Definizione, strumenti di accertamento e prevalenza dei disturbi da stress post traumatico correlati alle cure intensive: revisione narrativa della letteratura

Anna Pavan, Alvisa Palese


Introduzione: i disturbi da stress post traumatico (post traumatic stress disorders, PTSD) impattano pesantemente sugli outcome dei pazienti sottoposti a cure intensive. Si è svolta quindi una revisione narrativa allo scopo di dare una definizione di PTSD, chiarire quali siano gli strumenti di accertamento e definire un quadro di prevalenza del fenomeno.
Materiali e metodi: si è svolta una revisione della letteratura su banca dati Medline per definire il concetto di PTSD e la loro prevalenza. Si sono utilizzati i seguenti Mesh Terms

Full Text


Riferimenti bibliografici

needHaM DM, feldMan dr, KHo Me. The functional costs of ICU survivorship: col- laborating to improve post-ICU disabili- ty. Am J Respir Crit Care Med. 2011 Apr 15;183(8):962-4.

davydoW ds, gifford JM, desai sv, needHaM dM, bienvenu OJ. Posttraumatic stress dis- order in general intensive care unit survi- vors: a systematic review. Gen Hosp Psy- chiatry. 2008b Sep-Oct;30(5):421-34.

bienvenu oJ, colantuoni e, Mendez-tellez Pa, dinglas vd, sHanHoltz c, Husain n, denni- son cr, Herridge Ms, Pronovost PJ, needHaM dM. Depressive symptoms and impaired physical function after acute lung injury: a

-year longitudinal study. Am J Respir Crit Care Med. 2012 Mar 1;185(5):517-24.

davydoW ds, zatzicK df, rivara fP, JurKovicH gJ, Wang J, roy-byrne PP, Katon WJ, HougH cl, Kross eK, fan M, JoescH J, MacKenzie eJ. Predictors of posttraumatic stress disor- der and return to usual major activity in traumatically injured intensive care unit survivors. Gen Hosp Psychiatry. 2009 Sep-Oct;31(5):428-35.

rattray Je, Hull aM. Emotional outcome after intensive care: literature review. J Adv Nurs. 2008 Oct;64(1):2-13.

edMonson d, ricHardson s, falzon l, david- son KW, Mills Ma, neria Y. Posttraumatic stress disorder prevalence and risk of re- currence in acute coronary syndrome patients: a meta-analytic review. PLoS One.


PaParrigoPoulos t, MelissaKi a,tzavellas e, Kara-

isKos d, ilias i, KoKras n. Increased co-mor- bidity of depression and post-traumatic stress disorder symptoms and common risk factors in intensive care unit survivors: a two-year follow-up study. Int J Psychiatry Clin Pract. 2014 Jan;18(1):25-31.

girard td, sHintani aK, JacKson Jc, gordon sM, Pun bt, Henderson Ms, dittus rs, ber- nard gr, ely eW. Risk factors for post-trau- matic stress disorder symptoms following critical illness requiring mechanical ven- tilation: a prospective cohort study. Crit Care. 2007 11(1):R28.

rattray J, JoHnston M, WildsMitH JA. The Intensive care experience: develop- ment of the Intensive Care Experience (ICE) questionnaire. J Adv Nurs. 2004 Jul;47(1):64-73.

PaPatHanassoglou ED. Psychological sup- port and outcomes for ICU patients. Nurs Crit Care. 2010 May-Jun;15(3):118-28.

aKerMan e, granberg-axéll a, ersson a, frid- lund b, bergboM I. Use and practice of pa- tient diaries in Swedish intensive care units: a national survey. Nurs Crit Care. 2010 Jan-Feb;15(1):26-33.

WilKin K, slevin E. The meaning of caring to nurses: an investigation into the nature of caring work in an intensive care unit. J Clin Nurs. 2004 Jan;13(1):50-9.

Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author; American Psychiatric Associ- ation; 1994.

Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author; American Psychiatric Associ- ation; 2013.

breWin cr, lanius ra, novac a, scHnyder u, galea S. Reformulating PTSD for DSM-V: life after criterion A. J Trauma Stress. 2009 Oct;22(5):366-73.

friedMan MJ, resicK Pa, bryant ra, breWin cr. Considering PTSD for DSM-5. Depress Anxiety. 2011 Sep;28(9):750-69.

breWin cr. Systematic review of screening instruments for adults at risk of PTSD. J Trauma Stress. 2005 Feb;18(1):53-62.

