Bienvenu Oscar Joseph, Gerstenblith Ted-Avi
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street - Meyer 115, Baltimore, MD 21287, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street - Meyer 106, Baltimore, MD 21287, USA.
Crit Care Clin. 2017 Jul;33(3):649-658. doi: 10.1016/j.ccc.2017.03.006. Epub 2017 Apr 21.
This article focuses on a psychiatric morbidity in critical illness survivors, posttraumatic stress disorder (PTSD). We present a case in the second person, because it is helpful to imagine what being critically ill can be like from the perspective of a patient without medical training. One-fifth of critical illness survivors have clinically relevant PTSD symptoms in the year after intensive care, and markers of risk include prior psychiatric illness, benzodiazepine administration in the intensive care unit (ICU), and early post-ICU memories of frightening, nightmare-like experiences during intensive care. ICU diaries are a low-tech, low-cost interventions that can supplement psychiatric care.
本文聚焦于危重症幸存者中的一种精神疾病——创伤后应激障碍（PTSD）。我们以第二人称来讲述一个案例，因为从没有医学背景的患者角度去想象危重症的情况会很有帮助。五分之一的危重症幸存者在重症监护后的一年内有临床上相关的创伤后应激障碍症状，风险因素包括既往精神疾病史、在重症监护病房（ICU）使用苯二氮䓬类药物，以及在重症监护期间ICU后早期出现的可怕、噩梦般经历的记忆。ICU日记是一种低成本、低技术含量的干预措施，可以辅助精神科护理。
