Dell'Oste Valerio, Martelli Maria, Fantasia Sara, Andreoli Debora, Rimoldi Berenice, Bordacchini Andrea, Pini Silvia, Carmassi Claudia
Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
Department of Mental Health and Addiction, Azienda USL Toscana Nord-Ovest, 55100 Lucca, Italy.
Int J Environ Res Public Health. 2025 Mar 10;22(3):405. doi: 10.3390/ijerph22030405.
Intensive care unit (ICU) admission can represent a relevant physical and psychological burden in patients, leading to long-term mental health problems such as anxiety, depression, and post-traumatic stress disorder (PTSD). The present study aimed to systematically assess the physical and psychiatric (particularly depressive, anxiety, and post-traumatic stress) symptoms in patients discharged from the ICU of a major University Hospital in Italy (Pisa) 6 months earlier, with particular, attention to differences between patients who developed PTSD and those who did not. The strength of this study is to increase the understanding of PTSD, depressive and anxiety symptoms; in particular, their correlations with the physical sequalae. Subjects were assessed six months after ICU discharge by means of the Glasgow Outcome Scale-Extended (GOS-E), Quality of Life after Brain Injury (QOLIBRI), the 3-level version of the EQ-5D (EQ-5D-3L) questionnaire, Impact of Event Scale-Revised 22-item (IES-R), Patient Health Questionnaire, 9-Item Version (PHQ-9), and Generalized Anxiety Disorder Assessment, 7-item version (GAD-7). The results of this study showed, in accordance with the IES-R, a moderate prevalence of PTSD (25.3%) six month after ICU discharge and a statistically significant higher prevalence (63.6%, = 0.039) of moderate and severe disabilities in the PTSD group compared to the no-PTSD group, as well as higher depressive and anxiety symptoms and other psychiatric sequelae, suggesting the need for accurate long-term psychiatric assessment in ICU survivors.
入住重症监护病房（ICU）会给患者带来相当大的身心负担，导致长期心理健康问题，如焦虑、抑郁和创伤后应激障碍（PTSD）。本研究旨在系统评估6个月前从意大利比萨一家大型大学医院ICU出院的患者的身体和精神症状（尤其是抑郁、焦虑和创伤后应激症状），特别关注发生PTSD的患者与未发生PTSD的患者之间的差异。本研究的优势在于增进对PTSD、抑郁和焦虑症状的理解；特别是它们与身体后遗症的相关性。在ICU出院6个月后，通过扩展格拉斯哥预后量表（GOS-E）、脑损伤后生活质量量表（QOLIBRI）、EQ-5D问卷3级版本（EQ-5D-3L）、事件影响量表修订版22项（IES-R）、患者健康问卷9项版本（PHQ-9）和广泛性焦虑障碍评估7项版本（GAD-7）对受试者进行评估。本研究结果显示，根据IES-R，ICU出院6个月后PTSD的患病率为中度（25.3%），与非PTSD组相比，PTSD组中度和重度残疾的患病率显著更高（63.6%，P = 0.039），抑郁和焦虑症状以及其他精神后遗症也更高，这表明有必要对ICU幸存者进行准确的长期精神评估。