Wade d, Hardy r, HoWell d, MytHen M. Iden-

tifying clinical and acute psychological risk factors for PTSD after critical care: a systematic review. Minerva Anestesiol. 2013 Aug;79(8):944-63.

davydoW ds, desai sv, needHaM dM, bienvenu oJ. Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med. 2008a May;70(4):512-19.

griffitHs J, fortune g, barber v,young Jd. The prevalence of post traumatic stress disor- der in survivors of ICU treatment: a sys- tematic review. Intensive Care Med. 2007 Sep;33(9):1506-18.

JacKson Jc, Hart rP, gordon sM, HoPKins ro, girard td, ely eW. Post-traumatic stress disorder and post-traumatic stress symp- toms following critical illness in medical intensive care unit patients: assessing the magnitude of the problem. Crit Care. 2007 11(1):R27.

davydoW ds, zatzicK d, HougH cl, Katon WJ A. Longitudinal investigation of posttrau- matic stress and depressive symptoms over the course of the year following medical-surgical intensive care unit ad- mission. Gen Hosp Psychiatry. 2013 May- Jun;35(3):226-32.

tagliavini G. Modulazione dell’arousal, me- moria procedurale ed elaborazione del trauma: il contributo clinico del modello polivagale e della psicoterapia sensomo- toria. Cognitivismo Clinico. 2011 8:60-72.

freWen Pa, lanius r. Towards a psychobi- ology of posttraumatic self-dysregula- tion: reexperiencing, hyperarousal, disso- ciation, and emotional numbing. Ann N Y Acad Sci. 2006 Jul;1071:110-24.

first M, sPitzer rl, gibbon M, WilliaMs Jb. Structured Clinical Interview for DSM-IV Axis I Disorders. New York: New York State Psychiatric Institute; 1995.

blaKe dd, WeatHers fW, nagy lM, KalouPeK dg, gusMan fd, cHarney ds, Keane TM. The development of a Clinician-Adminis- tered PTSD Scale. J Trauma Stress. 1995 Jan;8(1):75-90.

briere J, runtz M. The Trauma Symptom Checklist (TSC-33): Early data on a new scale. J Interpers Violence. 1989 4:151-63.

neal la, busuttil W, rollins J, HerePatH r,

striKe P, turnbull G. Convergent validi- ty of measures of post traumatic stress disorder in a mixed military and civil- ian population. J Trauma Stress. 1994 Jul;7(3):447-55.

WeatHers fW, ford J. Psychometric review of the PTSD Checklist. In: b.H. staMM (Ed.), Measurement of stress, trauma, and ad- aptation. Lutherville, MD: Sidran Press; 1996. p.250-251.

sHeeran t, ziMMerMan M. Screening for post- traumatic stress disorder in a general psychiatric outpatient setting. J Consult Clin Psychol. 2002 Aug;70(4):961-66.

foa e, casHMan l, Jaycox l, Perry K. The val- idation of a self-report measure of PTSD: The Posttraumatic Diagnostic Scale. Psy- chol Assess. 1997 9:445-51.

davidson Jrt, booK sW, colKet, Jt, tuPler la, rotH s, Hertzberg M, MellMan t, becKHaM Jc, sMitH rd, davison rM, Katz r, feldMan Me. Assessment of a new self ratingscale for post-traumatic stress disorder. Psychol Med. 1997 Jan;27(1):153-60.

scragg P, Jones a, fauvel N. Psychological problems following ICU treatment.Anaes- thesia. 2001 Jan;56(1):9-14.

breWin cr, rose s, andreWs b, green J, ta- ta P, Mcevedy c, turner s, foa eb. A brief screening instrument for posttraumat- ic stress disorder. Br J Psychiatry. 2002 Aug;181:158-62.

creaMer M, bell r, failla S. Psychomet- ric properties of the Impact of Event Scale-Revised. Behav Res Ther. 2003 Dec;41(12):1489-96.

elHai Jd, gray MJ, KasHdan tb, franKlin CL. Which instruments are most common- ly used to assess traumatic event expo- sure and posttraumatic effects? A survey of traumatic stress professionals. J Trau- ma Stress. 2005 Oct;18(5):541-5.

tWigg e, HuMPHris g, Jones c, braMWell r, griffitHs rd. Use of a screening ques- tionnaire for post-traumatic stress disor- der (PTSD) on a sample of UK ICU pa- tients. Acta Anaesthesiol Scand. 2008 Feb;52(2):202-8.

liberati a, altMan dg, tetzlaff J, MulroW c, gøtzscHe Pc, ioannidis JP, clarKe M, dever- eaux PJ, KleiJnen J, MoHer d. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: expla- nation and elaboration. J Clin Epidemiol. 2009 Oct;62(10):e1-34.

scHelling g. Effects of stress hormones on traumatic memory formation and the de- velopment of posttraumatic stress dis- order in critically ill patients. Neurobiol Learn Mem. 2002 Nov;78(3):596-609.

