnesia related to Intensive Care. Memory 2000, 8: 79-94. 10.1080/096582100387632CrossRefPubMed Jones C, Griffiths RD, Humphris G: Disturbed memory and amnesia related to Intensive Care. Memory 2000, 8: 79-94. 10.1080/096582100387632CrossRefPubMed
7.
go back to reference Schelling G, Stoll C, Meier M, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuß U, Bullinger M, Schüffel W, Peter K: Health-related quality of life and posttraumatic stress disorder in survivors of adult respiratory distress syndrome. Crit Care Med 1998, 26: 651-659. 10.1097/00003246-199804000-00011CrossRefPubMed Schelling G, Stoll C, Meier M, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuß U, Bullinger M, Schüffel W, Peter K: Health-related quality of life and posttraumatic stress disorder in survivors of adult respiratory distress syndrome. Crit Care Med 1998, 26: 651-659. 10.1097/00003246-199804000-00011CrossRefPubMed
8.
go back to reference Jones C, Griffiths RD, Humphris G, Skirrow PM: Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med 2001, 29: 573-580. 10.1097/00003246-200103000-00019CrossRefPubMed Jones C, Griffiths RD, Humphris G, Skirrow PM: Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med 2001, 29: 573-580. 10.1097/00003246-200103000-00019CrossRefPubMed
9.
go back to reference Bergbom I, Svensson C, Berggren E, Kamsula M: Patients' and relatives' opinions and feelings about diaries kept by nurses in an intensive care unit: pilot study. Intensive Crit Care Nurs 1999, 15: 185-191. 10.1016/S0964-3397(99)80069-XCrossRefPubMed Bergbom I, Svensson C, Berggren E, Kamsula M: Patients' and relatives' opinions and feelings about diaries kept by nurses in an intensive care unit: pilot study. Intensive Crit Care Nurs 1999, 15: 185-191. 10.1016/S0964-3397(99)80069-XCrossRefPubMed
10.
go back to reference Bäckman CG, Walther SM: Use of a personal diary written on the ICU during critical illness. Intensive Care Med 2001, 27: 426-429. 10.1007/s001340000692CrossRefPubMed Bäckman CG, Walther SM: Use of a personal diary written on the ICU during critical illness. Intensive Care Med 2001, 27: 426-429. 10.1007/s001340000692CrossRefPubMed
11.
go back to reference Knowles RE, Tarrier N: Evaluation of the effect of prospective patient diaries on emotional well-being in intensive care unit survivors: A randomized controlled trial. Crit Care Med 2009, 37: 184-191. 10.1097/CCM.0b013e31819287f7CrossRefPubMed Knowles RE, Tarrier N: Evaluation of the effect of prospective patient diaries on emotional well-being in intensive care unit survivors: A randomized controlled trial. Crit Care Med 2009, 37: 184-191. 10.1097/CCM.0b013e31819287f7CrossRefPubMed
12.
go back to reference Jones C, Capuzzo M, Flaatten H, Backman C, Rylander C, Griffiths RD: ICU diaries may reduce symptoms of posttraumatic stress disorder. Intensive Care Med 2008, 32: S144. Jones C, Capuzzo M, Flaatten H, Backman C, Rylander C, Griffiths RD: ICU diaries may reduce symptoms of posttraumatic stress disorder. Intensive Care Med 2008, 32: S144.
13.
go back to reference Jones C, Humphris G, Griffiths RD: Preliminary validation of the ICUM tool: a tool for assessing memory of the intensive care experience. Clin Intensive Care 2000, 11: 251-255. 10.1080/714028717CrossRef Jones C, Humphris G, Griffiths RD: Preliminary validation of the ICUM tool: a tool for assessing memory of the intensive care experience. Clin Intensive Care 2000, 11: 251-255. 10.1080/714028717CrossRef
15.
go back to reference Ballenger JC, Davidson JR, Lecrubier Y: Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 2000, 61 Suppl 5: 60-66.PubMed Ballenger JC, Davidson JR, Lecrubier Y: Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 2000, 61 Suppl 5: 60-66.PubMed
16.
go back to reference Twigg E, Humphris G, Jones C, Bramwell R, Griffiths RD: Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Acta Anaesthesiol Scand 2008, 52: 202-208. 10.1111/j.1399-6576.2007.01531.xCrossRefPubMed Twigg E, Humphris G, Jones C, Bramwell R, Griffiths RD: Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients. Acta Anaesthesiol Scand 2008, 52: 202-208. 10.1111/j.1399-6576.2007.01531.xCrossRefPubMed
17.
