Posttraumatic Stress Disorder and Health-Related Quality of Life in Long-Term Survivors of Acute Respiratory Distress Syndrome

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Abstract
Intensive care often means exposure to physical and psychological stress, with long-lasting emotional sequelae for most patients. Psychiatric morbidity and negative effects on health-related quality of life were assessed in long-term survivors of acute respiratory distress syndrome. Forty-six long-term survivors were enrolled in a psychiatric follow-up study. All patients had received standard, protocol-driven treatment during intensive care. The median follow-up time was 8 years after treatment. DSM-IV was used for psychiatric diagnosis. Psychological tests were performed to measure posttraumatic stress symptoms; depression; state anxiety; somatization; symptoms regarding concentration, attention, and short-term memory; social support; and health-related quality of life. At time of discharge, 20 of the patients suffered from posttraumatic stress disorder (PTSD) and four from sub-PTSD. At follow-up, 11 patients continued to suffer from PTSD and eight from sub-PTSD. The patients with PTSD demonstrated a pronounced tendency for somatization and state anxiety. Among the groups with PTSD, sub-PTSD, and no PTSD, there were no statistically significant differences regarding social support and symptoms of cognitive dysfunction. Those with PTSD showed major impairments in some dimensions of health-related quality of life, whereas those without PTSD had scores that were in the range of the general population. Except for duration of stay on the intensive care unit, neither age, gender, sociodemographic variables, premorbid psychopathology, nor initial severity of illness discriminated between the groups. Long-term survivors of acute respiratory distress syndrome seem to face a major risk of PTSD and major impairments in health-related quality of life in the long term.