Hauer d, KaufMann i, streWe c, briegel i, caM- Polongo P, scHelling G. The role of glucocor- ticoids, catecholamines and endocanna- binoids in the development of traumatic memories and posttraumatic stress symp- toms in survivors of critical illness. Neuro- biol Learn Mem. 2014 Jul;112:68-74.

eHlers a, clarK dM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000 Apr;38(4):319-45.

Jones c, bacKMan c, caPuzzo M, rylander c, griffitHs rd. Precipitants of post-trau- matic stress disorder following intensive care: a hypothesis generating study of di- versity in care. Intensive Care Med. 2007 Jun;33(6):978-85.

Kress JP, geHlbacH b, lacy M, PlisKin n, PoHl- Man as, Hall Jb. The long-term psychologi- cal effects of daily sedative interruption on critically ill patients. Am J Resp Crit Care Med. 2003 Dec 15;168(12):1457-61.

roberts bl, ricKard cM, raJbHandari d, reyn- olds P. Patients’ dreams in ICU: Recall at two years post discharge and compari- son to delirium status during ICU admis- sion.A multicentre cohort study. Intensive Crit Care Nurs. 2006 Oct;22(5):264-73.

Jones c, bäcKMan c, caPuzzo M, egerod i, flaatten H, granJa c, rylander c, griffitHs rd, tHe racHel grouP. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a ran- domised, controlled trial. Crit Care. 2010 14(5):R168.

cutHbertson bH, Hull a, stracHan M, scott J. Post-traumatic stress disorder af- ter critical illness requiring general in- tensive care. Intensive Care Med. 2004 Mar;30(3):450-5.

rattray Je, JoHnston M, WildsMitH JaW. Predictors of emotional outcomes of intensive care. Anaesthesia. 2005 Nov;60(11):1085-92.

rose l, nonoyaMa M, rezaie s, fraser I. Psychological wellbeing, health related qual- ity of life and memories of intensive care and a specialised weaning centre report- ed by survivors of prolonged mechanical ventilation. Intensive Crit Care Nurs. 2014 Jun;30(3):145-151.

HatcH r, McKecHnie s, griffitHs J. Psycho- logical intervention to prevent ICU relat- ed PTSD: who, where and for how long. Crit Care. 2011 15(2):141.

tan t, brett sJ, stoKes T. Rehabilitation af- ter critical illness: summary of NICE guid- ance. BMJ. 2009 Mar 25;338:b822.

MicHie s, abraHaM c, eccles MP, francis JJ, HarleMan W, JoHnston M. Strengthening evaluation and implementation by spec- ifying components of behaviour change interventions: a study protocol. Imple- ment Sci. 2011 Feb 7;6:10.

KilPatricK dg, resnicK Hs, MilanaK Me, Mill- er MW, Keyes KM, friedMan MJ. National es- timates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. J Trauma Stress. 2013 Oct;26(5):537-47.

garrouste-orgeas M, coquet i, Périer a, tiM- sit Jf, PocHard f, lancrin f, PHiliPPart f, ves- in a, bruel c, Blel y, angeli s, cousin n, car- let J, Misset B. Impact of an intensive care unit diary on psychological distress in pa- tients and relatives. Crit Care Med. 2012 Jul;40(7):2033-40.

Peris a, bonizzoli M, iozzelli d, Migliaccio Ml, zagli g, baccHereti a, debolini M, vannini e, solaro M, balzi i, bendoni e, baccHi i, giovan- nini v, belloni L. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disor- ders, anxiety and depression symptoms in critically ill patients. Crit Care. 2011 15(1):R41.

Jones c,sKirroW P,griffitHs r,HuMPHris g,in- gleby s, eddleston J, WaldMann c, gager M. Rehabilitation after critical illness: a ran- domized, controlled trial. Crit Care Med. 2003 Oct;31(10):2456-61.

griffitHs Ja, barber va, cutHbertson bH, young JD. A national survey of intensive care follow-up clinics. Anaesthesia. 2006 Oct;61(10):950-5.

HuPcey Je, ziMMerMan He. The need to know: experiences of critically ill patients. Am J Crit Care. 2000 May;9(3):192-8.


  • Non ci sono refbacks, per ora.