go back to reference Foa EB, Cashman L, Jaycox L, Perry K: The validation of a self-reported measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psych Assess 1997, 9: 445-451. 10.1037/1040-3590.9.4.445CrossRef Foa EB, Cashman L, Jaycox L, Perry K: The validation of a self-reported measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psych Assess 1997, 9: 445-451. 10.1037/1040-3590.9.4.445CrossRef
18.
go back to reference Elhai JD, Gray MJ, Kashdan TB, Franklin CL: Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A Survey of traumatic stress professionals. J Trauma Stress 2005, 18: 541-545. 10.1002/jts.20062CrossRefPubMed Elhai JD, Gray MJ, Kashdan TB, Franklin CL: Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A Survey of traumatic stress professionals. J Trauma Stress 2005, 18: 541-545. 10.1002/jts.20062CrossRefPubMed
19.
go back to reference Bland M: An introduction to Medical Statistics. Oxford: Oxford University Press; 1997:205. Bland M: An introduction to Medical Statistics. Oxford: Oxford University Press; 1997:205.
20.
go back to reference Shaw K, McFarlane AC, Bookless C, Air T: The aetiology of postpsychotic posttraumatic stress disorder following a psychotic episode. J Trauma Stress 2002, 15: 39-47. 10.1023/A:1014331211311CrossRefPubMed Shaw K, McFarlane AC, Bookless C, Air T: The aetiology of postpsychotic posttraumatic stress disorder following a psychotic episode. J Trauma Stress 2002, 15: 39-47. 10.1023/A:1014331211311CrossRefPubMed
21.
go back to reference Ringdal M, Plos K, Örtenwall P, Bergbom I: Memories and health-related quality of life after intensive care: A follow-up study. Crit Care Med 2010, 38: 38-44. 10.1097/CCM.0b013e3181b42909CrossRefPubMed Ringdal M, Plos K, Örtenwall P, Bergbom I: Memories and health-related quality of life after intensive care: A follow-up study. Crit Care Med 2010, 38: 38-44. 10.1097/CCM.0b013e3181b42909CrossRefPubMed
22.
go back to reference Wegner DM, Shortt JW, Blake AW, Page MS: The suppression of exciting thoughts. J Pers Soc Psychol 1990, 58: 409-418. 10.1037/0022-3514.58.3.409CrossRefPubMed Wegner DM, Shortt JW, Blake AW, Page MS: The suppression of exciting thoughts. J Pers Soc Psychol 1990, 58: 409-418. 10.1037/0022-3514.58.3.409CrossRefPubMed
23.
go back to reference Girard TD, Shintani AK, Jackson JC, Gordon SM, Pun BT, Henderson MS, Dittus RS, Bernard GR, Ely EW: Risk factors for post-traumatic stress disorder symptoms following critical illness requiring mechanical ventilation: a prospective cohort study. Crit Care 2007, 11: R28. 10.1186/cc5708PubMedCentralCrossRefPubMed Girard TD, Shintani AK, Jackson JC, Gordon SM, Pun BT, Henderson MS, Dittus RS, Bernard GR, Ely EW: Risk factors for post-traumatic stress disorder symptoms following critical illness requiring mechanical ventilation: a prospective cohort study. Crit Care 2007, 11: R28. 10.1186/cc5708PubMedCentralCrossRefPubMed
24.
go back to reference Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M: Post traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 2004, 30: 456-460. 10.1007/s00134-003-2149-5CrossRefPubMed Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M: Post traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 2004, 30: 456-460. 10.1007/s00134-003-2149-5CrossRefPubMed
25.
go back to reference Orr SP: Psychophysiological studies of posttraumatic stress disorder. In Biological assessment and treatment of posttraumatic stress disorder. Edited by: EL Giller Jr. Washington DC: American Psychiatric Press; 1990:90-94. Orr SP: Psychophysiological studies of posttraumatic stress disorder. In Biological assessment and treatment of posttraumatic stress disorder. Edited by: EL Giller Jr. Washington DC: American Psychiatric Press; 1990:90-94.
