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VOLUME 14 , ISSUE 2 ( April, 2010 ) > List of Articles


Can we predict intensive care relatives at risk for posttraumatic stress disorder?

S. M. K. Husainy, L.V. Pillai, Supriya Aigalikar, Sunil Vishwasrao

Keywords : Hospital anxiety and depression scale score, ICU patient, IES-R score, posttraumatic disorder

Citation Information : Husainy SM, Pillai L, Aigalikar S, Vishwasrao S. Can we predict intensive care relatives at risk for posttraumatic stress disorder?. Indian J Crit Care Med 2010; 14 (2):83-87.

DOI: 10.4103/0972-5229.68221

License: CC BY-ND 3.0

Published Online: 01-06-2017

Copyright Statement:  Copyright © 2010; The Author(s).


Aims: To identify the relatives of the intensive care unit (ICU) patients at risk for developing symptoms of posttraumatic stress disorders. Setting: A multidisciplinary hospital ICU. Design: Prospective single center observational study. Material and Methods: Relatives of patients admitted in the ICU (May06-Nov06) who consented to answer the questionnaire participated in the study. Anxiety was assessed by using the Hospital Anxiety and Depression Scale (HAD) and vulnerability to posttraumatic disorder (PTSD) by using the Impact of Event Scale Revised (IES-R) which was administered on the fifth day of admission and at two months following discharge or death. Results: During admission, 48% of the relatives had a HAD score >11 and 72% showed IES-R score >26. There was no association of HAD with gender, patient outcome, working status, age of the patient, or mode of payment of the bills. There was significant association of IES-R >26 with trauma admission, HAD score >11 and mode of payment with the relatives of insured being more stressed as compared to those who settled their bills personally. A total of 35% relatives showed symptoms of posttraumatic stress reaction consistent with a high risk of PTSD after two months. Death in the hospital resulted in elevated HAD and IES-R score during admission and at the two month follow-up. Persistence of stress symptoms was more in school drop outs, working relatives, parents and those with initial anxiety score >11. Conclusions: HAD score greater than 11 was the only factor at admission which could statistically predict a higher PTSD score on follow-up. Adequate counseling of this group of relatives may prevent lasting psychological sequelae of an ICU admission in the relatives of critically ill.

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  1. Guntupalli K, McCaffree DR, Vender J, Clary G, Locicero J 3rd. Project director′s perspective -The critical care family assistance program. Chest 2005;128:106S-10.
  2. Dowling J, Vender J, Guilianelli S, Wang B. A model of family-centered care and satisfaction predictors: the Critical Care Family Assistance Program. Chest 2005;128:81S-92.
  3. Pillai LV, Ambike D, Husainy. The prevalence of post-traumatic stress disorder symptoms in relatives of severe trauma patients admitted to the intensive care unit. Indian J Crit Care Med 2006;10:181-6.
  4. Paparrigopoulos T, Melissaki A, Efthymiou A, Tsekou H, Vadala C, Kribeni G, et al. Short-term psychological impact on family members of intensive care unit patients. J Psychosom Res 2006;61:719-22.
  5. Jones C, Skirrow P, Griffiths RD, Humphris G, Dawson S, Eddleston J. Predicting intensive care relatives at risk of post traumatic stress disorder. Br J Anaesth 2000;84:666-6.
  6. Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, et al. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med 2005;171:987-94.
  7. Pochard F, Darmon M, Fassier T, Bollaert PE, Cheval C, Coloigner M, et al. Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. J Crit Care 2005;20:90-6.
  8. Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Task Force 2004-2005. Crit Care Med 2007;35:605-22.
  9. Rukholm EE, Bailey PH, Coutu-Wakulczyk G. Anxiety and family needs of the relatives of cardiac medical-surgical ICU patients. Can J Cardiovasc Nurs 1992;2:15-22.
  10. Lee LY, Lau YL. Immediate needs of adult family members of adult intensive care patients in Hong Kong. J Clin Nurs 2003;12:490-500.
  11. Weiss DS, Marmar CR. The Impact of Event Scale-Revised. In: Assessing Psychological Trauma and PTSD: A Practitioner′s. Handbook. Edited by Wilson JP, Keane TM. New York: Guilford; 1997. p. 399-411,21.
  12. Horowitz M, Wilner N, Alvarez W. Impact of event scale: A measure of subjective stress. Psychosom Med 1979;41:209-18.
  13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th), Washington, DC; 1994.
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