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Post-Traumatic Stress Endures Over Time in Family Members of ICU Patients

PITTSBURGH, September 22, 2008 — Family members may experience post-traumatic stress as many as six months after a loved one’s stay in the intensive care unit (ICU), according to a study by researchers at the University of Pittsburgh School of Medicine and University of California, San Francisco. The study, published online in the Journal of General Internal Medicine, found that symptoms of anxiety and depression in family members of ICU patients diminished over time, but high rates of post-traumatic stress and complicated grief remained. 

“Our findings suggest that family members of patients in the intensive care unit are at risk for serious psychological disorders that may require treatment,” said Cindy L. Bryce, Ph.D., associate professor of medicine and health policy and management at the University of Pittsburgh School of Medicine. “Unfortunately, it may be difficult to identify these family members while their loved one is in the hospital because the symptoms that we can observe and measure early – anxiety and depression – do not seem to be associated with the longer term outcomes like post-traumatic stress disorder and complicated grief. This tells us that screening family members after hospitalization is crucial.”

The study included 50 family members of patients who were admitted to the ICU. Researchers measured family members’ level of anxiety and depression in the ICU and at one- and six-month follow-up. They also measured symptoms of post-traumatic stress disorder and complicated grief during the six-month follow-up interview. 

Forty-two percent of family members exhibited symptoms of anxiety in the ICU. This percentage dropped to 15 percent at six-month follow-up. Likewise, 16 percent of family members displayed depression in the ICU that dropped to 6 percent at six months.

At six-month follow-up, 35 percent of all family members had post-traumatic stress while 46 percent of family members of patients who died had complicated grief. Surprisingly, post-traumatic stress was not more common in bereaved than non-bereaved family members.   

“As doctors, we tend to think only of the patient in an intensive care situation,” said Wendy Anderson, M.D., lead author and assistant professor, Division of Hospital Medicine, University of California, San Francisco. “Our results show that family members can be greatly influenced by a patient’s ICU stay, and that this impact persists after the patient leaves the ICU.”

Support for the study was provided by the University of Pittsburgh’s Institute for Doctor-Patient Communication and The Greenwall Foundation. Co-authors are Robert Arnold, M.D., and Derek Angus, M.D., M.P.H., University of Pittsburgh School of Medicine.

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