26.
go back to reference Van der Volk B, Greenberg M, Boyd J, Krystal J: Inescapable shock, neurotransmitters and addiction to trauma: towards a psychobiology of post traumatic stress. Biolog Psych 1985, 20: 314-325. 10.1016/0006-3223(85)90061-7CrossRef Van der Volk B, Greenberg M, Boyd J, Krystal J: Inescapable shock, neurotransmitters and addiction to trauma: towards a psychobiology of post traumatic stress. Biolog Psych 1985, 20: 314-325. 10.1016/0006-3223(85)90061-7CrossRef
27.
go back to reference Ehlers A, Clark DM: A cognitive model of posttraumatic stress disorder. Behav Res Ther 2000, 38: 319-345. 10.1016/S0005-7967(99)00123-0CrossRefPubMed Ehlers A, Clark DM: A cognitive model of posttraumatic stress disorder. Behav Res Ther 2000, 38: 319-345. 10.1016/S0005-7967(99)00123-0CrossRefPubMed
28.
go back to reference Kindt M, Soeter M, Vervliet B: Beyond extinction: erasing human fear responses and preventing the return of fear. Nature Neuroscience 2009, 12: 256-258. 10.1038/nn.2271CrossRefPubMed Kindt M, Soeter M, Vervliet B: Beyond extinction: erasing human fear responses and preventing the return of fear. Nature Neuroscience 2009, 12: 256-258. 10.1038/nn.2271CrossRefPubMed
29.
go back to reference Brunet A, Orr SP, Tremblay J, Robertson K, Nader K, Pitman RK: Effect of post-retrieval propranolol on psychophysiological responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder. J Psychiatr Res 2008, 42: 503-506. 10.1016/j.jpsychires.2007.05.006CrossRefPubMed Brunet A, Orr SP, Tremblay J, Robertson K, Nader K, Pitman RK: Effect of post-retrieval propranolol on psychophysiological responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder. J Psychiatr Res 2008, 42: 503-506. 10.1016/j.jpsychires.2007.05.006CrossRefPubMed
30.
go back to reference Schelling G, Stoll C, Kapfhammer HP, Krauseneck T, Durst K, Haller M, Briegel J: The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health related quality of life in survivors. Crit Care Med 1999, 27: 2678-2683. 10.1097/00003246-199912000-00012CrossRefPubMed Schelling G, Stoll C, Kapfhammer HP, Krauseneck T, Durst K, Haller M, Briegel J: The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health related quality of life in survivors. Crit Care Med 1999, 27: 2678-2683. 10.1097/00003246-199912000-00012CrossRefPubMed
31.
go back to reference Schelling G, Briegel J, Roozendaal B, Stoll C, Rothenhausler HB, Kapfhammer HP: The effect of stress doses of hydrocortisone during septic shock on post traumatic stress disorder in survivors. Biol Psychiatry 2001, 50: 978-985. 10.1016/S0006-3223(01)01270-7CrossRefPubMed Schelling G, Briegel J, Roozendaal B, Stoll C, Rothenhausler HB, Kapfhammer HP: The effect of stress doses of hydrocortisone during septic shock on post traumatic stress disorder in survivors. Biol Psychiatry 2001, 50: 978-985. 10.1016/S0006-3223(01)01270-7CrossRefPubMed
32.
go back to reference Weis F, Kilger E, Roozendaal B, de Quervain DJ, Lamm P, Schmidt M, Schmolz M, Briegel J, Schelling G: Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomised study. J Thorac Cardiovasc Surg 2006, 131: 277-282.CrossRefPubMed Weis F, Kilger E, Roozendaal B, de Quervain DJ, Lamm P, Schmidt M, Schmolz M, Briegel J, Schelling G: Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomised study. J Thorac Cardiovasc Surg 2006, 131: 277-282.CrossRefPubMed
33.
go back to reference Rose S, Bisson J, Churchill R, Wessely S: Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2001, (3):CD000560. Rose S, Bisson J, Churchill R, Wessely S: Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2001, (3):CD000560.
Metadata
Title
Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial
Authors
Christina Jones
Carl Bäckman
Maurizia Capuzzo
Ingrid Egerod
Hans Flaatten
Cristina Granja
Christian Rylander
Richard D Griffiths
the RACHEL group
Publication date
01-10-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9260

Other articles of this Issue 5/2010

Critical Care 5/2010 Go to the issue